Chicago Tribune (CT) - THURSDAY October 30, 1986
Jon Van, Science Writer

The report, issued in Washington, called upon the federal government to spend at least $1 billion annually for AIDS education and other public health measures and another $1 billion annually for AIDS research by 1991.

Despite progress made in understanding acquired immune deficiency syndrome since it was first discovered in the United States five years ago, it is unlikely that any vaccine or cure for the disease will be available within the next five years, the committee of scientists concluded.

For the foreseeable future, explicit education and modified behavior will be humankind's most effective weapon against the virus that can immobilize the body's normal defenses against infection, said the report titled "Confronting AIDS."

Committee members, representing some of the nation's top universities, called for plain talk to combat the sexually transmitted disease. Teens, who often are experimenting with sex and drugs--two activities most closely tied to spread of the AIDS virus--must be a prime target of the education effort, the report said. It called sex education in the schools "a life or death matter."

"If an educational campaign is to change behavior that spreads HIV (human immunodeficiency virus), its message must be as direct as possible," the report said.

"Educators must be prepared to specify that intercourse--anal or vaginal --with an infected or possibly infected person and without the protection of a condom is very risky. They must be willing to use whatever vernacular is required for that message to be understood. "Admonitions to avoid 'intimate bodily contact' and the 'exchange of bodily fluid' convey at best only a vague message."

Besides warning against those sexual practices that may spread the AIDS virus, the education effort should also tell which practices are safe, such as unprotected intercourse between individuals who maintain an exclusive relationship, the report said.

This information should get maximum public exposure, especially in the black and Hispanic communities where AIDS infection is disproportionately high.

"Legal and administrative barriers to the use of paid television for these educational purposes should be removed," the committee said.

The scientists' study, perhaps the most comprehensive yet to consider policy matters associated with AIDS, comes a week after Dr. C. Everett Koop, the surgeon general, issued his own report on AIDS in which he also stressed the need for sex education, especially of the young, to combat the disease.

Washington insiders said that Koop worked his staff overtime to issue his report before the one from the NAS came out, possibly to blunt criticism of the government in the scientists' report.

The NAS committee, cochaired by Dr. David Baltimore of the Massachusetts Institute of Technology and Dr. Sheldon Wolff of Tufts University School of Medicine, accepts AIDS projections issued in June by the Public Health Service.

Those projections anticipate that by 1991 there will have been a cumulative total of more than 270,000 AIDS cases in the United States with more than 74,000 of those occurring in 1991 alone. It is expected that about 10 percent of the new cases will be acquired through heterosexual contact.

Last week in Chicago, Dr. Lonnie C. Edwards, city health commissioner, said that if current trends continue, more than 13,000 Chicagoans will have been diagnosed with AIDS by mid-1990, "with nearly 6,000 of them alive at that time."

The scientists' report said the United States must begin now to plan to treat the escalating numbers of people afflicted with AIDS. More than 1 million people in the United States and up to 10 million worldwide have been exposed to the AIDS virus and can transmit it, the report said. It urged international cooperation to fight the epidemic.

The committee also recommended establishment by the federal government of a national commission on AIDS to coordinate efforts to combat the disease and urged the President to take a leadership role in making control of AIDS a major national goal.

CAPTION: Graphic: Recommendations to fight AIDS Proposed by National Academy of Sciences

Curb spread of infection

Blood tests: Increase availability of voluntary, confidential serologic tests, especially among high-risk groups such as homosexuals.

Drug abuse: Increase treatment and prevention programs against intravenous drug use; experiment with supplying clean needles.

Improve patient care

Medical personnel: Plan and train for expected increase in cases; minimize hospitalization.

Data collection: Identify cost-effective approaches to care by improving collection of health, demographic and cost statistics.

Funding: Devise ways to provide adequate funds for care of patients.

Increase research efforts

Drugs: Try to develop vaccine and other drugs through research in virology, immunology and viral protein structure.

History: Use epidemiologic and clinical research to improve understanding of how it spreads.

Lifestyles: Reduce risk of infection through studies of sexual behavior and IV drug use.

Funding: Increase funding for academic scientists to conduct original research.

Animal studies: Expand experiments using chimpanzees and other animals. Worldwide cooperation

Participation: The U.S. should be a full participant in international efforts against the epidemic.

Organizations: U.S. involvement should support both World Health Organization and bilateral efforts.

Industry: Encourage industry to participate in research programs. Chicago Tribune Graphic; Source: National Academy of Sciences.

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