The Miami Herald, Inc.; Sunday, December 15, 1991
Paul Anderson, Herald Washington Bureau

After a decade of steady increases, federal funding for AIDS research is leveling off in the 1992 budget, in part because victims of other diseases are adopting the strategy of AIDS advocates and going public with their suffering.

Some critics of AIDS spending argue that cancer, heart disease and other illnesses have killed millions of Americans, while AIDS, in its first decade, killed fewer than 200,000. That's about the same number of women who are diagnosed with breast cancer each year.

Such arguments are making it increasingly difficult to extract additional AIDS funding from federal budgets, even with the recent publicity given Magic Johnson, who has the HIV virus. As a result, once fierce competitors for medical research dollars are now acknowledging a need to coordinate their appeals to avoid alienating lawmakers.

"We have to go in as a united front of all biomedical research," said Dr. Anthony Fauci, the head of AIDS programs at the National Institutes of Health.

"We do not have an entirely sympathetic ear any longer among the appropriations committees" in Congress, Fauci told the last meeting of NIH's AIDS advisory committee. "After six or eight years of the increases they've given us, they really feel they've done enough. Clearly, with our scientific opportunities, they have not."

But continued competition between AIDS researchers and those seeking cures for other diseases "is clearly not desirable," Fauci said.

Some of the political advocacy groups also acknowledge that fact.

Media-savvy AIDS lobbyists in New York, San Francisco and Washington have been advising newly active breast cancer victims how to get more attention -- provided the cancer groups help lobby for more funding for all medical research. A shared tactic: complain loudly and frequently about discrimination in federal spending priorities, drug-testing trials and the like.

Meanwhile, there are members of Congress who are trying to balance the competing interests.

Rep. Henry Waxman, D-Calif., is one of the most outspoken advocates of increased funding for AIDS research and treatment. But he uses his position as chairman of the House subcommittee on health and the environment to spotlight the needs of other diseases as well.

He held a high-profile hearing this fall to commemorate the 20th anniversary of the National Cancer Act. It turned into a forum for the American Cancer Society and cancer victims to call for additional federal funding, but Waxman refused to let anyone criticize levels of funding for AIDS or other diseases, saying such parochialism would be "counterproductive."

President Bush recently called the government's effort "the best research program going on AIDS . . . because we are spending a tremendous amount of money on AIDS, much more per capita on AIDS than we are on cancer, on heart disease, the biggest killers."

The president noted that some critics have complained the government is "disproportionately engaged" with AIDS research, and -- in the wake of Magic Johnson's announcement that he is infected with the virus that causes AIDS -- Bush has spoken out for more public education, but not research.

From a standing start, and despite early condemnation of AIDS as the "gay plague," federal funding earmarked for AIDS research rose from nothing in 1981 to $1.3 billion in the 1992 budget.

That compares in 1992 with $1.8 billion for cancer research and $750 million for heart disease.

But officials at NIH and other government agencies insist the funding can't be categorized that simply, because some basic research overlaps. The largest killers of patients whose immune systems have been weakened by AIDS are rare forms of cancer, tuberculosis and pneumonia, they note.

At NIH, AIDS research goes on not only at Fauci's National Institute of Allergy and Infectious Diseases, but at the National Cancer Institute, the National Heart, Lung and Blood Institute and other centers.

The NIH budget just for AIDS research in 1992 totals $854.5 million, up $50 million or 6 percent from 1991. Increases in the previous five years were much larger.

The National Cancer Institute's 1992 budget, including its AIDS research, totals $1.99 billion, up $277 million or 16 percent from 1991.

Some AIDS activists insist the urgency for AIDS research is greater because the disease is still new and the number of cases has multiplied rapidly -- while the growth in the number of people diagnosed with most cancers and heart disease has become relatively stable.

Also, the AIDS advocates argue, there are tried and true treatments for many forms of cancer and other diseases, while there is no surgery, radiation or chemotherapy yet known to cause a remission of AIDS.

"You get AIDS, you die. There simply is no cure," says Daniel Bross of the AIDS Action Council.

CAPTION: CHART Research Funds (see microfilm)

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