San Francisco Chronicle - Thursday June 15, 1989
David Perlman, Chronicle Science Editor

Federal spending to combat AIDS since the epidemic began will reach a total of more than $5.5 billion by the end of this year, and exceeds $2 billion this year alone, according to a team of health experts. Current federal outlays for AIDS account for a third of all spending on the disease, the analysis shows, and are running three times higher than the total being spent by all the states combined.

Costs will continue to climb, according to the report, and by 1992 the yearly total of federal spending for treatment, research, education and prevention will reach $4.3 billion or more. The numbers, prepared by a team of federal, university and Kaiser-Permanente Health Plan experts, are appearing today in the New England Journal of Medicine.

Several other groups, including the presidential AIDS commission, the Institute of Medicine and the congressional General Accounting Office, have contended that hundreds of millions of dollars more will be needed as the epidemic spreads. Federal spending solely for research, education and prevention efforts in the AIDS epidemic is now running at levels close to similar efforts for heart disease and cancer - even though heart disease deaths will exceed 777,000 this year and deaths from cancer will reach nearly 500,000, significantly higher than the AIDS total.

The AIDS death toll is expected to be about 35,000 this year, but health officials know that AIDS deaths will continue climbing as more and more infected people die before a cure is found. Some estimates place the number of HIV-infected people in the United States at more than 1.5 million.

Although the authors of the AIDS report concede that "simply spending more money will not necessarily hasten the development of a cure," they do offer several reasons to justify increased spending:

-- Because of many uncertainties, they say, the extent of the epidemic itself may have been seriously underestimated and more funds should be committed "to avoid a worst-case outcome" - particularly inasmuch as AIDS is an infectious disease and is likely to continue spreading.

-- Although the death toll from AIDS is far less than deaths from such major killers as heart disease and cancer, the epidemic is killing primarily young people "and the indirect costs in lost years of life are great."

-- In addition, spending for AIDS research "will bring benefits for the understanding of other diseases, particularly cancer, because so much will be learned about cancer-causing viruses."

-- Finally, the analysts argue, in view of the clear and growing link between intravenous drug abuse and transmission of the AIDS virus, HIV, "it is notable that only a relatively small amount (of money) has been allocated to drug abuse treatment and prevention."

In an editorial commenting on the analysis, Dr. David E. Rogers of Cornell University Medical College in New York said the report provides "solid evidence that will be gobbled up avidly and used vigorously to support the views of those who come down on either side of the question of the adequacy of our efforts to combat the epidemic of AIDS."

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