San Francisco Chronicle - Monday July 24, 1989
Randy Shilts

This disheartening prospect undoubtedly was on the minds of many of the 15 appointees to the new National AIDS Commission, whose selection was finally completed last week.

The new panel need look no further than its predecessor for some unhappy tutelage. President Reagan's Commission on the HIV Epidemic won universal accolades in the public health community last June when it issued its report. Since then, however, few of its hundreds of detailed recommendations have been implemented.

The dearth of action on the Reagan commission report is one reason that congressional leaders moved late last year to establish a new two-year commission that would advise Congress and the White House on national AIDS issues.

With one-third of the panel's members appointed by House leaders, one-third by Senate leaders and another one-third by the president, members could theoretically forge a consensus on often-volatile issues that would be acceptable to both the executive and legislative branches of the government.

Although the Reagan commission's experience stands as a cautionary tale for what might unfold for the new panel, there are many early indications that the new commission may leave a more impressive legacy.

Because some of the Reagan appointees were long on conservative ideological credentials but short on AIDS expertise, that commission was greeted with immense skepticism from its inception. Even worse, the more conservative members created a fractious minority who voted against such key panel recommendations as federal legislation banning HIV-related discrimination.

The new commission has none of these liabilities. In fact, it's striking how qualified its members are, considering the turbulent political waters each nominee had to navigate either among the Democratic and Republican congressional leaders or at the White House. There's hardly an area of the epidemic in which one member or another does not have some expertise.

President Bush's appointment of Dr. David Rogers, a former president of the Robert Wood Johnson Foundation, means there will be an expert on the unglamorous but crucial issues of health-care delivery systems.

Similarly, the panel includes a Yale law professor who is expert on AIDS legal issues, the leader of a community-based AIDS group, a noted expert on AIDS among intravenous drug users, a minister who has worked with AIDS patients and Representative Roy Rowland, D-Georgia, the only physician serving in Congress.

Members include representatives of the black, Latino and gay communities, the three minorities most affected by AIDS. Also significant is the Bush appointment of Belinda Mason, a housewife who contracted AIDS from a blood transfusion and who is now the widely respected president of the National Association of People With AIDS.

"It's really the first time a president and administration has recognized people with AIDS as part of the solution and not part of the problem," says Tom Sheridan, director of public policy for the AIDS Action Council.

Commission member Dr. June Osborn is optimistic that the panel can be an effective adviser to government and play an important role in educating the public on what is needed to combat AIDS.

"I think it looks real positive," says Osborn, dean of the School of Public Health at the University of Michigan. "This is a group of people with broad backgrounds and a collective experience which should be able to be very helpful."

The first commission meeting is expected within the next two weeks. The group will elect a leader from its own members. Most pundits predict that Osborn, the commissioner best-known for her AIDS work, will win what will certainly become a very high-profile job.

Given the commission's composition, the panel is virtually certain to endorse most of the Reagan commission report, particularly its opposition to any mandatory AIDS testing and its call for vastly increased treatment programs to get intravenous drug users off their addiction.

As a first order of business, expect the panel to endorse the legislation now pending in Congress to forbid HIV-related discrimination. "The anti-discrimination act is on the table as we speak," Osborn says. "I expect we'll endorse the previous commission's finding."

Although stands on such social issues will grab the headlines, the measure of the panel's effectiveness will be in such areas as addiction treatment programs and pending proposals to make new AIDS-related drugs more readily available.

The price tags on such programs are already being estimated to be in the billions of dollars. Neither Congress nor the White House will be eager to make substantive moves on such expensive projects in an era of tightening budgets.

Without any doubt, the National AIDS Commission will play an important role in writing the history of AIDS in America. What remains to be seen is whether the role will be as a key influence on how AIDS policy is shaped or as but another Greek chorus for the epidemic, telling an unheeding populace what should be done to thwart the spread of this awful disease.

Always watch for outdated information. This article first appeared in 1989. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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