Important note: Information in this article was accurate in September 2000. The state of the art may have changed since the publication date.CHICAGO (October 11, 2000) -- AIDS is an "invisible issue" in the 2000 presidential campaign, with neither candidate articulating a vision or strategy for combating an epidemic labeled by the US government and the United Nations as threats to human security. So says the International Association of Physicians in AIDS Care (IAPAC), which recently asked both Vice President Al Gore and Governor George W. Bush for their positions on a number of domestic and international HIV-related issues. The candidates' responses to the IAPAC policy questionnaire appear in the current issue of IAPAC Monthly, a publication covering scientific and public policy developments for the association's 10,000 members worldwide, as well as on the IAPAC Web site.
"Considering the new vision and massive effort required to address parallel epidemics of poverty, disease (including HIV), and inequality that exist in rich and poor countries alike, the candidates' responses to the IAPAC questionnaire fall short. In fact, this most pressing of public health issues is invisible in a campaign about America's future," said José M. Zuniga, president of IAPAC.
The questionnaire pinpointed the critical HIV/AIDS issues that the next president will likely face as his administration sets domestic and international policy. Each candidate was questioned for his views on the following issues: where he ranks AIDS among public policy priorities; prohibitions against HIV-infected people entering the US; measures to be taken by the US healthcare system to promote widespread HIV testing; condom distribution and education on abstinence and safer sex in public schools; prevention and education in the military (considering worldwide deployments); early access to government-funded treatment for low-income Americans with HIV/AIDS through Medicaid; federal funding for needle exchange programs; steps to build the infrastructure needed for appropriate distribution of an AIDS vaccine in developing countries; and trade mechanisms and their impact on access to life-saving drugs and technologies in the developing world.
Gore's response to IAPAC's questionnaire suggest that he will continue with programs and policy implemented under the Clinton-Gore administration. Zuniga, while acknowledging many positive outcomes of the Clinton-Gore administration's efforts against HIV/AIDS, points out that an evolving HIV pandemic requires the nation's next leader not conduct business as usual.
"Great progress has been made under the present administration. However, there have also been great deficiencies. Until recently, for example, the administration did little to expand access to AIDS care around the world – not just in Africa, but also in the US where low-income HIV-infected Americans today still cannot obtain Medicaid coverage," Zuniga said.
As an example of how Gore would inappropriately continue existing policy, Zuniga cited the candidate's position on maintaining the current administration's (as well as the US Congress') position to deny federal funding for needle exchange programs and instead promote as an option for local authorities the implementation of needle exchange programs.
"This position violates a human right to tools and strategies that can save lives. The federal government needs to send a strong message–through word and deed (in this case funding)–to local governments and communities that needle exchange programs are effective in reducing HIV transmission," he said.
Bush did not respond directly to the IAPAC questionnaire but instead submitted a statement articulating his hope for an AIDS cure, support for government-funded research and an extension of the research and development tax credit for pharmaceutical companies, and intent to double the US National Institutes of Health's research budget. He also states his belief in the effectiveness of the Ryan White CARE Act, which provides crucial services to Americans living with HIV/AIDS, and existing HIV prevention campaigns.
"George W. Bush states that ‘conquering AIDS will be a priority in a Bush White House,' however his response to our query makes transparent not only a lack of insight into the scope of the epidemic, but a lack of vision on how best to face the tremendous social, political and economic challenges it poses," Zuniga commented. "Vowing simply to support ongoing government-funded research and care initiatives, as well as tax credits for pharmaceutical companies, does not demonstrate leadership in addressing what is a threat to human security."
Of the next US president, Zuniga suggested that it is of paramount importance for either President Bush or President Gore to do more than recognize that AIDS is one of the greatest security threats of the 21st century. "The next leader of this country must have a vision of how to tackle the burgeoning crises created by parallel epidemics of poverty, disease, and inequality that plague so many people worldwide, including citizens in the richest and poorest nations on earth," Zuniga said.
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The International Association of Physicians in AIDS Care is a nonprofit professional association representing 10,000 physicians and other healthcare professionals in 52 countries. Founded in 1995, IAPAC develops and implements global educational and advocacy strategies to improve the quality of care provided to all people living with HIV/AIDS and other coinfectious diseases. The association publishes IAPAC Monthly and other publications, hosts clinical and public policy conferences worldwide, and facilitates delivery of HIV care in developing countries. IAPAC's headquarters are in Chicago. The first of several regional offices opened recently in Johannesburg, South Africa.
For more information about IAPAC, please contact Gary Mohr at (312) 795-4956 or gmohr@iapac.org
EDITORS: José M. Zuniga is available for interviews related to this story.
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