Activists Worry ‘Nobody Home’ on White House AIDS Policy

With the White House Office of National AIDS Policy now a Web site directing callers to "an empty office with a telephone no one answers" and the 35-member Presidential Advisory Council on HIV/AIDS unsure "if it still exists," AIDS activists, lawmakers, foreign governments and international organizations worry that "high-level engagement" in the issue will never "materialize" in the Bush administration, the Washington Post reports. Although President Bush said last month, "We're concerned about AIDS inside our White House, make no mistake about it," a congressional staff member who follows HIV/AIDS said that "[i]t's hard to say" what is the White House's position on AIDS policy, adding, "Right now, there's nobody home. My concern is that the epidemic is not going to wait. ... There needs to be somebody in the system who is the focal point" on a number of "fast-moving" AIDS-related issues. Sen. Bill Frist (R-Tenn.), a "vocal advocate of an activist policy" on international AIDS issues, said that while he remains "confident" the administration will "come up with a strategic plan," he has urged Bush "at every opportunity" that "this is a big issue and ... that the world looks to the United States to address the big issues." White House officials "insist" that Bush is "aware" of the need to establish a "government-wide structure" to address AIDS, "particularly in Africa," but while a Bush spokesperson said that the White House has "work[ed] on developing the structure of our initiative," a senior official said that decisions on "what the policy will be, who will lead it and how it will be coordinated could be months away."

Advocates a 'Little Deflated'
Government officials outside the White House also have raised concerns that they "are not in a dialogue" with the president on the AIDS issue. According to one official, "The White House is holding a very tight rein on all policy decisions and on all meetings, including international meetings, we attend. They don't know what they want to do yet. They tell us, 'Just hang in there. You can go (to meetings), but don't say anything.'" The official added, "This is going on a little longer than is optimal. ... [I]t's hard not to feel a little deflated over the lack of movement." Senior administration officials have "said repeatedly" that Bush plans to decrease the number of issues handled by the White House, but the Post reports that moves to "downgrade White House involvement" on AIDS would likely prompt "outrage" from AIDS activists. Last month, the administration "got an early taste of the danger" when White House Chief of Staff Andy Card told USA Today that Bush planned to close the National AIDS Policy Office. The statement "outrage[d]" AIDS activists, prompting White House press secretary Ari Fleischer to announce within hours that Card was " mistaken. ... There is nothing that is closing. That office is open." The Post reports, however, that the office "has remained unoccupied," and other announced AIDS measures "remain similarly unrealized." In addition, some of the administration's "few substantial steps" on AIDS issues have "discouraged" activists. After taking office, Bush "reinstituted" a "gag rule" that prohibits U.S. funding for overseas family planning and health organizations -- many of which provide HIV/AIDS counseling and treatment -- that use their own funds to advocate or perform abortions. He also has eliminated the AIDS adviser's position on the National Security Council.

'Benefit of the Doubt'
However, some who support a "vigorous" White House AIDS policy "give the administration the benefit of the doubt." Todd Summers, a member of the "inactive" Presidential Advisory Council on HIV/AIDS, said, "It's a new administration, and they're entitled to some time to come up to speed." According to Helene Gayle, who heads the CDC's HIV prevention program, "I'd rather it be done right than fast." Former Rep. Steve Gunderson (R-Wis.) said that he has urged HHS Secretary Tommy Thompson not to "let the cacophony of international AIDS issues control the administration's decisions or the pace at which it makes them," adding, "I happen to believe that everybody, when they see HIV/AIDS today, thinks internationally. That's the 'cool' aspect of AIDS 2001. The danger and risk is that we focus on it internationally and imply ... that the domestic disease is over. Nothing could be more unfortunate." While HHS officials have touted Thompson's commitment to the issue, Secretary of State Colin Powell has "captured center stage," calling for a 10% increase in international AIDS funding in next year's budget. "Peppered with questions" on AIDS policy at congressional hearings last month, he vowed that AIDS "will get the attention it deserves in the State Department" (DeYoung, Washington Post, 3/31).