America Living With AIDS

CHAP T E R SIX
GOVERNMENT
RESPONSIBILITIES
he lack of a clear definition of government roles and intergovernmental partnerships has seriously hampered the
nation's response to the HIV epidemic. A comprehensive national HIV plan
should be developed with full participation of involved federal agencies and with
input from national organizations representing various levels of government to
identify priorities and resources necessary for preventing and treating HIV disease.
The lack of a national plan seriously impairs efforts to end discrimination, to
finance health care, to organize and deliver health and social services, to recruit and
train health care workers, to provide housing for the sick, to provide effective AIDS
education and prevention programs, and to provide substance use treatment. This
chapter identifies government functions that are key to controlling the HIV epidemic, considers the extent to which these functions are actually fulfilled, and recommends a series of measures for improving the response of all levels of government to the HIV epidemic.
LEADERSHIP AND PARTNERSHIP
The single most important role for government at all levels in the HIV epidemic is
leadership: the ability to inspire citizens, to mobilize resources to provide for those
in need, and to do so with foresight, compassion, and competence.
Appropriate government response to AIDS is a subject of enduring controversy.
Elected officials at all levels of government have the responsibility to be leaders in this
time of health care crisis and should exercise leadership based on sound science and
informed public health practice. The Commission recognizes that many issues raised
by the HIV epidemic place pressures on elected officials to pass laws intended to
respond to constituent fears and concerns. The Commission, however, is very concerned that policies are being enacted into law that are better left to scientists and
public health experts. Legislative action should focus on full funding of programs

111