America Living With AIDS

AM E R I C A Living With AIDS

demic. Even the ADA excludes active
drug users, a significant portion of the
people infected with HIV, from protections against discrimination. As a
nation we must look carefully at all of
our antidiscrimination laws and ordinances (federal, state, and local), work
toward the development of additional
protections where they are needed,
aggressively pursue enforcement programs, and actively work to educate
public and private employers, proprietors, and service providers about
their lawful requirement to adhere to
these laws.
- D il FR \ I i \NjMl \ 1
While a general lack of leadership has
been evident at the federal level, there
have been a number of
important exceptions.
The early and pivotal
s work of the Centers for
at Disease Control (CDC)
'ss in epidemiologic studies
and to determine the modes
/ays of transmission of HIV
infection was a major facose tor in alerting and
ur informing the world
about the epidemic. The
primary role played by
the National Institutes of
Health (NIH) in supporting both intramural and
extramural biomedical
and clinical research is
another example of federal leadership.
NIH efforts contributed enormously
to the rapid identification of the
causative agent of HIV disease, the

development of the HIV antibody test,
and the development of drugs for
treatment of HIV disease. The federal
government has also played a leadership role in improving the protection
of the blood and tissue supply, by
accelerating procedures for testing
licensure, and by production of drugs,
vaccines, diagnostic reagents, and
medical devices.
While these successes are dramatic
and noteworthy, the Commission
believes that serious and substantive
problems persist in the coordination
of planning, policy, and program
development among federal agencies.
Within the Department of Health and
Human Services (HHS), there is still a
lack of effective coordination between
the Public Health Service (PHS) and
other agencies within HHS. This is
particularly true between PHS, the
Health Care Financing Administration, and the Social Security Administration. Reimbursement and disability
issues are all crucial to the care for
many people with HIV disease and
should be closely linked to research,
prevention, and care programs. An
even greater potential for gaps exists
between HHS programs and other
non-health-related federal agencies.
This coordination could be significantly enhanced by the adoption of a
national plan for HIV including a
mechanism for interdepartmental
coordination within the federal government.
Although the National AIDS Program Office is designated as the coordinating agency for HIV within PHS
and reports to the Assistant Secretary
for Health, there is no cabinet-level

I urge you a
mission to insist th
esident and Congre
e silence of denial
it candidly about u
curb the spread of
V virus and why th
e infected deserve o
e and compassion.
BRIAN COYLE
January 1990

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