The AmFAR Report

disqualify anyone from any
service, but reprehensible conduct.
(ii) He should lift the ban on
entry into this country by HIV
seropositive individuals. Such a
ban has no public health signifi-,
cance and is contrary to stated
HHS policy. This ban's abrogation
will bring great relief to all people
with HIV/AIDS and particularly
so to all hemophiliacs and to HIV
seropositive Haitians qualifying as
political refugees but now forcibly
held under uns'anitary and inhumane conditions in Guantanamo
Bay camps or in U.S. prisons.
(iii) As part of his health care
reform proposal, the President
should eliminate the ability of selfinsured employers to cut health
care benefits of workers diagnosed
with AIDS or other serious
illnesses.
(iv) The President should
end mandatory testing for HIV in
the Job Corps, the Peace Corps
and the State Department. If a
rational justification exists for such
testing, it should be explained and
voluntary testing recommended,
but testing should never be a
condition for admission into any
group or access to any career.
(v) The, President can also
serve HIV/AIDS research well by
promptly conferring with.leaders
of the pharmaceutical and biotechnology industries in order to stress
his personal interest, encourage
their cooperation with government efforts and their active
participation in cooperative
agreements with each other or
government agencies for the
purpose of conducting clinical
trials on combination, sequential
or alternating regimens of new
treatments with proprietary drugs
owned by different companies.
(vi) The President should

reappoint Dr. David Kessler as
Commissioner of the Food and

Drug Administration because Dr.
Kessler has rare qualifications of
personal integrity and ability to
fruitfully negotiate with consumers,
industry and Congress to achieve
desirable goals; he has also demonstrated managerial competence.
(vii) Since the term of the
National Commission on AIDS
expires in 1993, the President
should propose to Congress that its
term be renewed or another body
formed to constitute a forum where
public consultation can occur. It
would assess the nation's reactions
to both the epidemic itself and
current public policies and programs. It would provide recommendations to the Executive and
Legislative branches of government.
RECOMMENDATIONS
ON RESEARCH:
1. The creation of a new NIH
institute is inappropriate.
While the HIV/AIDS epidemic is
of a gravity equal to or greater
than that of other important
human diseases, the multiple
infectious and neoplastic manifestations of the immunodeficiency
syndrome and the variety of
scientific and medical questions it
raises require the continuing
involvement of several established
NIH institutes, the Centers for
Disease Control, the Food and
Drug Administration, the Department of Defense and others.
2. Investigator originated
research must be preserved.
Modern biology has acquired the
technologiesnecessary for a
complete understanding of living
systems at the molecular leveL We
can now rapidly master the
fundamental knowledge to very
specifically suppress HIV's

multiplication and/or its damage
to cells and organ systems, in

particular the immune and nervous systems. We can also learn to
better diagnose, treat and prevent
opportunistic diseases and to
'restore immune function. There
cain be no doubt that enduring
solutions to the HIV/AIDS
epidemic will be found.
While the urgency of the task
requires a strongly goal-oriented
and coordinated effort, much
knowledge remains to be acquired, particuliirly if highly
effective and cost-effective solutions are to be developed. Thus, a
"Manhattan Project" for AIDS
cannot merely consist of the
upsciled and accelerated application of existing technology. Quite
the contrary, it must mobilize the
best scientific expertise as broadly
as possible, and only facilitate and
coordinate the scientists' and
clinical investigators' work, as
well as support their efforts. We
therefore believe that the historic
Manhattan Project is inappropriate as a model for an intensified
and accelerated national HIV/
AIDS research effort.
We fully agree, in this respect,
with Dr. Anthony Fauci and many
other prominent scientists. Traditional investigator originated basic
research, shaped and qualitycontrolled by the peer review
mechanism, remains the most
appropriate system for determining the scope and direction of
much of biomedical and behavioral research on HIV/AIDS. No