WASHINGTON -- Warning that the United States has reached a crossroads in the AIDS epidemic, the National Commission on AIDS yesterday predicted "relentless, expanding tragedy in the decades ahead" if concerted action is not taken soon to curb the crisis.
The commission, which released its final comprehensive report after two years of work, blamed societal and governmental apathy for the nation's failure to develop a comprehensive strategy on acquired immune deficiency syndrome or to devote sufficient resources to combat the disease.
"There is so much that we can do . . . and so much that we must do," the report said. "But there are two destructive attitudes within our borders that hamper these actions. They are a thinly veiled feeling that those who acquire the virus are getting what they deserve, and a collective indifference to their fate."
The commission condemned federal policy-makers for not doing more to address the epidemic.
AIDS has claimed the lives of 120,000 Americans over the last decade, the panel said, and the toll is expected to grow to 350,000 by the end of 1993. An estimated 1 million Americans are believed to be infected with the human immunodeficiency virus (HIV), which causes AIDS.
"Our nation's leaders have not done well," the report said.
The White House "has rarely broken its silence" on AIDS during the last decade, it said, and Congress, while developing important AIDS legislation, "has often failed to provide adequate funding for AIDS programs."
White House spokesman Marlin Fitzwater took issue with the panel's criticism of the Bush administration's efforts on AIDS.
"We believe that the government has been aggressive in responding to the AIDS crisis," he said. "This is a new problem in an historic sense. We've been trying to deal with AIDS for probably less than a decade. Enormous resources are being put into it, and we will take this report and try to improve the system as best we can."
The commission made more than two dozen recommendations for fighting the epidemic, including development of a federal AIDS-prevention initiative and adoption of universal health-care coverage for everyone living in the United States.
As a starting point, it called on the White House to develop a national plan to identify priorities and resources needed to prevent HIV transmission and to treat AIDS. "The United States, which has more people with AIDS than any country in the world, is one of the few developed nations with no national plan," the panel said.
Since universal health insurance is expected to be a long time in coming, the commission proposed taking other, more immediate steps. It recommended making all low-income people with HIV eligible for Medicaid coverage and increasing Medicaid payment rates to providers to encourage greater participation in the program.
The report criticized national leaders for adopting a "false calm" about the epidemic and for fostering a belief that "enough has been done about AIDS since it is just one disease" and that attention should be directed to other diseases that currently kill more people.
AIDS organizations and policy-makers praised the report.
Daniel T. Bross, executive director of the Washington-based AIDS Action Council, urged that elected officials "take to heart" its message.
"It is now up to the president and the Congress -- especially the president -- to move from occasional symbolic gestures to true compassion," he said.
Dr. Mervyn F. Silverman, president of the American Foundation for AIDS Research, agreed that the report underscored the need for more determined action.
"People will say there is nothing new in this report, that it will gather dust like other reports," he said. "It's true there is nothing new -- the problems are still there. The issues are still there. The lack of administration response is still there. And what's also still there, sadly, is that people are still dying."
The 15-member commission was created by federal statute to advise Congress and the White House on the development of a "consistent" national AIDS policy. It includes members appointed Congress and the White House. One of President Bush's appointees, Belinda Mason, recently died from AIDS.
U.S. faces 'relentless, expanding tragedy,' AIDS panel warns