AIDS Back into the Spot light

September 28, 1991

The poignant congressional testimony of Kimberly Bergalis has dramatically underscored the National Commission on AIDS' final report. "My life has been taken away," said the emaciated 23-year-old. "I did nothing wrong, yet I've been made to suffer like this . . ."

Aside from the circumstances of Ms. Bergalis' infection, this could have been a mantra for the 120,000 Americans killed by AIDS. Another victim, David Barr of New York's Gay Men's Health Crisis Center, noted that, "Although we may have acquired this virus in different ways, I never asked for this, [either]."

The person to blame for Kimberly Bergalis' fate is already dead. David Acer, the dentist who infected her and four others in the first documented doctor-to-patient transmission, had failed to disclose his condition. Ms. Bergalis and Rep. William E. Dannemeyer, R-Calif., want mandatory testing of patients and health workers who do invasive procedures such as dentistry. Mr. Dannemeyer's bill would bar infected doctors from working on patients without their consent.

The debate has pitted natural allies in the AIDS fight against each other and threatens to distract policymakers from the central point of the AIDS Commission's report: To halt the epidemic will require a radically different federal policy on prevention. That policy can succeed only if health care is universally available, so that poor communities wracked by severe AIDS outbreaks can get the help they need to avoid becoming disease repositories. With 32 percent of all adult and adolescent AIDS cases intravenous drug-related, progress can be made only if Congress funds, and the White House supports, drug-treatment programs. The National Institute on Drug Abuse says 107,000 addicts are on waiting lists, but too much public money goes to prisons, not AIDS treatment.

No compassionate heart could fail to ache for Kimberly Bergalis, but the reality is that Dr. Acer's patients represent a tiny fraction of the AIDS cases. A strong argument can be made that Centers for Disease Control guidelines on doctors' responsibilities in event of infection, made mandatory by other congressional action, would give patients the necessary protection without eviscerating doctors' rights in the process.

Federal AIDS programs by no means have been neglected. By 1990, funding for research, education and prevention of AIDS reached $1.3 billion, exceeding U.S. spending on every major ailment except cancer. What is lacking is emphasis on people-centered prevention and treatment, not laws to punish and ostracize victims who happen to be doctors. As Congress considers measures to fight AIDS, it is important to remember that historic imbalance.

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