Experts nationwide say the federal government's response to the AIDS epidemic is "uncoordinated and insufficient" and complain that AIDS prevention programs are tangled in red tape, according to a congressional study released yesterday.
Public health authorities and medical experts surveyed by the General Accounting Office say that the approximately $790 million the Reagan administration proposes to spend on acquired immune deficency syndrome research and prevention in fiscal 1988 is at least $365 million too little, the report said.
But the GAO found that "weak federal leadership and the lack of a sense of urgency in the education area" are considered "at least as troublesome as shortfalls in the budget."
Some state officials are so frustrated by the procedures required to obtain federal funds that "they would rather have less money than more money with federal strings attached," the report said.
"The experts . . . told us that the patchwork of federal and state funding available for AIDS prevention programs and the lengthy and cumbersome application processes for grants have prevented a quick response to the AIDS epidemic in many instances," said the report, which was prepared for the Senate Appropriations subcommittee on labor, health and human services, education and related agencies.
The study, based on a review of the literature on AIDS and interviews with 20 experts across the country, said health professionals, advocacy groups and public officials support the general AIDS prevention priorities contained in the administration's budget proposal but call for funding increases of at least:
$50 million for drug-rehabilitation treatment to contain the spread of the AIDS virus among intravenous drug abusers.
$65 million for educational campaigns targeted at high-risk groups and the general population.
$250 million for expanded voluntary testing and counseling.
Those recommendations were made without consideration of competing budget priorities, the GAO noted. Part of the burden should be shouldered by private sources, such as insurance companies faced with major outlays for AIDS patients, it added.
In addition to the funding increases, medical experts called for a national study of a random sample of the population to find out how many people are infected with the AIDS virus and to establish a baseline to track its spread. The administration has not sought funding for such a study, although the idea is reportedly under consideration.
The report cautioned, however, that widespread testing of people outside categories at high risk for contracting the disease would be inordinately expensive. The federal Centers for Disease Control (CDC) estimated the cost of detecting the virus among low-incidence segments of the population at more than $18,000 per infected person identified, compared with $130 in high-incidence groups.
In a statement to the Senate panel, GAO senior associate director Michael Zimmerman stressed the experts' opinion that a massive educational campaign must be mounted to limit the spread of AIDS infection.
The cost of the epidemic is difficult to project, the GAO report said, but the CDC estimated that total costs to society may reach $64 billion by 1991.