Interim report of the Presidential Commission on the Human Immunodeficiency Virus Epidemic: Chairman's recommendations--Part I.

The Presidential Commission was created in September 1987 with the mandate to advise the White House "on the public health dangers including the medical, legal, ethical, social, and economic impact, from the spread of the HIV and resulting illnesses including AIDS, AIDS related complex, and other related conditions." This paper covers the Commission's interim policy recommendations as of March 15, 1988, in the areas of intravenous drug abuse, patient care, and basic research and drug development. The scope of recommendations in the area of intravenous drug abuse includes provision of treatment services, treatment research, drug abuse prevention, and outreach education. There must be a national policy of "treatment on demand" for drug users. An expanded program of drug treatment research must include research on cocaine as well as heroin addiction treatment. Drug abuse prevention should coordinate efforts at all levels of government as well as community and religious organizations and schools. Outreach education, which is especially difficult with drug users because drug use is illegal, will cost roughly $126.5 million a year over current funding. Outreach programs should train and utilize street outreach workers, including former addicts, and should have special focuses on adolescents, minorities, and women of childbearing age. The scope of recommendations in the area of patient care includes health care provider education, health care systems, psychosocial needs, nursing care, minorities and underserved populations, and information coordination and exchange. AIDS needs to be integrated into the educational curricula of medical and all other health professional schools. In the area of health care systems, the recommendations emphasize the need for integrated community-based services for people with HIV infection. 22 AIDS Service Delivery Demonstration projects are currently being conducted in the US, 13 funded by the US Public Health Service and 9 funded by the Robert Wood Johnson Foundation.