JESSE HELMS could have done without the vitriol. Even if he shares a common view that homosexual acts are distasteful or unnatural, it wasn't necessary or gentlemanly to say so, at least not in a newspaper interview, and particularly not when talking about people who have AIDS. The senator from North Carolina (annual tobacco crop: 595 million pounds) would never describe lung cancer patients as the victims of their own "deliberate, disgusting, revolting conduct," even though, as a rule, they are. He should have resisted his temptation to say it about AIDS patients.
Predictably, Helms' execration of homosexuals obscured the real point he had set out to make. Which was: The government is spending too much money on AIDS.
According to the US Public Health Service, the government will spend $2 billion this year on AIDS research and prevention ($2.7 billion, if you include funds earmarked for treatment). That compares with just $800 million allocated to heart disease. Yet AIDS will kill less than 2 percent of Americans who die this year, while heart disease will kill more than 33 percent.
In 15 years, AIDS has killed 270,000 Americans. Heart disease kills that many every 19 weeks. The disproportion is staggering. Is it logical -- or fair -- to be spending 2 1/2 times more money on AIDS than on heart disease, which kills 18 times as many people?
Last year, 40,000 people died of AIDS in the United States. That is fewer than the number who died of diabetes. Fewer than the number who died of pneumonia and flu. Fewer than the number who died of cancer -- fewer, in fact, than the number who die of cancer every month. Yet more federal money is spent to fight AIDS than to fight any of these other diseases. Is that good public policy? Is it good science?
Would that there were ample funds to combat every illness to which human beings are prone. But the federal debt is severe, the demands for cures are many, and the government's dollars are limited. It is hard to see a justification for raising AIDS to a privileged status, as though it poses a graver threat than diseases that kill far more victims, and kill them just as dead.
This issue isn't new. In 1992, the Associated Press calculated that the US government was spending about $79,000 for every American who died of AIDS -- as against only $7,300 for every death from cervical cancer, $6,300 for diabetes, $2,800 for breast cancer, $800 for prostate cancer, and $600 for stroke. "There is more money going into AIDS," the AP was told by Dr. David Denhardt, chairman of biological sciences at Rutgers University, "than any rational distribution would come up with."
Now Helms is fixing his attention on the matter just as Congress prepares to reauthorize the Ryan White Care Act of 1990. At stake is not only $3.6 billion (over the next five years) for the treatment of people with AIDS, but the principle that one -- and only one -- class of sufferers is entitled to such a subsidy. Politically, the Ryan White Act is popular. Morally, it is problematic.
Ryan White funds do not go for research; they save no lives. The money is used wholly for care -- drugs, meals, inpatient treatment, at-home nursing. It's a blessing for those sick with AIDS, of course, but such largesse is not offered to the victims of other illnesses. "For anybody with any disease besides AIDS, the sign on the door reads, 'Go Away!' " notes AIDS scholar Michael Fumento. "There is no Gilda Radner Act for victims of ovarian cancer, no Ronald Reagan Act for Alzheimer's Disease patients."
To take care of sick people who are aged or poor, Americans created Medicare and Medicaid. Those programs do not discriminate among diseases. But Ryan White funds are reserved exclusively for AIDS patients. And the argument for creating this unique, $3.6 billion benefit for a tiny fraction of the population is -- what, exactly?
Maybe it was possible to rationalize the enormous funding disparity in favor of AIDS back when some scientists believed that AIDS was going to "break out" into the public at large. But there has been no heterosexual breakout. Long after the point by which many alarmists expected the plague to be widespread, AIDS in America remains a disease confined almost exclusively to homosexuals, drug abusers, and their sexual partners.
That does not minimize the horror of AIDS, a cruel, wasting disease that cuts down victims in the prime of life. But unlike most cancers, unlike muscular dystrophy, unlike Lou Gehrig's disease, unlike schizophrenia, unlike Alzheimer's -- horrors all -- AIDS is a disease whose cause is not a mystery. We all know how AIDS is spread. It is hard to justify preferential treatment for a disease that can usually be prevented.
The life of an AIDS patient is no less precious than that of someone with any other disease. But it isn't more precious, either. What Helms ought to have said is that every AIDS patient deserves compassion and help. Then he might have added that those who claim that people with AIDS are entitled to special compassion and special help bear the burden of explaining why.