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AIDS Commission Undecided On What Administrative Changes Will Tackle Problem

June 17, 1988

WASHINGTON (AP) _ President Reagan’s AIDS commission came down to its final meeting today still undecided on what to recommend in the way of administrative changes to cope with the epidemic.

After hearing from about 500 witnesses and concluding that a cornerstone of the final report should be a call for national anti-discrimination protection for the more than 1 million Americans estimated to be infected with the deadly virus, the 13-member panel was split on what - if any - changes it should recommend in the federal health hierarchy. The report is due June 24.

Retired Navy Adm. James D. Watkins, the commission’s chairman, is on record as favoring the vestment of sweeping new powers in the office of the Surgeon General - now Dr. C. Everett Koop - to cope with present and future health emergencies such as AIDS.

However, several commissioners have expressed reservations at that approach. Some suggested an alternative would be to call for legislation that would allow the appointment of a special assistant designated by the president to coordinate battles against particular health emergencies.

In an effort to deal with one aspect of what the commission viewed as a need to take extraordinary procedures in dealing with health threats like AIDS, the panel agreed tentatively on Thursday to recommend that the National Institutes of Health have more independence.

Although adoption of the specific language was delayed until today, the commission agreed unanimously with the concept outlined by Dr. Burton James Lee III of the Memorial Sloan-Kettering Cancer Center in New York City.

″As a clinical researcher in cancer medicine, I have worked with the NIH all of my professional life and it is my strong view that NIH has been unable to function as effectively as it could simply because the mechanisms are buried under so much bureaucracy,″ Lee told his fellow commissioners.

He won backing for a recommendation that the president direct that the NIH director report directly to the Health and Human Services secretary, rather than to subordinates in the department, for a two-year trial period and that the NIH chief have broad discretionary budget and personnel authority during that period.

Lee said if that change in procedure did not result in greater flexibility for NIH to ″achieve its scientific mandate,″ Congress should consider setting the NIH up as a separate agency answerable directly to the White House and Congress.

Watkins, a strong supporter of Lee’s proposal, emphasized that the change would not alter the requirement for NIH to win its allocation from Congress in competition with other government needs.

Nor, he said, would it give the NIH director power to shift funds from one institute to another - from the National Institute on Aging, for example, to the National Cancer Institute.

Watkins said the main idea was to insulate the NIH director - now Dr. James B. Wyngaarden - from having to clear internal personnel and spending priorities with several layers of bureaucrats at HHS and, especially, at the Office of Management and Budget.

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