Press Briefing by Patsy Fleming, National A.I.D.S. Policy Director

The Briefing Room

2:15 P.M. EST

MS. FLEMING: Good afternoon. First let me say how grateful I am to the President for this opportunity. The task of directing the federal response to the AIDS epidemic is a demanding one, but it's a challenge I welcome and one I am ready to take on.

Many of you may recall that when I agreed to be interim director, or coordinator it was called at that time, I had said I was not interested in being a candidate for the permanent appointment. However, the last three months have shown me that this is a position that can have enormous impact on the government's response to the AIDS epidemic. I also appreciate the encouragement I received from the AIDS community to take this job.

The demand for action is tremendous. Every day 90 Americans die as a result of AIDS. We estimate that more than 40,000 Americans are becoming infected with HIV every year. And despite our education and prevention efforts, that number has remained fairly constant for the last five years.

As the President noted, AIDS is striking at the core of our collective community. Today AIDS is the number one cause of death among Americans between the ages of 25 and 44. My mission is clear. We must begin to reduce the number of infections while we vigorously pursue the scientific research that we hope will eventually produce a cure. No stone can or should be left unturned.

The President has asked me to provide him with a report on the spread of HIV among adolescents. We already know that today half of all new infections with HIV occur among Americans under the age of 25. One in four new infections is among people who are younger than 20. These are very troubling trends, and they must be addressed quickly.

I'm also quite concerned about the continued rise in HIV infection among women. Traditional prevention methods do not ensure the safety of women, so we must aggressively seek ways to empower women to protect themselves, including the use of female condoms and microbicides.

Finally, let me say that the gay community has made tremendous progress in reducing the rate of growth in HIV infection in that population. But the fact remains that the largest number of infections are occurring among gay men, particularly those who are in their teens and twenties. Clearly, more must be done.

AIDS remains a critical public health crisis in this country. It's time to roll up our sleeves and get to work.

I'll be happy to take some questions.

Q: What about the budget aspect of your job, Ms. Fleming? The AIDS community is very concerned that there won't be enough money to do the things that you've outlined. To what extent -- do you have any kind of a commitment from the President to put more money into AIDS research, treatment and prevention?

MS. FLEMING: The President is committed to fully funding Ryan White. In the '95 budget you've seen increases in all three areas. I will work to try to make sure that such increases are included in the next budget. I'm working with Alice Rivlin and I will be working with the President on the budget. I've also worked with HHS.

Q: Any idea what kind of increase might be --

MS. FLEMING: Not at this time.

Q: Can you tell us a little more specifically about what the adolescent AIDS initiative is going to include?

MS. FLEMING: Well, the President just asked me to do it today, so I don't really have an answer to your question right now.

Q: But from your experience what, maybe, needs to be done in terms of --

MS. FLEMING: Well, certainly, prevention is the area that needs the most work. We need to look at the demographics, see where they are and what they're doing, and then try to find ways to convince them to use safer sex methods and to listen to our prevention messages. We need to find ways of reaching them that we haven't developed.

Q: With the Republicans now in control of Congress, how is this going to affect AIDS funding, do you foresee?

MS. FLEMING: Well, I can talk about the last time the Republicans controlled the Senate. Senator Mark Hatfield was chairman of the Appropriations Committee then, and I believe he will be chairman again next year.

At that time the Congress pushed through very large increases in AIDS funding. So I really believe that AIDS is not a partisan issue whatsoever. It's not politics. It's people. And every congressional district, every state in this country is affected by AIDS. So it is my hope that both Houses of Congress will continue to see this as a major priority.

Q: Are you satisfied that you're going to have the kind of access to the President that's more than lip service, that will let you be effective?

MS. FLEMING: During the months that I've been interim coordinator I have been very comfortable with my access to the President. I have had opportunities to talk with him about what I see as the important issues related to the AIDS epidemic, and that will continue. The President said, when he made the announcement, that I have access to him. I do.

Q: The President said the White House AIDS Office has been newly strengthened. Could you comment on how, if at all, it has been reorganized or strengthened?

MS. FLEMING: The White House AIDS Office has been separated from HHS. Formerly, they were joined at the hip, sort of. But now they're separate and it will be a much more effective way of running the operation. So management-wise, it's very much stronger.

In terms of the other part of that, I think that it has something to do with the way the person in the position operates. I will pursue my duties in this job very vigorously. I feel very passionate about this epidemic. I will do everything that I can to convince Congress, to convince the administration that we must support efforts to prevent AIDS, to develop new drugs and technologies, and to take care of people who are affected by the epidemic, to the greatest extent possible.

Q: Congress certainly has been sympathetic to some elements of dealing with AIDS. I was listening to you talk about the idea of pushing prevention messages to adolescents. And I'm curious about what you anticipate will be the reaction from the new Congress to the idea of pouring money into prevention messages involving safer sex. I mean, we all know in the past, you know, what the sentiments of some of the Republican members of Congress have been, and those are likely to intensify. How do you expect to deal with that when those particular issues come up on the Hill?

MS. FLEMING: We will have to find a way. There have to be approaches that will be acceptable to a wide range of people, and that is something we'll be looking into.

Q: Your predecessor, Kristine Gebbie, before she left had laid out some sort of national plan for dealing with AIDS. What is the status of that? Is that now no longer a viable document, and are you going to take that on?

MS. FLEMING: Under my leadership there will be a plan developed. My view of the development of that plan is that it has to come from the bottom up. It has to begin in the agencies. The agencies and departments that are going to have responsibility for implementing have to be involved in the development from the very beginning. There will be an interdepartmental task force. Representatives from each of the departments that have anything to do with AIDS will come together. That group will go back to their agencies and help develop a plan for implementing their aspect to the AIDS agenda. And then we'll put it together.

So we'll have a national plan. But it will grow up from the bottom, rather than be imposed on the agencies from above.

Q: When do you think that plan will be finished?

MS. FLEMING: We don't have a timetable yet. We have to convene the task force and we're going to try to do it quickly.

Q: What about the report of the Presidential Commission that came out in '92, is that something you can work with? Or why isn't that a good enough --

MS. FLEMING: Yes, we can. We intend to. There are very good recommendations in that report. Some of them have already been implemented. We will look at all the others and see what we can do with them.

END 2:27 P.M. EST