The resignation of Kristine Gebbie has left national AIDS policy in limbo at a critical time when Congress is hammering out a healthcare reform plan.
Ms. Gebbie, who will leave her post next month as the nation's first National AIDS Policy Coordinator, made strides to focus national attention on the deadly disease, but some healthcare providers and AIDS activists said her office lacked organization and any authority during her 11-month tenure. AIDS activists in particular had put the Clinton administration under pressure to do more about the epidemic.
"The Office of the National AIDS Policy Coordinator is broken and needs to be fixed," said Daniel Bross, executive director of the Washington-based AIDS Action Council. "We now look to President Clinton to demonstrate the leadership the president promised and that the epidemic demands. This is the opportunity for a new beginning."
Many healthcare providers said Ms. Gebbie was in a no-win situation as the first leader appointed to deal with a massive problem while having no control over the AIDS budget. Ms. Gebbie, former secretary of the Washington state health department, could make proposals but had little say in their implementation.
The new person has to have the ear of the White House and HHS, said Benjamin Schatz, executive director of the San Francisco-based American Association of Physicians for Human Rights.
Among those mentioned as potential successors are: AIDS Action Council's Mr. Bross; New York City Health Com- missioner Margaret Hamburg; Oregon Gov. Barbara Roberts, a Democrat; Connecticut Gov. Lowell Weicker, a political independent; and Timothy Westmoreland, an aide to Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce health subcommittee.
"She was set up," Mr. Schatz said of Ms. Gebbie. "She was given a job with very little power, and someone with power and influence in Washington is needed."
But other healthcare providers credit her with lobbying for more money for AIDS care. Ms. Gebbie has proposed a $579 million fiscal 1995 budget for the federal Ryan White Care Act program, which provides healthcare providers with block grant money for outpatient AIDS care. Of that budget, $19 million will be allocated toward primary care.
Healthcare providers say the Office of National AIDS Policy could be stronger now that Ms. Gebbie's resignation has gained national attention and healthcare reform proposals in Congress are coming to a head.
"The AIDS issue needs to be linked with healthcare reform efforts," said Gina Pugliese, director of infection control for the American Hospital Association. "We want to make sure that the policy coordinator has governmental support and that these activities are coordinated."
The Clinton administration has been reviewing the "structure of the office and the position of coordinator," said John Gurrola, director of communications for the Office of National AIDS Policy.
In her resignation statement, Ms. Gebbie said her office and the Clinton administration made strides to fight AIDS and HIV, the virus that causes AIDS.
"Many communities in our nation have yet to feel the full effect of this epidemic; particularly women and young Americans, gay and straight," Ms. Gebbie said. "Unless we frankly address prevention issues in these communities, hundreds of thousands of lives will be unnecessarily lost. The next (coordinator) must have the tools necessary to take on this position and achieve success and confidence within the AIDS community."