THE world has come to a major fork in the public-policy road as it confronts the challenges posed by the disease AIDS, says Dr. Jonathan Mann, director of the World Health Organization's AIDS program. One path leads to a continuation of the significant progress made during the 1980s, Dr. Mann says in an interview. But he warns that taking that road requires a long-term commitment to combating the disease and a reversal of what he sees as the smug contentment of some Western nations, including the US.
It also requires a recognition by the more-affluent nations, including the US, that they must increase the amount of money they are providing for the worldwide effort, Mann says. Besides just federal governments, local officials and community leaders must be involved.
The other path is far easier to take - in the short run. It requires no commitment, no increase in funds, and permits apathy. But down this road the world would eventually confront much more serious problems for international public policy.
The United States is in a pivotal position, Mann says, ``with its unparalleled capacity to help itself and others in time of need.'' It can provide leadership, technical expertise, and - despite its budget deficit problems - funds.
``It's clear that the US resources are in a position to play a dominant role'' in the worldwide effort, he adds.
Mann says that during the 1980s the world has made dramatic and unprecedented progress in combating the illness, not now considered medically curable. Squabbling and finger-pointing among nations has died down, and there is ``the sense that we're in this together.''
``Every country has developed a plan for dealing with the illness, and has at least begun to put it into effect,'' Mann says, adding: ``We're beginning to see the positive effects of the implementation of the strategy.''
All of this provides an excellent foundation upon which to build, he says. Nonetheless, ``we are in danger of losing the race against AIDS,'' he warns in a somber assessment: ``The epidemic is gaining momentum.''
In 1981 his organization estimated that about 100,000 people worldwide were then afflicted with the AIDS virus. It now estimates that between 5 million and 10 million are today infected.
Mann warns that to conquer this ailment mankind must also be willing to deal with a series of social problems. These include drug abuse, prostitution, inadequate sex education, poverty, and insufficient access to health and social services.
Finally, there is the problem of complacency, which he sees rising, especially in the developed world.
``This is lulling people into dangerous assumptions that threaten'' to undo the past decade's progress in fighting AIDS, he says.
For example, in the US AIDS is thought of as a disease confined to minorities, intravenous drug abusers and their sexual partners, and male homosexuals. Scientists report that the disease has moved into the heterosexual white population much more slowly than previously expected.
Yet the American public should not let down its guard, Mann cautions. The disease still remains a serious potential problem for the average American, he says, if not in the current generation then in the next. ``The message has still not reached the American public well enough that this is not a problem that has gone away.''