BERKELEY — Dr. Donald Francis, who is something of a medical gumshoe, fought epidemics in Africa before the Centers for Disease Control sent him to help California control AIDS. But these days he devotes more and more time to the Nov. 4 election.
And he is angry about it.
On that day California voters will decide the fate of Proposition 64, the AIDS initiative sponsored by two longtime followers of political extremist Lyndon H. LaRouche. Like most of his colleagues in public health, who have had to watch at close hand as AIDS claimed 13,270 lives nationally, Francis said the initiative would ravage the state's effort to control the disease.
"It's an incredible waste of time," Francis said. "It's just an absurd proposition."
The sponsors, who are backed by LaRouche's Virginia-based political and publishing empire, contend that the measure would simply force health officials to treat AIDS with the same seriousness as any other infectious disease.
Storms of Fury
But the measure has whipped up storms of fury among physicians and health officials, who say they have power enough now. Some health officers, citing legal advice that they may be compelled to quarantine AIDS patients without medical justification, have threatened to quit rather than comply.
Legal opinion varies on the initiative's impact on the law. Two lawyers in state government, representing the attorney general and the Department of Health Services, concluded separately that Proposition 64 would make little change in the sweeping powers that public health authorities already have to control infectious diseases, including AIDS.
However, an American Civil Liberties Union analysis said it could require mass testing and possible quarantine. Matt Coles, a professor at San Francisco's Hastings Law School, comes down somewhere in between, but said the measure could be used to remove thousands of people from jobs in agriculture, restaurants and schools.
"Nobody can really be terribly clear because of how the initiative is written," Coles said. "I suspect we're looking at four, five years of litigation."
At the very least, health officials said, it will tie them up in lengthy court battles they can ill afford and seriously curtail the effort against AIDS in California.
"The real movers and doers on AIDS have been the gay community," Francis said. "And what are you doing? You're taking them off AIDS and putting them to work on Proposition 64."
Even worse, health officials said, it could undermine the campaign to convince people who are the most likely to spread the disease through sexual contact--especially gay men--to be voluntarily tested for infection.
A state law now bars the disclosure of test results for antibodies to the human immunodeficiency virus that causes AIDS. The law was passed last year to encourage people to be tested before they donate blood. But the initiative seeks to require that the names of immunodeficiency virus "carriers"--presumably anyone who tests positive for antibodies to the virus--be reported to the government.
"How can we recommend that these people get tested when they might lose their job and be quarantined--and for no reason?" Francis asked.
The California Medical Assn. and physicians who work with infectious diseases said a quarantine would be useless against AIDS, which is sexually transmitted in the vast majority of cases. Besides discouraging voluntary testing, the reporting of names would be a costly and meaningless step, since the state Department of Health Services already has more names of AIDS patients than it knows what to do with, the critics said. (An estimated 300,000 people in California are infected with the virus.)
Other Diseases Reported
Other sexually transmitted diseases, such as syphilis and gonorrhea, are reported and authorities are empowered to investigate their sexual contacts. But many local health agencies lack the money to trace sexual contacts for even those diseases, and health officers said they could not begin to trace the contacts of people who test positive for AIDS.
Under a radical but possible interpretation, according to some legal opinions, the measure could force mass testing of students and anyone who works with food or in schools.
Anyone with a positive test--from harvest workers to grocery clerks to vice principals--would lose their jobs, according to some legal analysts, even though AIDS experts said the disease cannot be transmitted through food or non-intimate contact.
Food workers and school personnel would be affected if the initiative was interpreted by courts to trigger state health regulations that govern carriers of infectious diseases. Although state law requires that there be some chance of transmitting the disease, the regulation that implements the law drops that language and flatly bars anyone with an infectious disease from a food establishment--whether or not the disease can be passed through food.
Seldom Used Rule