courses for laboratory workers in the latest techniques. This fall they picked up on the activities that were started at the Public Health Service level involving the development and distribution of educational materials in cooperation with the American Red Cross and distribution of the Surgeon General's Report on AIDS. In 1987, CDC will provide additional specialized training to program coordinators, AIDS health educators, AIDS antibody test counselors, and other health providers. They will also be developing training modules and educational materials to train both practicing dental professionals and dental students about infection control procedures with an emphasis on AIDS.

Conclusion

I have been highlighting the work of our PHS agencies, and I am proud to be associated with all the dedicated persons in the Public Health Service who have committed so much personal effort to the battle to prevent and control AIDS. But it must be emphasized that we are not working in isolation. We must recognize the role that the media has played in helping to create the information base among our populations upon which we will be able to build. And, it is important that we recognize the hard work and invaluable efforts of the many voluntary organizations that have been such a major part of this Nation's effort to deal with this modern day scourge. As I stated at the outset, to meet the AIDS challenge will require an all out effort by the whole of our society. Thank you, Mr. Chairman. I will be happy to answer any

questions that you may have.

Mr. WEISS. Thank you very much, Dr. Windom. What we will be doing during the course of our questioning is to attempt to determine to what extent the various proposals or programs which you have outlined have in fact been implemented or are being implemented.

Because we will have, I think, extensive questioning, I will be breaking off my part of the questioning from time to time to allow my colleagues also then to ask their questions.

Dr. Windom, several years ago, HHS Secretary Heckler announced with great fanfare that AIDS treatments and vaccines were close at hand. Those predictions, I believe, were extremely misleading, and may have lulled the general public into a false sense of security about the seriousness of AIDS. These may also have lulled the Federal Government into a false sense of security. How would you now characterize the likelihood that we will have an effective vaccine and treatment in the near future?

Dr. WINDOM. Mr. Chairman, a number of vaccine programs are underway where testing is being done within the laboratory, in animals. It is anticipated that if progress continues as it is estimated based on today's circumstances, there is hope that a vaccine may be available within 5 to 10 years. No one can say that definitely. It's just not possible because of what has to be done at various stages in order to get a final product. This is just a projected estimate.

Mr. WEISS. I appreciate that. Then Secretary Heckler's projection was that within 2 years, we would have a vaccine. Many scientists suggested that that was just an unrealistic statement, but coming from Secretary Heckler it was believed. I think that your statement is a very realistic one. I applaud it because it demonstrates why we have to be focusing, as you said in your statement, on education/information efforts.

Dr. WINDOM. Yes. Thank you, sir.

Mr. WEISS. Did you review the Surgeon General's report on AIDS before it was released in October 1986? Were you in agreement with its findings and recommendations?

Dr. WINDOM. No. We did not review that document because it was produced as a result of a direction to the Surgeon General for him to provide the report and to present it as a response to the President's request. It was Dr. Koop's own document that was put together and distributed without our having been involved in the review.

Mr. WEISS. He reports to you through channels; isn't that right? That's the way the system works?

Dr. WINDOM. Yes, sir.

Mr. WEISS. He received a directive from the President to prepare this report; is that correct?

Dr. WINDOM. Yes, in January 1986, I believe, President Reagan asked him to prepare this report and to release it to the Nation. Mr. WEISS. He did that, and was not asked to submit it to you before it was released?

Dr. WINDOM. No, sir.

Mr. WEISS. Was the Surgeon General's report presented to the

Dr. WINDOM. I understand it was presented to the Domestic Policy Cabinet Group and I presume to the President. I do not know that for sure, sir.

Mr. WEISS. Has the President made any public statements on the report or on AIDS, since the report was issued in October?

Dr. WINDOM. No, I have not heard any public report on that from the President.

Mr. WEISS. Indeed, I just saw a recent copy of the Department's green sheet, the compilation of stories relating to AIDS. In a story dated March 5, 1987, I read that Koop has urged Reagan to take a lead in the war on AIDS.

Have there been discussions within your Department or with the President urging him to take a lead in the war on AIDS?

Dr. WINDOM. No, not that I'm aware of, sir, any personal contacts or expressions; not that I'm aware of.

Mr. WEISS. Your testimony reflects that 325,000 copies of the Surgeon General's report have been printed. Can you tell us how many have actually been distributed to date?

Dr. WINDOM. I do not know that total number but I know there is an ongoing distribution process. We are continuing to have the report distributed because it has been a very well received and is an important document. I do not know the exact number that have been distributed, sir.

Mr. WEISS. Dr. Dowdle, would you have that information?

Dr. DOWDLE. Yes. In fact, that's very close to the number. It's over 300,000. I think, more to the point, that copies have also been provided in a camera-ready form to all the States and to many other organizations. They also are distributing copies of the report. Mr. WEISS. There have been some discussions, I understand, of having that report mailed directly to every home in the country. Do you know how much it would cost to do that?

Dr. WINDOM. That proposal, Mr. Chairman, has been raised, and we will be talking about that. I will be convening a group of members of our staff to look at the questions of whether a direct mailing would be feasible, what type of document would be appropriate for a mass mailing, the size, and the cost. That is a concern of ours and we are in the process of evaluating it.

Mr. WEISS. Dr. Koop is quoted in a Sacramento headline, dated March 6, saying that the Public Health Service is considering mailing a simplified version of his widely publicized AIDS report to every household in the country. When do you expect to have a decision on that?

Dr. WINDOM. We would hope probably that by about the middle of April we will come up with something to resolve that question. Mr. WEISS. At about the same time as the Surgeon General's report in October, the National Academy of Sciences released its comprehensive AIDS report. Have you read that document? Are you familiar with its detailed recommendations?

Dr. WINDOM. Yes, sir.

Mr. WEISS. Are you and the Department in agreement with its findings?

Dr. WINDOM. We feel it makes a very significant contribution to the subject and we have listened to and met with members of the

Institute of Medicine and discussed their findings even prior to their releasing that report.

Mr. WEISS. Did the Department prepare any type of response to the report?

Dr. WINDOM. No, officially, no one asked for a response to the report, sir.

Mr. WEISS. How about unofficially? Did you have an analysis? Dr. WINDOM. Within our Public Health Service, we asked our various agencies to look at the report and give their opinions to us. That was just in-house.

Mr. WEISS. Can you make copies of those reports available to us? Dr. WINDOM. Yes, sir.

[On June 2, 1987, the Department advised the subcommittee that "none of the agencies have started the reports."]

Mr. WEISS. Did you express any disagreements? Were any disagreements expressed with the report?

Dr. WINDOM. I think the question that has been raised most has been about the figures for 1991. We feel they are estimations, but we want to try to approach them. We feel we are making progress along the line, and with the budget increases from year to year, particularly in the education area, are approaching the total that they mentioned, Federal combined with other sources, of $1 billion for education. I would say that very likely this target may be met, indeed may be exceeded.

Mr. WEISS. Last month, the Department scheduled a press conference to finally announce a major new AIDS Information/Education Plan. Later, we were advised by your staff that the plan would be released around the 1st of March. In fact, Dr. Mason testified at an Appropriations Committee hearing 2 weeks ago that the plan was complete.

Why was its release delayed?

Dr. WINDOM. In order to come forth with a plan of this type, and in the process to respond to all people and groups involved, a considerable amount of time was needed for the plan to be reviewed and for input to be received. As you can recognize, this is a most sensitive matter, and it is best to react to the concerns of all the individual participants. It has taken time. We are just about ready to go to press. We anticipate that very, very soon.

Mr. WEISS. Dr. Dowdle, when did CDC begin working on this new major information/education plan? When was the plan first requested, by whom, and why?

Dr. DOWDLE. Well, CDC was given the responsibility for working on the plan in November, about the time we were given the responsibility for an information education program. However, it was started a few weeks or months earlier within the Public Health Service.

Mr. WEISS. Who first requested it and why?

Dr. DOWDLE. Dr. Windom requested it.

Mr. WEISS. What was the basis for the request, Dr. Windom?

Dr. WINDOM. The basis, Mr. Chairman, was that I felt we needed to develop a document that would be available for many people in the Nation to use and that it would be best for this document to come from the Public Health Service. In order to do this, I asked

Dr. Mason and his people at CDC to take the lead in putting it together.

Mr. WEISS. When did you make that request?

Dr. WINDOM. It was in November, as I recall. I'm not sure exactly what date.

Mr. WEISS. Dr. Dowdle has just indicated you began working on it-the date actually is October 28, I believe. You had discussions on it for some months previously. You must have made that request earlier.

Dr. Dowdle, what's your recollection as to when you were requested to start working on that plan?

Dr. DOWDLE. Well, actually it emerged from other bits and pieces of work that was going on. It was weeks after the idea had started at PHS that CDC was asked to put the plan together. Again, I don't know the exact date, but early October probably.

Mr. WEISS. Was that before the Coolfont meeting in June 1986? Dr. DOWDLE. I think actually there may be a little misunderstanding here. As far as the Public Health Service Information/ Education strategy goes, all of this evolved out of the meetings that were held as early as 1985. In fact, the Public Health Service published a strategy in 1985 in Public Health reports. It was updated in 1986 with the Coolfont report. Both documents said that a major information/education effort would be required to combat AIDS. This current document grew out of Dr. Windom's request that there be a specific document on information/education.

Mr. WEISS. The discussions had been going on for the better part of a year before you actually started this final plan?

Dr. DOWDLE. That specific document. Not only were activities discussed, but information education activities have been implemented beginning as early as 1984 and 1985.

Mr. WEISS. When did you, or Dr. Mason, first review a draft of this new plan?

Dr. DOWDLE. The present plan?

Mr. WEISS. Yes.

Dr. DOWDLE. The plan was reviewed over the Christmas holidays and submitted on January 2.

Mr. WEISS. We have a memorandum, minutes of a Public Health Service task force, dated September 8, 1986, and this among other documents will be entered into the record.

[The memorandum follows:]