Bush on AIDS: the appointment of the White House's newest AIDS officials could signal a renewed emphasis on fighting the disease at home.

While President Bush has won very little praise from gay advocates in his nearly three years in office, he has been commended for his appointments to the federal Office of National AIDS Policy. Scott Evertz and Joseph O'Neill were the first two MDS czars Bush appointed and the first two gay men to hold the position.

Nevertheless, the president and his MDS policy team have been criticized for giving too much of their attention to international AIDS concerns and too little of it to problems here at home. As if to prove that point, O'Neill left the AIDS policy office this past summer to go to the State Department, where he focuses exclusively on international AIDS assistance.

Now, with his latest appointments to the the national AIDS office--Carol Thompson as acting director and Chris Bates as acting deputy director--Bush is again winning praise from gay activists. And those activists say they are hopeful that this shake-up will finally signal an increased commitment to work on domestic AIDS issues.

The White House did not respond to several requests for interviews with Thompson, formerly an executive assistant to Office of Management and Budget director Josh Bolten, and Bates, who is openly gay and previously served as deputy director of the Department of Health and Human Services' own Office of HIV/AIDS Policy. But activists who have worked with he Office of National AIDS Policy in the past say the appointments of Thompson and Bates are a good sign.

"Dr. O'Neill's interest is in the international fight against MDS, and that's a good thing," says Ernest Hopkins, director of federal affairs for the San Francisco AIDS Foundation. "But Chris, who has the trust of the African-American gay community, will bring a broad understanding of domestic AIDS issues and a sensitivity to the White House. I have felt domestic issues were being neglected."

Among the priorities of Thompson and Bates will be the reauthorization of the Ryan White CARE Act, which expires in 2005; the law provides HIV/AIDS aid for those lacking the needed health coverage. Other looming battles include the increasing prominence of federal abstinence-only education campaigns and the policy implications of a new HIV test that produces results within 20 minutes.

"During the last three funding cycles, there have nut been increases for Ryan White programs when there is more need than ever," Hopkins says. "The president has failed to indicate to Congress that AIDS funding is a priority."

Hopkins cited long waiting fists for the AIDS Drug Assistance Program, a part of the Ryan White act that provides anti-HIV drugs to the underinsured and uninsured. West Virginia health officials have reported that at least two people on waiting lists for drug assistance--newly implemented this year--have died of AIDS complications before they could be treated. "This is not something that should ever happen in this country," he says.

Under Clinton, the Office of National AIDS Policy served as a bully pulpit for the domestic fight against AIDS, advocating for stepped-up prevention campaigns as well as increased funding for treatment and research. It has adopted a far less visible presence under Bush, who has often sought to balance the competing demands of religious conservatives, who seek abstinence-only prevention efforts, and established AIDS service organizations and activist groups, which advocate a far more comprehensive approach.

"It's great that the president has put good people in the AIDS policy office," says A. Cornelius Baker, executive director of the Whitman-Walker Clinic in Washington, D.C. "But they can't do the job alone. There is an AIDS leadership void that can't be filled by the office. The office reports to the president. He is the boss, and he has had no clear agenda about arresting the epidemic."

But Carl Schmid, a prominent Republican AIDS activist, insists that Bush has indeed made AIDS a priority, on both the international and domestic fronts. "Tiffs White House has made a bigger commitment internationally than Clinton ever did," he says, pointing to Bush's promise to spend $15 billion over five years in developing nations. "And Clinton never appointed a gay AIDS czar. He's gotten a lot of heat from the right wing over that, mad it's time we gave the president a little credit for doing the right thing."