Editorial
Public health is no place for politics

It's not much fun being the U.S. surgeon general. It's even worse becoming the U.S. surgeon general.

The job went empty for three years as Republican senators blocked Clinton nominees. David Satcher, who had been director of the federal Centers of Disease Control and Prevention, finally won confirmation in 1998 despite a filibuster led by Sen. John Ashcroft, now the Bush administration's attorney general.

Opponents had complained about Satcher's support for abortion rights and for a CDC study of needle-exchange programs aimed at curtailing the spread of the AIDS virus among drug addicts. (Any fair-minded look at Hawai'i's needle-exchange program suggests that jurisdictions without them border on irresponsibility.)

Once again the surgeon general's office has become a political battleground as Satcher unveiled a long-awaited report he hoped would use science-based strategies to find "common ground" upon which the nation could work to promote sexual health and responsible sexual behavior.

Indeed, it is clear that Satcher tried hard to write a report that could win acceptance even by conservatives who reject virtually all forms of public health efforts in the sexual health field except for abstinence.

He may have been wasting his breath. Too many right-wing politicians aren't about to let facts stand in the way of a good dogma.

"We face a serious public health challenge regarding the sexual health of our nation," Satcher said. "Doing nothing is unacceptable."

But in too many cases, reliance on preaching abstinence is the equivalent of doing nothing.

Among the sexually related public health problems cited by Satcher:

• The infection of 12 million Americans a year with sexually transmitted diseases.

• 800,000 to 900,000 Americans living with HIV, with one-third of them unaware that they are even infected.

• Unintended pregnancies accounting for nearly one-half of all pregnancies in the U.S.

• An estimated 1.36 million abortions in 1996.

• An estimated 104,000 children becoming victims of sexual abuse each year.

• Reports that 22 percent of American women and 2 percent of American men have been victims of rape.

The White House said Bush is frustrated with Satcher's report, although it acknowledged that the report to some degree confirmed the president's belief that "the best way to prevent pregnancy, the only surefire way, is through abstinence, and that's the best way to avert disease as well."

Of course that's true, and in a world where all unmarried folks remained abstinent (and gays and lesbians changed their sexual orientation), it would be a fine policy.

But Satcher's report reflects the real world, a world that too many are unable or unwilling to face.