The AIDS Bureaucracy.

• Author: Blow, Richard

The AIDS Bureaucracy. Sandra Panem. Harvard University Press, $22.50, cloth; $295, paper The government's health care bureaucracy couldn't handle AIDS because of structural flaws, Panem writes. Had the flaws not existed, the government could-and would-have contained AIDS.

No one denies imperfections in the Public Health Service, the Centers for Disease Control, the National Institutes of Health, and the Department of Health and Human Services, There is, for instance, little systematized cooperation between the epidemiologists at CDC and the research scientists at NIH, and frequently there's a great deal of tension. These government agencies are illequipped to react quickly to a health emergency. (There isn't even a clear definition of what constitutes such an emergency.) To solve these and other problems, Panem, a science writer, proposes a number of remedial steps: the establishment of an AIDS "czar"; "generous and centralized finances"; central oversight of research; longterm strategic planning, and others.

There's nothing wrong with any of these recommendations. But even...