of the Roundtable from special interests and political constraints is especially critical. As with the Campaign to catalyze social change toward a new norm of healthy sexual behavior, while the committee recognizes the important role of government agencies in establishing a comprehensive system of STD prevention, it believes that political constraints on such agencies may sometimes impede the development of collaborations between the public and private sectors. In addition, some potential Roundtable participants may be reluctant to join in a government-agency-led activity. To maximize the range of Roundtable private sector participants, the committee believes that ensuring that all potential Roundtable members have an opportunity to participate on an equal basis is important. The Roundtable would not have bureaucratic functions or be an administrative hurdle for agencies or the private sector, because it would not have administrative authority over government agencies or private organizations. The Roundtable's work would be determined by its participating agencies and organizations. Although the Roundtable's activities should be coordinated with the activities of the previously proposed national Campaign (e.g., through regular joint meetings and appointed liaisons), the two entities would be independent. Independence of the two entities is necessary because, in the case of the Campaign, government agency participation is likely to constrain the effectiveness of its work; in the case of the Roundtable, the participation of government agencies is critical.3 The activities of the two entities, however, must be coordinated to ensure that they are not only complementary, but synergistic.

An example of a roundtable that brought disparate agencies and organizations together toward a common, although more limited, goal was the IOM Roundtable for the Development of Drugs and Vaccines Against AIDS that operated from 1988 through 1994. The purpose of this roundtable was to identify and help resolve the impediments to the rapid availability of effective drugs and vaccines for HIV infection and AIDS. Roundtable participants included leaders from government, the pharmaceutical industry, academia, and affected communities.

Leadership is needed to establish and maintain a Roundtable on STD prevention. At the current time, there is a lack of leadership among private health care sector organizations in this area. The Department of Health and Human Services, therefore, is the logical agency for ensuring the establishment of the Roundtable because of its mission and its oversight of the major government activities and agencies involved in STD prevention. These include: the CDC (prevention services, technical assistance, and surveillance); the National Institutes of Health (biomedical and behavioral research); the Agency for Health Care Policy and


In developing this recommendation, the committee considered the advantages and disadvantages of many types of potential structures for the Campaign and the Roundtable. The committee believes that, of the options considered, the proposed structures are most likely to succeed and are practical based on the experiences of other campaigns and the roundtable cited.

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