Remarks Presented to the Institute of Medicine, Washington, DC
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1987-11-16 (November 16, 1987)
Koop, C. Everett
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AIDS, the Surgeon General, and the Politics of Public Health
"Remarks Presented to the Institute of Medicine, Washington, DC" [Reminiscence] (2003)
By C. Everett Koop, M.D., ScD.
Surgeon General of the U.S. Public Health Service
Presented to the Institute of Medicine
November 16, 1987
Institute of Medicine
Thanks to Sam Their and the Council of the Institute of Medicine for the opportunity to speak to you briefly on the subject
The AIDS experience has shown me the full potential of cooperative ventures between the Public Health Service and the IOM.
The interesting thing about it is that you financed "Confronting AIDS" yourself. That is a a dangerous precedent.
Seriously, the combination of the IOM report on AIDS and the Surgeon General's report on AIDS had a major impact on getting
AIDS into the open so that it could be discussed frankly with the full force of the scientific and medical community behind
Since that time Dr. Baltimore, Dr. Wolff and I have become T.V. stars and have brought the AIDS message to the American people
via a very supportive media.
That wouldn't have been possible without the close working relationship between my office and the IOM.
In the report IOM called for large growth in federal research support to prevent HIV infection and to treat the diseases caused
by it. You also called for major prevention programs.
It is difficult to know exactly how Gramm-Rudman-Hollings Act impact AIDS funding. Currently it looks like an 8 1/2% decrease
across the board to find at least $23 billion to cut government wide.
However, the "Economic Summit" could cut up to $30 billion in a less even fashion.
The good news is that current proposals for AIDS research and prevention are high enough that Gramm-Rudman will not substantially
alter our course. Unless the "freeze mechanism is used that approach would be a disaster to expanding programs like AIDS.
For FY 1988 - The President's budget for AIDS (less FDA) is $791 million, the House mark is $970 million and the Senate
The President's budget is an increase over 1987 of $200 million for research and $120 million for education and information.
The House and Senate marks are $77 million and $88 million more for research respectively.
It is very very clear that we have the financial backing we need.
Our responsibility as administrators of research programs is to insure the best use of these funds and fund only quality
I find that most of my time is taken up by AIDS and that gives me some concerns given its relative importance in public health.
For example AIDS has claimed about 26,000 lives since 1981. Cigarette smoking will claim over 330,000 lives this year alone.
It is up to us as public health leaders to take the public interest and funding and apply them more broadly to the whole area
We must encourage basic research in the social sciences to learn more about human behavior and how to influence it, especially
in the areas of risk and assessment of relative risk.
Just as AIDS biomedical research can expand our knowledge of virology, AIDS social science research can expand our knowledge
on how to reduce preventable morbidity and mortality.
The public is really behind us on this one. We mustn't let them down.