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The C. Everett Koop Papers

"Statement by C. Everett Koop, MD, Surgeon General, U.S. Public Health Service, Washington, DC" [Reminiscence] pdf (263,331 Bytes) transcript of pdf
"Statement by C. Everett Koop, MD, Surgeon General, U.S. Public Health Service, Washington, DC" [Reminiscence]
AIDS Statement Wed. October 22, 1986
Number of Image Pages:
3 (263,331 Bytes)
Koop, C. Everett
Reproduced with permission of C. Everett Koop.
Medical Subject Headings (MeSH):
Acquired Immunodeficiency Syndrome
Exhibit Category:
AIDS, the Surgeon General, and the Politics of Public Health
Metadata Record Surgeon General's Report on Acquired Immune Deficiency Syndrome [1986] (in The Reports of the Surgeon General) pdf (2,077,499 Bytes) ocr (45,581 Bytes)
Metadata Record "Surgeon General's Report on Acquired Immune Deficiency Syndrome" (Front cover) [October 1986] jpg (182,026 Bytes)
Metadata Record "Surgeon General's Report on Acquired Immune Deficiency Syndrome" (Back cover) [October 1986] jpg (171,001 Bytes)
Metadata Record Surgeon General's Report on Acquired Immune Deficiency Syndrome [October 1986] pdf (1,861,872 Bytes) ocr (44,773 Bytes)
Metadata Record Statement by C. Everett Koop, MD, Surgeon General, U.S. Public Health Service (October 22, 1986) pdf (655,924 Bytes) ocr (11,346 Bytes)
Metadata Record "Statement by C. Everett Koop, MD, Surgeon General, U.S. Public Health Service, Washington, DC" [Reminiscence of the Press Conference] (2003) pdf (120,667 Bytes) transcript of pdf
Box Number: 54a
Folder Number: 3
Unique Identifier:
Document Type:
Physical Condition:
Series: Sequential Files
SubSeries: October 1986
Folder: Surgeon General's Report on Acquired Immune Deficiency Syndrome, Oct. 1986
Statement by C. Everett Koop, MD, ScD
Surgeon General
U.S. Public Health Service
Wednesday, October 22, 1986
Washington, DC
The user should not begin to read this unique archive on AIDS -- Acquired Immunodeficiency Syndrome -- without having listened to or read my comments designed to be an introduction to this entire AIDS archive.
As, has already been made clear, AIDS was a strange disease with unbelievable political overtones. This most mysterious epidemic of the 20th century in the United States, and worldwide, was ushered in by a report in MMWR and a concomitant staff meeting of the United States Public Health Service in June of 1981. Yet, I am presenting the basic elemental facts of AIDS to a press conference 64 months after that first report. That fact in itself is a measure of the reluctance of the administration to come to grips with AIDS and it was compounded by the fact that, for reasons unknown to me, in the internal planning of HHS and the Public Health Service at the level of the Assistant Secretary for Health, I was never informed why the Surgeon General was not to discuss AIDS at any public forum. In retrospect, any fool would know that if there were ever a disease that needed the communication of a Surgeon General, especially one already proven to be reliable and accepted by the public, it was AIDS.
With the departure of many political appointees toward the end of the first Reagan term and as the second term approached, there were many unfilled posts in the Public Health Service, which I stepped into because of the existing vacuum because there was no one to tell me not to. Even though this statement was made to the press in October of 1986, I didn't assume the role of chief spokesperson for AIDS until January 1987, at which time I went into high gear and in addition to innumerable radio and television appearances, the preparation of documentary films, within two years I had delivered well over one hundred lectures in every conceivable forum. This does not include the constant pressure on me as chief delegate to the World Health Assembly each year and in my role as Director of International Health for the Public Health Service and as a member of the House of Delegates to the American Medical Associated to be a resource person for AIDS information.
This is not to say that scientists such as Fauci and Gallo and their associates were not saying things when asked by the media, but there was no planned agenda other than my own. It should be made clear that this undertaking to bring AIDS to the attention of the public was not discussed at staff meetings of the Public Health Service, nor with those superior to me in the chain of command. It would be fair to say that except for the Public Affairs Department for the Public Health Service and my speechwriter, Ted Cron, all of the work emanated from a very narrow authority.
I began this presentation by going back to the report that I had prepared for the American people at the request of President Reagan in February 1986. Then with references to specific details made available in the press kit, I described the preparation of that document. I discussed the people with whom I had consulted, referred to the controversial and sensitive issues inherent in the report, gave the statistics of 15,000 Americans already dead from the disease and the projection of a 12-fold increase only live years hence.
I mentioned the lack of a vaccine or pharmaceutical cure and estimated that one and a half million were now infected with the virus. The majority of these were a-symptomatic but able to spread the disease.
What we knew of the epidemiology of the disease was then explained not only how it was transmitted, but also particularly how it was not transmitted. This permitted us a segue into the highly emotional and often irrational responses of not only the public, but also parts of the health professions to the mounting knowledge of AIDS.
Prevention by education was stressed, but not without pointing out the difficulties of communicating this sensitive material with all of its sexual overtones through the usual educational methods and channels. I pointed out the need for special concerns in reference to Afro-Americans and Hispanics. I pointed out the discrepancies in their infection rates compared to their partition in the American population.
I decried that our youth were not receiving the information so vital to health and well-being because of reticence in dealing with the subject of sex, sexual practices and for this particular disease homosexuality and its practices. I stated flat-footedly something the public was to hear from me, literally thousands of times - education about AIDS should be started as early an age as possible so the children would grow up knowing the behaviors to avoid to protect themselves from exposure to the virus. Statistics were mentioned: 47 million students attend 90,000 elementary and secondary schools in the nation. The schools could, but do not provide sex education, and I, of course, pointed out the fact that parents objected to such education, but did not fill in the gap themselves.
In reference to the information that adults had to know before they could inform children, I was extraordinarily explicit about the methods of transmission and the ways to prevent it. The public was already confused about mandatory blood testing for AIDS, now that it was possible to check for antibodies to the virus. AIDS, up until this time, had never been treated the way an infectious disease usually is with testing of contacts and widespread follow-up. The concern of many in the public health field was that because of the secrecy involved in many homosexual liaisons, it was thought probable that mandatory testing would drive underground the very people we were trying to reach most. I indicated that quarantine played no role in the control of the disease and the compulsory blood testing was unnecessary, not feasible, and cost prohibitive. This required an explanation of the false security that might be engendered by the presence of a negative test for the antibodies to the virus due to the latency of antibody appearance after exposure.
In closing, I referred back to the specifics of the report I had prepared, talked of the vigorous research into drug therapy and vaccine development that was necessary, and even mentioned the drug azidothymidine - AZT - formally an anti-cancer drug, now known to be beneficial to those afflicted with AIDS.
I showed a public service announcement being released that day concerning the Surgeon General's report, referred the press to the press kit with information about obtaining the written report, a copy of which follows this press statement.
Because of the nature of this presentation, and the essential nature of every sentence therein, no index is given.
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