American Science’s “Odd Couple” – Dr.’s Koop and Fauci. (Part 3)

The following 5-part series is excerpted from an as yet unpublished history of 20th Century medicine in the United States by Mike Magee MD.

Part III: Sidelined – HIV Off-Limits

By 1984, as Reagan’s second term approached, Brandt was gone and Koop’s strength continued to grow. He had successfully raised esprit de corps among the 5,600-person Public Health Corps, who were now required to wear uniforms to enhance their visibility and hopefully contribute to the long term funding viability of the department. (1) But in the most pressing public health challenge of the day, HIV/AIDS, the department was AWOL. Brandt and Margaret Heckler, probably at the insistence of Reagan’s domestic policy adviser and “family values” enforcer, Gary Bauer, had assigned themselves the duty of addressing all questions on the topic. It was explicitly off-limits to Koop.(2)

Not surprisingly, the situation deteriorated rapidly. Heckler at one point suggested that AIDS was Reagan’s “number one priority” even though he had never uttered the words HIV/AIDS in public.(3) She also told the public to expect a curative vaccine in two years. That was 1984.(4) As for Brandt, when he tried to align with the increasingly vocal and activist gay community that was pressing for increased funding for research and treatments for the disease, and agreed to attend their fundraising event, conservatives made such a fuss about it that Heckler forced him to back down.(5) Soon after Brandt resigned. Everyone was feeling the heat, including the CDC, who removed funding for AIDS education after being accused of promoting sodomy by conservatives.(6)

As more and more people died – now not only gays, but also heterosexuals, hemophiliacs, drug users, newborns of infected mothers – Reagan’s silence became deafening. To relieve the pressure, in 1986, the President finally directed Koop to coordinate a report on AIDS for the American public.(7)

In October, 1986, Reagan first uttered the word, AIDS. By then, over 16,000 Americans were already dead.(8) Inside his Administration, Reagan gave voice earlier to people like Bill Bennett who discouraged providing AIDS information in schools and Gary Bauer, who Koop said, was “my nemesis in Washington because he kept me from the President. He kept me from the cabinet and he set up a wall of enmity between me and most of the people that surrounded Reagan because he believed that anybody who had AIDS ought to die with it. That was God’s punishment for them.”(9) And Bauer wasn’t the only one. Jerry Falwell declared the disease “the wrath of God upon homosexuals”. Pat Buchanan cruelly labeled the disease “nature’s revenge on gay men”.(9)And William F. Buckley suggested, in a New York Times article on March 18, 1986, that HIV-positive gay men should have the information forcibly tattooed on their buttocks.(10)

Reagan’s conversion was indirect. Elizabeth Taylor wrote he and Nancy a letter on April 10, 1987, that began, “On Sunday evening, May 31st, at 6:00 P.M., at Potomac on the River, the American Foundation for AIDS Research will host a dinner to help raise the research funds that are so desperately needed to help stop the ‘AIDS epidemic’ that threatens us all. Also, during the dinner, U.S. Surgeon General C. Everett Koop, will be honored for his leadership in educating the public on the AIDS issue. I am writing from my heart to ask if you both would attend the dinner and if you, Mr. President, would give the keynote speech.”(11) The actress felt the time had come, not only because of their friend Rock Hudson’s publicized death, but also because the latest federal budget included an 11% cut in AIDS spending compared to the prior year.(12)

On that evening, May 31, 1987, he delivered his first major address on the topic. It was six years late. 21, 000 Americans were now dead, and 36,000 more lived with a diagnosis of the disease. His prior actions could not be blamed on ignorance or lack of exposure. Koop had done his best to keep the President informed. Nor is it possible to simply say that his bias against gays was historic or “principled”. In fact, his defeat of Jimmy Carter in 1980 was achieved with active gay support in California in return for his opposition to the Jerry Falwell and Anita Bryant led antigay measures that went down in defeat in California in 1978 with his help.(13)

As the president moved into his second term, he had the full support of the Moral Majority. The doors of the White House were wide open to Christian Conservative elite. Policies were being pushed, as promised, to reinstitute traditional Judeo-Christian values.(14) All the while, a pandemic was raging, which some believed was “the hand of God at work”. And yet, there was the wild card, Koop, now self proclaimed the “Nation’s Doctor”, had evolved.(15)

Next: PART IV – “We Are Fighting Disease – Not People.”

Entire Series with References.