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Former Surgeon General Koop Calls AIDS ‘Forgotten Epidemic’

December 1 is the 23rd annual World AIDS Day, and to mark the occasion the NewsHour’s Ray Suarez spoke with former Surgeon General of the United States C. Everett Koop.

Koop was appointed to the position of America’s doctor in 1981, just as HIV was emerging as a public health threat in this country. He became the government’s chief spokesperson on the disease during his eight years as surgeon general, and continues to educate the public about health issues today.

He spoke with Suarez for the first intallment of our new online interview series on global health issues, the Check Up. Read excerpts below, or listen to the interview here:

Ray Suarez: Looking back on three decades of the progress of what we now know is HIV, how would you say America is handling this disease?

C. Everett Koop: Well, it’s a story that is dynamic. We were criticized very much in the early days for what they called foot dragging, and that really wasn’t true because we learned as much about AIDS in six years as it took us 40 years to learn about polio. So we really made progress, we found the virus, we named it, we renamed it, we discovered a test that picked up the antibodies of the virus of HIV, and we really made progress.

The difficulty in that whole story really culminates in today. AIDS has become in the United States the forgotten epidemic. In the beginning, when people were scared to death that a dirty typewriter, or a toilet seat or a faucet in a men’s room would give you AIDS, they were all alert to the various ways it could and could not be transmitted.

Today is new business…today 60 million plus people have been infected in the past 30 years, and approximately 30 million of them are still alive. The next thing that is important to know is that nearly one half of the new HIV infections worldwide are in the reproductive age and heterosexual intercourse is responsible for most of these infections. Now that’s quite different than we would have told you in 1982, 83 and 84, and we’ve gotten to take a sort of relaxed attitude. And the significance of AIDS Day to me is that you never, never, never can stop teaching about AIDS.

Suarez: I remember very well your years as surgeon general because I was working as a reporter in three of the epicenters of the infection in the United States—New York, Los Angeles and Chicago, and I remember both the Manhattan-project style operation that wastaken to isolate the virus, and understand what we were dealing with, and your own attempts to get people to speak frankly and honestly and openly about how it was spread. It seems like we’ve come a long way…

Koop: I think the Pope’s statement is a very wonderful step in the right direction. He has said that at times use of a condom is less objectionable than somebody getting AIDS. Now that is the door opening. I think we’ll have a much better chance in the future than we’ve had in the past because the Catholic Church has always been opposed to condoms because they are associated with contraception. But here’s a pope coming out and saying its better to use a condom than to get AIDS and that’s absolutely true.

Suarez: With the discovery of antiretroviral medications, for many people who are infected, they are managing a chronic condition rather than facing a death sentence. How has this changed the way with think about HIV and AIDS?

Koop: As soon as you have a way of curing something, it fits the American way of life, we are fixers. And if you have medication for something you consider that you have beaten the enemy, which is death. Back in 1982 if you got AIDS your chances of living two years were very slim, your chances of living three years were practically nil, and then we had the antivirals come along and now if you take your medicineon the right day, at the right time and in the right amount you can have a life expectancy just as long as you would have had if you hadn’t caught AIDS.

Now that is absolutely remarkable, and because that exists it doesn’t seem as threatening to the average individual. But who knows who is positive and who is negative, and that is what the message has to be—everyone is positive until proven otherwise.

Suarez: Can you take me back to the early 1980s and the internal struggles you had inside the Reagan administration. Were there cultural conflicts in those early days when people were deciding what the government should say to Americans?

Koop: Oh very much so, I was taken out of the loop as far as AIDS was concerned and I was out for three years and I never knew why, I don’t know until this day why. But I do know—I’m not speaking of President Reagan himself now, but I’m speaking of his cabinet, especially the domestic policy part of his cabinet. They felt, well the question was this “Who get’s AIDS? Well promiscuous people, gay people and drug abusers. Don’t they really deserve what they get?” That was the official quiet attitude of the cabinet and to work against that was an unbelievable story. It was barrier after barrier after barrier, and when I look back at it the big miracle is that we got as far as we did with the opposition that we had.

Suarez: Well Dr. Koop thank you for your service to this country and great to talk to you.

Koop: Thank you. I enjoyed it all.

Suarez: C. Everett Koop was the surgeon general of the United States during the earliest days of the epidemic in the United States. Thanks to all of our listeners for tuning in. For the NewsHour Check Up, I’m Ray Suarez.

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