Medicine: The Appalling Saga of Patient Zero

A stunning book traces the mishandling of the AIDS epidemic

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As if to reinforce that judgment, the Reagan Administration demonstrated on two fronts last week how political agendas still burden AIDS policy. Secretary of Education William Bennett disseminated his department's first major recommendations on how to educate young people to avoid the disease. Bennett's 28-page pamphlet, cleared by the White House, is a model of moralizing and seems mainly to be meant as a challenge to Surgeon General C. Everett Koop, an advocate of bluntly practical counsel. Bennett's booklet suggests that schools and parents "teach restraint as a virtue," downplays the use of condoms in sex and does not even mention the importance of clean needles if injecting drugs. Critics condemned Bennett's emphasis on abstinence, noting that by 17, almost half of all boys and nearly a third of girls have had intercourse. Said Congressman Ted Weiss, a Manhattan Democrat: "It's totally out of touch with reality."

The more troubling event was a pair of resignations from President Reagan's advisory commission on AIDS two months before that body was to issue its first report on the "medical, legal, ethical, social and economic impact" of the disease. Since its appointment in July, the 13-member commission has been beset by factional squabbling and accusations that it is heavy on conservatives and light on expertise. The last shortcoming was only intensified by the departures of its chairman, Dr. W. Eugene Mayberry, chief executive of the Mayo Clinic, and its vice chairman, Dr. Woodrow Myers Jr., Indiana's health commissioner. Said Myers: "We did not receive the full degree of support from the Administration." The new chairman is not a medical scientist but retired Admiral James Watkins.

Turmoil in federal AIDS policymaking is anything but new, according to Shilts. His book quotes extensively from internal memos at CDC and the Department of Health and Human Services to show that the very officials who testified before Congress that research scientists had all the money they needed to pursue the disease were privately arguing just the opposite. He quotes a May 13, 1983, note from Assistant Secretary for Health Edward Brandt seeking new funds. "It has now reached the point," the memo reads, "where important AIDS work cannot be undertaken because of the lack of available resources . . . ((which)) will have a detrimental effect on CDC's important prevention programs." The memo, Shilts adds, was written just four days after Brandt testified before a House subcommittee that emergency funding was "unnecessary."

Shilts contends that as part of the Administration's efforts to distract attention from its inadequate financing and poor leadership, the U.S. Government "brazenly" conspired to steal credit for discovering the AIDS virus from researchers at France's Pasteur Institute. He dismisses as a myth the competing claim of Robert Gallo of the National Cancer Institute and, quoting U.S. researchers, strongly implies that Gallo stole the French strain and presented it as his own, a charge Gallo denies. Shilts labels as a "pleasant fiction" a 1987 U.S.-French political accord that settled lawsuits and deemed Gallo and France's Dr. Luc Montagnier "co-discoverers" of the virus.

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