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PASSAGES Former U.S. Surgeon General Koop dies

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1980s-era U.S. Surgeon General Dr. C. Everett Koop, 96, who was one of the few voices of reason during the start of the AIDS epidemic, died Feb. 25.

Koop, a pediatric surgeon by training, was appointed to his national post by President Reagan in November 1981 and served until October 1989.

In the 2009 book Infectious Ideas: U.S. Political Responses to the AIDS Crisis (University of North Carolina Press), Jennifer Brier, UIC assistant professor of gender and women's studies and history, wrote how the AIDS crisis, in the face of the expanding New Right, influenced American political matters involving health care and foreign policy, reproductive health, gay and lesbian rights and racial justice.

Brier wrote that AIDS divided conservatives. One example was between Koop and Gary Bauer, who served as under secretary of education, and later, as chief domestic policy adviser for President Reagan. Brier said the conservatives fought over the role of testing for HIV, the promotion of condom use, and the need for conversations about sexual practices as the best way to change people's behavior. "While Koop was never entirely successful in implementing policies that acknowledged people's sexuality, Bauer was equally stymied when trying to enact AIDS policies that were driven by his strict definition of morality," she said.

"The disagreement among administration conservatives became even more visible as the Reagan administration entered the global AIDS arena in the late 1980s," Brier writes.

On March 31, 2011, Koop published his own memories of the era in The Annals of the Forum for Collaborative HIV Research. Koop's paper, "The Early Days of AIDS, As I Remember Them", was based on what he described as his "last major address" on HIV/AIDS, which was presented in Washington Nov. 18, 2010 before 350 HIV researchers, healthcare providers, policymakers and advocates attending the 2010 National Summit on HIV Diagnosis, Prevention and Access to Care.

With a foreword from Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), Koop's personal account chronicles the very real challenges facing the public health community at the beginning of the AIDS crisis and presents a candid assessment of how a small number of cases mushroomed into the AIDS epidemic of the late 1980s.

Koop's paper chronicled the developments and controversies that marked the early AIDS crisis from 1981 to 1989, which he referred to as two "phases of America and AIDS." Starting with the "the first phase of America and AIDS"—from 1981 until the release of the Surgeon General's Report on Acquired Immune Deficiency Syndrome in October 1986—Dr. Koop describes a climate "marked by mystery, fear, suspicion, judgment and the unknown" when political leaders attempted to quarantine AIDS patients in San Francisco and New York City and to deny these individuals housing, employment and even access to public schools. "As a result, our first public health priority—that is, to stop further transmission of the AIDS virus—became needlessly mired in the homosexual politics of the early 1980s," Dr. Koop wrote.

Human Rights Campaign President Chad Griffin released the following statement: "As HIV/AIDS was growing into a public health crisis, Dr. Koop was a lone voice for aggressive, comprehensive intervention to curb the disease. Motivated by 'scientific integrity and Christian compassion,' Koop was a hero at a moment when a hero was desperately needed. All Americans should be grateful for Dr. Koop's service to our country, and our thoughts and prayers are with his family and friends."

See more details on Koop's article here: . Koop's paper is available online at .

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