AIDS lecture July 11, 1987
Address by C. Everett Koop, MD, ScD
Surgeon General of the U.S. Public Health Service and Deputy Assistant Secretary of Health
U.S. Department of Health and Human Services
Presented at the Gold Medallion Book Awards Banquet of the Evangelical Christian Publisher's Association
Anaheim, California
July 11, 1987
It was three days since I last spoke about AIDS to NAACP in New York.
At the time I delivered this address the definition of Evangelical Christian was a little tighter than it now is and I acknowledged to the members of this organization that I was myself, an Evangelical Christian, and I thanked the audience for maintaining a place for Christian publications in our society. I didn't know much about their business, but I couldn't believe that it was easy.
I wondered out loud why in this wonderful country of ours, it was so terribly hard to be good and to do good. I told them I knew there was a message there and it had to do with need of investing oneself to feel the joy and to feel the hurt when carrying out acts of love and charity and of peace and of justice.
I was speaking this audience's language when I said to live as salt and light remained a great challenge for a Christian in our society. In public life the commitment to decency was under the constant siege of powerful and negative forces in our culture:
Television shows that glamorize violence . . .
Motion pictures that brutalize the act of love . . .
Newspapers that sensationalize human pain and sorrow . . .
And book publishers that scandalize the human spirit.
I acknowledged that I knew they were better than that, and thanked them on behalf of myself and millions of others just like me. I looked forward to the day when I would be a plain citizen once more having hung my uniform up in the closet for good and said I would spend some time getting reacquainted with my good friends in the Evangelical movement -- friends who had shown me infinite love and patience through these two terms as Surgeon General.
Had I written this a little later in my second term, I would have been more guarded in those comments, because in the long run a great many people of faith never understood what I was trying to do as the Surgeon General to prevent the spread of AIDS and I was certainly misunderstood when President Reagan asked me to write a report on the effects of abortion on women -- a misguided effort to focus on women instead of the fetus.
Nevertheless, I reminded them of the fact that we stood together on "Baby Doe" in most instances, we confronted the issue of pornography together, I acknowledged that I was no stranger to controversy, but I had been blessed with good friends, good colleagues, and a good strong faith and I needed all three.
I finally got around to the issue of AIDS, which was what I had gone for and presented it in four general categories.
First, I talked about the mysterious virus, how it was named, noted that we had to move forward conservatively and carefully, making some necessary adjustments, but not putting our fundamental values at risk. I reaffirmed my belief that science, especially scientific inquiry in a free society like ours would eventually get us out of this AIDS mess. But I added that with this disease, like no other, science and morality walked hand-in-hand and side-by-side to the containment of the epidemic.
Second, I reminded them again that AIDS was a contagious disease and that it was growing, reporting 10,000 new cases in a year which had ended on June 1, 1986 and 15,000 new cases in the year ending June 1, 1987. I pointed out conservatively that in the ten-year future history of this disease, a quarter of a million people would have contracted AIDS.
My third point was that the disease of AIDS was spreading geographically having at first been seen almost exclusively in the populations most at risk, primarily homosexual and bisexual men in San Francisco, Los Angeles, and New York City. But at the time of this lecture 19 major cities had each reported more than 300 cases since 1981. This disease was not longer someone else's problem; it was now everyone's problem. It's also a "world class" disease with World Health Organization having reported 50,000 cases from 113 countries including Iceland, Paraguay, and the Bahamas. That was the first time I called it this a "world class" disease and gave those statistics.  It was also the first time that I said that in some Central African countries as many as 11 per cent of the population were infected with the virus. I noted that villages were decimated and exposed my fear that in the next decade and a half, there would be, not a sufficient number of young, educated, men and women to run the government, the factories, and the business of those developing countries.
The fourth and final point was that the disease of AIDS was considered to be 100 per cent fatal -- the fundamental reason we were so worried about it. That statement, of course, was before our present knowledge of the containment of AIDS -- not cure -- with pharmaceutical cocktails, but at this particular time, the message was that it didn't matter who had it and how they got it, we couldn't overlook the fact that people died from it.
With those four pillars out of the way, I discussed the transmission of AIDS rather explicitly and then because of the audience I was addressing, I made it clear that I did not condone intravenous drug abuse and flatly opposed the kind of sexual promiscuity -- among men and women -- that endangered any persons physical, mental, emotional, or spiritual health.
I told them I thought that kind of behavior was wrong -- wrong on public health grounds and wrong on moral grounds.
However, I was not the Chaplain of the American people, I was their Surgeon General -- also it was the first time I had said that. It was my job to wage all-out war on that disease . . . and not against people. My concern was to stop the chain of transmission in the most effective way possible, consistent with our laws and traditions.
The actual closing pages of this speech cannot be found.
"A closed mouth gathers no feet."
Advantages of scientific inquiry
"Baby Doe"
Blood and semen in the transmission of AIDS
Books publishers that scandalize the human spirit
Cause of AIDS
Chaplain of the American people is not the Surgeon General
Contagion of AIDS
Current figures on AIDS
Endangerment of physical, mental, emotional and spiritual health
Fatality of AIDS
Geographic spread of AIDS
Global figures on AIDS
Heterosexual transmission of AIDS
Identifications with this group of Evangelical Booksellers
Intravenous drug abuse and AIDS
Motion picture that brutalize the act of love
Mystery of AIDS
Newspapers that sensationalize human pain and sorrow
Plight of central African countries due to health organization statistics
Pornography in American life
Powerful and negative forces in our culture
Science and morality as partners in the containment of AIDS
Television shows that glamorize violence to decency