ORIGINAL

ADDRESS
By
C. Everett Koop. M.D., Sc.D,
SURGEON GENERAL
OF THE
U.S. PuBLic HEALTH SERVICE
U.S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

CES QD

PRESENTED TO THE CONFERENCE ON
CLINICAL-PATHOLOGICAL CORRELATES OF
HUMAN IMMUNODEFICIENCY Virus (HIV) INFECTION
WASHINGTON, D.C.

FEBRUARY 26, 1988
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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETC.)

IT IS MY GREAT PLEASURE TO WELCOME YOU ALL TO THIS HISTORIC
CONFERENCE.

_T ALMOST BLUSH AT SAYING THAT, HOWEVER. HERE IT IS, ALMOST
7 YEARS SINCE THE FIRST REPORTS OF WHAT WE NOW CALL “AIDS” WERE
PUBLISHED BY THE CENTERS FOR DISEASE CONTROL. AND, AT THIS LATE
DATE, WE ARE FINALLY HOLDING THE FIRST CONFERENCE WHICH WILL
EXPLOIT THE COMBINED EXPERTISE OF CLINICIANS AND PATHOLOGISTS.
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BUT I’M AFRAID THIS INCLINATION TO BE SEPARATE AND APART

STILL PERSISTS IN MEDICINE, DESPITE ALL. THE RECENT EVIDENCE THAT
THE CONTRARY MODUS OPERANDI IS WHAT THE AMERICAN PEOPLE REALLY
NEED,

THE COUNTRY NEEDS THE COMBINED, COLLEGIAL EFFORTS OF LIFE
SCIENTISTS ACROSS THE BOARD, WE NEED THE RESULTS OF INTELLECTUAL
CROSS-STIMULATION. WE NEED MORE SERIOUS AND MORE INTENSIVE
INFORMATION SHARING.

WHAT WE DON’T NEED ARE THE OLD SEGREGATED KINGDOMS OF
SPECIALIZATION,
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AND SO I’M DELIGHTED TO BE HERE TO OPEN THIS MEETING AND TO

OFFER MY PERSONAL CONGRATULATIONS TO DR. HAROLD GINZBURG OF THE
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES AND DR.
ABE MACHER OF THE ARMED FORCES INSTITUTE OF PATHOLOGY FOR
CONCEIVING THIS IDEA AND FOR BRINGING IT TO FRUITION.

THIS IS NOT, HOWEVER, AN INTELLECTUAL EXERCISE ... OR A

BUREAUCRATIC TOUR DE FORCE ... SOMETHING TO NOD OUR HEADS OVER
AND THEN DISMISS,

 

THE PURPOSE BEHIND THIS JOINT CONFERENCE IS -- IF I MAY USE
THE PHRASE -- "DEADLY SERIOUS.”
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WE NOW HAVE A GREAT DEAL OF CLINICAL EXPERIENCE WITH AIDS --

OR, MORE PRECISELY, WITH THE HUMAN IMMUNODEFICIENCY VIRUS, OR
HIV,

WE DON’T KNOW EVERYTHING THERE IS TO KNOW ABOUT H.I.V. BY A
VERY LONG SHOT, NEVERTHELESS, THE WORLD LITERATURE IS ALREADY
BURSTING WITH CLINICAL DATA REGARDING AIDS AND AIDS-RELATED
CONDITIONS.

SIMILARLY, WE ARE AMASSING A TRULY IMPRESSIVE ARCHIVE OF
PATHOLOGICAL DATA INDICATING THE EXTENT TO WHICH THIS VIRUS
INVADES AND DESTROYS THE HUMAN MIND AND BODY,
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IT SHOULD BE CLEAR TO EVERYONE BY NOW THAT BOTH ARCHIVES OF

INFORMATION ARE ESSENTIAL FOR THE DEVELOPMENT OF MORE EFFECTIVE
THERAPIES AND OVERALL REGIMENS OF PATIENT CARE.

AND THE NEED IS URGENT. THE TOTAL COUNT SINCE 1981 OF
PERSONS REPORTED TO HAVE AIDS HAS NOW PASSED 54,000. OF THAT
NUMBER, MORE THAN 30,000 HAVE DIED -- THAT’S A RATE OF 56
PERCENT.

56 PERCENT IS BAD ENOUGH ... BUT IT’S NOT THE REAL FIGURE.
FOR EXAMPLE, OF THOSE WHO HAD THE DISEASE IN 1981, OVER 93
PERCENT HAVE DIED. AND 93 PERCENT AT THE VERY LEAST IS, TO MY
WAY OF THINKING, THE TRUE MORTALITY RATE FOR THE DISEASE OF AIDS.
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WE ARE WORKING VERY HARD AT PUBLIC EDUCATION PROGRAMS TO

ALERT PEOPLE TO THE DANGERS OF THIS DISEASE -- ESPECIALLY PEOPLE
WHO PRACTICE CERTAIN HIGH-RISK BEHAVIORS ... NEEDLE-SHARING AND
RECEPTIVE ANAL INTERCOURSE IN PARTICULAR,

BUT EVEN IF EVERYONE WE REACH WITH OUR MESSAGE SHOULD
IMMEDIATELY AND IRREVOCABLY ABANDON SUCH HIGH-RISK BEHAVIORS, WE
KNOW THAT WOULD NOT ERASE THE DISEASE FROM OUR SOCIETY.
UNFORTUNATELY, A GREAT MANY PEOPLE -- AS MANY AS A MILLION-AND-A-
HALF BY SOME ESTIMATES -- ARE INFECTED WITH THE AIDS VIRUS BUT
JUST AREN'T SHOWING ANY SYMPTOMS AS YET,
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BUT AT LEAST 60 PERCENT OF THEM WILL -- AGAIN, SOME

ESTIMATES PUT THAT FIGURE CLOSER TO 90 PERCENT -- AND, THEREFORE,
WE STILL DESPERATELY NEED THE KIND OF INTELLIGENCE, JUDGMENT, AND
SCIENTIFIC ACUMEN THAT IS PRESENT AT THIS UNIQUE CONFERENCE,

1 COULD GO ON IN THIS VEIN FOR THE REST OF THE MORNING,
BECAUSE I FEEL SO STRONGLY ABOUT THE NEED 10 FIGHT THIS DISEASE
WITH EVERYTHING WE’VE GOT. BUT I PROMISED DRS. GINZBURG AND
MACHER THAT I WOULD NOT STEAL TOO MUCH VALUABLE TIME FROM THEIR
AGENDA,
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SO I WILL CLOSE NOW WITH A SHORT LINE FROM GOETHE -- I’M

SURE YOU'VE HEARD IT BEFORE ... IT’S VERY POPULAR WITH AFTER-
DINNER SPEAKERS. BUT IT SEEMED TO BE ESPECIALLY APPROPRIATE FOR
THIS GATHERING,

THE LINE GOES LIKE THIS:

"OUR FRIENDS SHOW US WHAT WE CAN DO, OUR ENEMIES TEACH US
WHAT WE MUST DO.”

TODAY, CLINICIANS AND PATHOLOGISTS HAVE COME TOGETHER AS
FRIENDS AND AS ALLIES AND, IN THE CONTEXT OF THIS PRECEDENT-
SETTING CONFERENCE, YOU WILL SHOW EACH OTHER WHAT YOU CAN DO IN
THE FIGHT AGAINST AIDS.
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BUT AIDS IS THE ENEMY ... A PARTICULARLY BRUTAL ENEMY ...

AND AIDS TEACHES US WHAT WE MUST DO -- TOGETHER -- IF WE HOPE TO
SAVE THOUSANDS UPON THOUSANDS OF HUMAN LIVES IN THE MONTHS AND
YEARS TO COME,

 

THANK YOU... AND BEST WISHES FOR A MOST SUCCESSFUL MEETING,

Het HH