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The President's Commission on the HIV Epidemic was a commission formed by President Ronald Reagan in 1987 to investigate the AIDS pandemic. It is also known as the Watkins Commission for James D. Watkins, its chairman when the commission issued its final report in 1988.
President Reagan issued Executive Order 12601 creating the President's Commission on the HIV Epidemic on June 24, 1987. [1] [2] On June 26, he appointed Dr. W. Eugene Mayberry, CEO of the Mayo Clinic, to chair the commission. Jeff Levi, executive director of the National Gay and Lesbian Task Force objected to the appointment of someone with no experience with the disease, but others praised Mayberry's experience in both medical research and clinical services. [3] [4] Administration officials said it would resist pressure from gay rights activists to include a representative of the gay community on the commission. Gary Bauer, the assistant to the President for policy development who would soon become head of the Family Research Council, said: "I would be very surprised if an administration opposed to making appointments on the basis of race or sex would agree to make an appointment based on bedroom habits". [3] The commission was charged with producing a preliminary report in 3 months and a final report within a year. [3]
The president named the other commission members on July 23. [5] Saying AIDS needed to go "the way of smallpox and polio", President Reagan announced the appointments at the commission's first meeting. They included: [6]
At the commission's first meeting, Lilly and O'Connor, seated side by side, "chatted cordially", the New York Times reported. When the meeting ended, reporters and television cameras surrounded Lilly leaving him, he said, "shell-shocked" and "scared to death". [7] Senator Gordon Humphrey, a New Hampshire Republican, attacked Lilly's appointment, said the President "should strive at all costs to avoid sending the message to society—especially to impressionable youth—that homosexuality is simply an alternative lifestyle" and said the President should have named heterosexual experts to the commission. [7]
The commission planned visits to review activities in several localities, beginning with a two-day visit to New York City by 5 commissioners in August/September. They visited hospitals and met with volunteers, health-care providers, and representatives of gay organizations. [10]
The commission's executive director was forced to resign in September "after a power struggle and allegations of inadequate performance," wrote the New York Times, in which Mayberry yielded to the demands of some members of the commission for better staff support than they felt they were receiving. Lee said: "For whatever reason, lack of staff or whatever, things just weren't happening. With Gene Mayberry out in Rochester, Minnesota, most of the time, the commission felt we had to get a really good, high-powered, full-time person" to manage the commission staff. [5] On October 7, Mayberry and Myers quit, as did the commission's senior staff adviser for medical and research affairs, Dr. Franklin Cockerill 3d, a Mayo Clinic physician specializing in AIDS. Lilly said he was considering resigning but would wait to see who replaced the chairman and vice-chairman. The administration immediately announced the appointment of James D. Watkins, a retired admiral who had been Chief of Naval Operations. [9] The New York Times said Mayberry had been "viewed as a moderating influence on the views of other members who are considered more ideological in their approach" and that "[b]y virtually all accounts, the commission has got off to a slow start in recruiting staff and organizing for its task." Myers said that "The personalities are intense" and that "I don't feel the commission as currently constituted would be effective." [9] Comments from those familiar with the commission and its responsibilities expressed dismay at the resignations. Richard Dunne, executive secretary of GMHC, said: "The AIDS epidemic is out of control, and it seems, so is the Presidential Commission on AIDS." [9] On October 9, DeVos said that the president needed to avoid naming commissioners who were "emotionally" involved in the commission's work and that, in one newspaper's account of his statement, "some homosexuals want to 'capture the agenda'". [11]
Years later, Watkins' wife reported that Watkins told Reagan "I'm a sailor and a submariner, and I know nothing about medicine", and that Reagan replied: "You're exactly who we're looking for." [12] On October 11, Watkins announced plans to move quickly with reorganizing the commission staff. Noting that he was speaking to reporters on the day of a political march and rally in Washington, he said, "We have in Washington today one of the largest gay rights activist demonstrations that we have had—we are sensitive to them as human beings and to their issues". He continued: "We haven't done the job to date, I am sorry to say, but I feel comfortable and the other members of the commission feel comfortable that I can take it and mold them together and bring all of our prima donnas, including me, into a nice, neat, unified package." [11] He named a new executive director on October 13. [13]
Without Bauer's approval, Watkins later added two commission members who had track records as critics of the Reagan administration: Kristine Gebbie, Oregon public health commissioner and president of the AIDS Task Force of the American Society of State and Territorial Health Officers and Dr. Benny J. Primm, director of a New York City treatment program for addicts. Primm was the only African American on the commission and the only one with expertise on the intravenous drug use. [14] Of the challenge of heading the commission, Watkins later said: "I really wasn't sure I could pull it out of the swamp." [14]
In February 1988, the commission released an interim report focused on IV drugs that called for a $20-billion, 10-year effort to fight AIDS. Watkins described it as "only seven-tenths of a percent of the defense budget." [14] William B. Rubenstein, an attorney with the American Civil Liberties Union (ACLU) who earlier sued the commission anticipating that its membership would bias its findings, found Watkins' work "a pleasant surprise". [14]
On June 2, 1988, Watkins described the commission's draft report and called for state and federal laws to provide anti-discrimination protection for AIDS patients. He called that discrimination "the rule, not the exception." He explained that testing and the identification of sexual partners could not be successful without such protections against discrimination: "So, once those with HIV are treated like anyone else with a disability, then we will find that what is best for the individual is also best for the public health." He said "Semen, blood, and ignorance surround this epidemic, and we were in that last category" when starting work. [15]
In an initial review, Dr. Mathilde Krim, founder of the American Foundation for AIDS Research thought the commission's work both more expert than she expected and free of ideology. [15] Tim Sweeney, executive director of GMHC call the draft report "courageous, aggressive and compassionate" and added: "We challenge the President, Congress and presidential candidates to respond to this report by implementing its recommendations". [15] The American Public Health Association called it "an aggressive first step towards developing an integrated national strategy to deal with the AIDS epidemic." [15]
The commission produced its final report on June 24, 1988. The commissioners approved it by a vote of 7 to 6. Its recommendations surprised observers by arguing against every measure advocated by conservative observers, such as mandatory testing, and characterizing partner notification as an inappropriate activity for medical professionals. [16] Its principal findings and recommendations were designed to provide a national strategy for managing the epidemic. It made more than 500 recommendations, which it summarized under these headings: [17]
Vice President George Bush, who was running for President at the time, immediately endorsed both an executive order and legislation to meet the commission's call for the extension of Federal anti-discrimination protection to those with AIDS and those who test positive for HIV. He emphasized children in his discussions with reporters: "My conscience has been advising me on AIDS.... I'd hate it if a kid of mine got a blood transfusion and my grandson had AIDS and the community discriminated against that child, that innocent child". Reagan said his drug policy advisor would review the report and make recommendations to him in 30 days. [18] President Reagan later said he opposed such discrimination in principle but took no action before his term as president ended in January 1989. [19] The administration took small steps. It acted to inform recipients of blood transfusions that they were at risk, made plans to speed FDA drug approvals, and developed proposals to add facilities for the Centers for Disease Control and the National Institutes of Health. [20]
Dr. Anthony Fauci later described the significance of Watkins' military background to the debate over the nation's response to AIDS: "To have a presidential commission chairman with his background to come out so strongly against stigma and discrimination was a very, very important step". [12] Randy Shilts called the report "a sweeping battle plan.... AIDS was war, Watkins reasoned, and in a war somebody must be in charge; that's how you get things done." [21]
Congress passed legislation sponsored by Representative Roy Rowland, a Georgia Democrat and the only physician in Congress, that created the National Commission on AIDS. The legislation specified that commission's members must be "individuals with experience and/or expertise pertinent to the AIDS epidemic". It produced several reports over the next 4 years. [22]
Ryan Wayne White was an American teenager from Kokomo, Indiana, who became a national poster child for HIV/AIDS in the United States after his school barred him from attending classes following a diagnosis of AIDS.
The AIDS epidemic, caused by HIV, found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.
John Joseph O'Connor was an American prelate of the Catholic Church. He served as Archbishop of New York from 1984 until his death in 2000, and was made a cardinal in 1985. He previously served as a U.S. Navy chaplain (1952–1979, including four years as Chief, auxiliary bishop of the Military Vicariate of the United States, and Bishop of Scranton in Pennsylvania.
The GMHC is a New York City–based non-profit, volunteer-supported and community-based AIDS service organization whose mission statement is to "end the AIDS epidemic and uplift the lives of all affected."
Sir Peter Karel, Baron Piot, is a Belgian-British microbiologist known for his research into Ebola and AIDS.
The Presidential Advisory Council on HIV/AIDS (PACHA) advises the White House and the Secretary of Health and Human Services on the US government's response to the AIDS epidemic. The commission was formed by President Bill Clinton in 1995 and each president since has renewed the council's charter.
James David Watkins was a United States Navy admiral and former Chief of Naval Operations who served as the United States Secretary of Energy during the George H. W. Bush administration, also chairing U.S. government commissions on HIV/AIDS and ocean policy. Watkins also served on the boards of various companies and other nongovernmental organizations and as the co-chair of the Joint Ocean Commission Initiative.
This is a timeline of HIV/AIDS, including cases before 1980.
AIDS is caused by a human immunodeficiency virus (HIV), which originated in non-human primates in Central and West Africa. While various sub-groups of the virus acquired human infectivity at different times, the present pandemic had its origins in the emergence of one specific strain – HIV-1 subgroup M – in Léopoldville in the Belgian Congo in the 1920s.
Gordon John Humphrey is an American politician from New Hampshire who served two terms in the U.S. Senate as a Republican from 1979 to 1990, and twice ran for Governor of New Hampshire, though both bids were unsuccessful.
And the Band Played On is a 1993 American television film docudrama directed by Roger Spottiswoode. The teleplay by Arnold Schulman is based on the best-selling 1987 non-fiction book And the Band Played On: Politics, People, and the AIDS Epidemic by Randy Shilts, and is noteworthy for featuring both a vast historical scope, as well as an exceptionally sprawling cast.
The New York Native was a biweekly gay newspaper published by Charles Ortleb in New York City from December 1980 until January 13, 1997. It was the only gay paper in New York City during the early part of the AIDS epidemic, and pioneered reporting on AIDS when most others ignored it. The paper subsequently became known for attacking the scientific understanding of HIV as the cause of AIDS and endorsing HIV/AIDS denialism.
Initial events and trends in the discussion of HIV and AIDS in mass media contributed to the stigma and discrimination against those affected with the disease. Later discussion, sometimes led by HIV+ individuals themselves, moved toward advocacy and education on disease prevention and management. The UNESCO report on Journalism Education says, "Well researched television content can create public awareness about HIV prevention, treatment, care and support can potentially influence the development and implementation of relevant policies."
The U.S. National Commission on AIDS was established by a statute enacted November 4, 1988, with the aim of "promoting the development of a national consensus on policy concerning acquired immune deficiency syndrome [AIDS]". It produced several reports over the next 4 years.
AIDS amendments of 1988, better known as the Health Omnibus Programs Extension (HOPE) Act of 1988, is a United States statute amending the Public Health Service Act. The Acquired Immune Deficiency Syndrome amendments were compiled as Title II - Programs with Respect to Acquired Immune Deficiency Syndrome within the HOPE Act of 1988. The Title II Act appropriated federal funding for Acquired Immune Deficiency Syndrome (AIDS) education, prevention, research, and testing. The U.S. legislative title provisioned the establishment of the presidentially appointed National Commission on AIDS. The S. 2889 legislation was passed by the 100th U.S. Congressional session and signed by President Ronald Reagan on November 4, 1988.
New York City was affected by the AIDS epidemic of the 1980s more than any other U.S. city. The AIDS epidemic has been and continues to be highly localized due to a number of complex socio-cultural factors that affect the interaction of the populous communities that inhabit New York.
Beny Jene Primm was a prominent American physician, HIV/AIDS researcher, lecturer and advocate for public health policy reform.
Burton James Lee III was a physician and oncologist who is best known for having been Physician to the President under President George H. W. Bush and (briefly) Bill Clinton. He also served on the President's Commission on the HIV Epidemic.
Social and political activism to raise awareness about HIV/AIDS, as well as to raise funds for effective treatment and care of people with AIDS (PWAs), has taken place in multiple nations across the world since the 1980s. As a disease that began in marginalized populations, efforts to mobilize funding, treatment, and fight discrimination have largely been dependent on the work of grassroots organizers directly confronting public health organizations as well as politicians, drug companies, and other institutions.
Barry Gingell was an American internist, nutritionist, computer scientist and AIDS activist. He served as a medical director for the Gay Men's Health Crisis and an advocate for experimental drugs during the AIDS epidemic in the 1980s.