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Lesson 2: U.S. Government (In)Action

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Lessons

  1. Lesson 1: Early AIDS History and Emerging Infectious Diseases

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    The first lesson explores how historical interpretations of AIDS changed dramatically in the first years after its identification, just as our understanding of other infectious diseases have shifted and evolved over time. Close

  2. Lesson 2: U.S. Government (In)Action

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    The second lesson focuses on analysis and interpretation of the government’s response to the AIDS epidemic following its emergence.Close

  3. Lesson 3: Visual Culture and Public Health Posters

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    The third lesson explores the subject of visual culture and the role of imagery in the history of responses to AIDS by deconstructing the various strategies used in public health posters as tools of public education designed to encourage disease prevention.Close

  4. Lesson 4: Target Populations, Harm Reduction, and Preventive Practices

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    The fourth lesson focuses on analysis of how public health officials and activists created messages designed for target populations. Close

  5. Lesson 5: Doing Science, Making Myths

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    The fifth lesson examines how and why scientists struggled to understand AIDS in the 1980s. Against the backdrop of fear and misunderstanding that permeated society, scientists’ initial findings sometimes produced unintended political consequences. Close

  6. Lesson 6: Fight Back, Fight AIDS

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    The final lesson explores how AIDS presented unprecedented challenges and opportunities for activists. The lesson pays particular attention to how activism and advocacy shaped public policy and responses to AIDS.Close

  7. About the Author

Introduction

The United States government remained largely silent in the face of the AIDS crisis in the early 1980s. Elected leaders often avoided the issue and funding requests for research and patient care went unfulfilled. In Lesson 2, students are asked to analyze and evaluate the action and inaction of the government in the decade following the emergence of AIDS. The lesson begins with a personal look back at AIDS policy failures by epidemiologist Donald P. Francis.

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The United States government remained largely silent in the face of the AIDS crisis in the early 1980s. Elected leaders often avoided the issue and funding requests for research and patient care went unfulfilled. In Lesson 2, students are asked to analyze and evaluate the action and inaction of the government in the decade following the emergence of AIDS. The lesson begins with a personal look back at AIDS policy failures by epidemiologist Donald P. Francis. Historian Daniel M. Fox then outlines the origins of what he calls a “crisis of authority” that shaped the anemic response to AIDS. Primary sources highlight the central role played by Surgeon General C. Everett Koop in developing the government’s first authoritative response, along with reactions to the controversial Surgeon General's Report on Acquired Immune Deficiency Syndrome. For additional context and insight on the relationship between the fields of public history and public policy, students may be asked to read historian Allan M. Brandt’s article on lessons from the history of sexually transmitted diseases. Students should be asked to complete the assigned readings before coming to lesson. Discussion questions may be provided to students in advance of reading. Close

Materials

Readings

  • Supplemental Readings:
    • Brandt, Allan M. “AIDS in Historical Perspective: Four Lessons from the History of Sexually Transmitted Diseases.” American Journal of Public Health, 78 (April 1988): 367-371. https://pubmed.ncbi.nlm.nih.gov/3279834/. (accessed 10/18/2021).

Discussion Questions

  1. What does successful control of any dangerous epidemic require according to Donald P. Francis? How did the agenda of the Reagan White House conflict with good public health practices? Why did the Reagan administration reject an AIDS prevention plan for the country?
  2. How and why had infectious diseases declined in importance prior to the emergence of AIDS, while chronic degenerative diseases were increasingly prioritized? What was the justification for emphasizing increased individual responsibility for health and what were its consequences? How did the unfulfilled promises of science and rising costs lead to a “crisis of authority”? How did this crisis influence actions in the areas of surveillance, research, paying treatment costs, and organizing services for persons with AIDS?
  3. How and why was Surgeon General C. Everett Koop restricted in responding to the AIDS epidemic? What are the main features of his landmark Surgeon General's Report on Acquired Immune Deficiency Syndrome? Why was the report considered so important and how and why did people respond so vociferously to it?

Supplemental Question

  1. How are the four lessons from the history of sexually transmitted diseases, identified by Allan M. Brandt, relevant in the context of the early AIDS epidemic?  Are those lessons still important to keep in mind today with HIV/AIDS or other diseases?  Consider and explain whether you agree with Brandt’s analysis and assessment.