AIDS Lecture March 6, 1987
Address
By C. Everett Koop, MD, ScD
Presented to the Joint Session on AIDS
Of the California Legislature
Sacramento, California
March 6, 1987

This speech was delivered sixteen days after the last speech I made on AIDS and ranks in
importance with perhaps the top three lectures on this subject given to representatives of
governing bodies. In addition to testimony before the Senate and the House of
Representatives of the United States Congress, I had the privilege of speaking to the Joint
Session of Legislators in Texas and in California and then addressed the United Nations
General Assembly on the same subject. This was the address given before the California
Legislature.

 

On this occasion I really had to note that Californians was the first of our citizens to be
identified as being the victim of AIDS back in June of 1981. They were the first to die of
the disease and before the rest of the country knew about or truly understood the nature of
this catastrophe, the people of California were already beginning to bury their dead.

The history of the development of AIDS and our knowledge of what to do about it was
then presented step-by-step before I recognized the leadership of the Legislature of the
State of California and its governor, George Deukmejian. California was the first state to
establish mandatory reporting of the disease and a statewide registry of cases. Within the
week of the approval of the blood tests for AIDS (antibodies to the virus) California had
its own emergency regulations in place to protect the blood supply. California was also
very careful to build into the law a respect for confidentiality and an understanding of the
overwhelming burden it could be for a person to learn that he or she has AIDS and will
soon die.

I raised the question of the number of babies born with AIDS, and noted that according to
the best of our understanding, that some of them will die within the first year or two of
life; indeed we were already seeing that occur. But other children will carry the virus and
may not exhibit any symptoms of an AIDS-related disease until they are well into their
school years.

It was appropriate before a legislative body to try to put the costs into dollars and cents
on the table. I noted that the federal contribution that year would be $416 million with
about $300 million of that in research, $100 million for public education and $10 million
for patient care. I also noted that California by itself had spent nearly half the total
dollars expended by all state governments on AIDS since 1983 — some $56 million so far,
apportioned among patient care, public information, and research. | then gave the
prediction of the experts that by 1991, the total national bill for caring for AIDS would be
$16 billion a hear, or twice what we were spending that current year to support all the
programs of the entire U.S. Public Health Service. I warned that AIDS related conditions
)ARCs) such as pneumonia and cancer would increase (the term ACRs fell into eventual
disease). It didn’t seem out of place to philosophize a little about how we could live so
that we may be a humane and civilized people, noting that it was difficult to imagine this
country ever becoming financially bankrupt, but our society — like every other society in
human history — always runs the risk of becoming morally and ethically bankrupt. This
we must never let happen.

Inasmuch as sex education and my comments about it continued to rile the American
public, I had been spending more and more time in my lectures talking about the
justification for AIDS education. In my report to the American people released on
October 22, 1986, I had said: “‘ Education about AIDS should start in early elementary
school and at home so that children could grow up knowing the behavior to avoid to
protect themselves from exposure to the AIDS virus. The threat of AIDS can provide an
opportunity for parents to instill in their children their own moral and ethical standards.”

People were unduly alarmed by that phrase, “Early elementary school” and the first thing
they asked was, “Does that mean kindergarten?” To that my answer was, “I’m afraid so.”

I had concluded the aforementioned report with the quote: “Education concerning AIDS
must start at the lowest grade possible as part of any health and hygiene program...there
is now no doubt that we need sex education in schools and that it must include
information on heterosexual and homosexual relationships. The threat of AIDS should b
sufficient to permit a sex education curriculum with a heavy emphasis on prevention of
AIDS and other sexually transmitted diseases.”

I might have, if given the opportunity, taken word “early” out of the first quotation, but I
would not remove a single word from the last. I noted that California officially, through
their governor and representatives had endorsed the need to begin teaching about AIDS
no later than the 7" grade. Subsequent history of the behavior of pre-adolescence shows
that that is far too late to begin. California also had adopted, one way or another, a
curriculum with elements that introduced human sexuality and reproductive health in a
positive and caring way to children in elementary grades — generally speaking the 5" and
6" grades.

Abstinence

Age of starting AIDS education

AIDS & sensitive & affirmative human

relationships

AIDS education

“AIDS -related complex”

Babies as innocent victims of AIDS

“Baby Doe”

“Baby Fae”

Blood tests for AIDS

California’s early response to AIDS

Californians as the first to experience the

problems of AIDS
Confidentiality in reference to AIDS
Danger of moral & ethical bankruptcy

Economics of AIDS

Economic predictions

History of the development of our
knowledge of AIDS

Joint Sessions of state legislature

“Katie Beckett”

Management and prevention

Mandatory reporting of AIDS

Mutually faithful monogamy

Obligation & privilege parents have as sex
educators

Parents as sex educators

Report of the School Health Task Force for
Los Angeles

State health officers

Statewide registry of cases

Transplantation of organs

 

Christian Life Commission of the Southern
Baptist Convention

National Coalition of Black & Lesbian Gays

National Conference of Catholic Bishops

National Council of Churches

National Education Association

National PTA

Synagogue Council of America

“The Bridge of San Luis Rey”

The Washington Business Group on Health

U.S. Public Health Service