C. Everett Koop, the Ronald Reagan-appointed surgeon general who would go on to become a hero to AIDS activists, died yesterday in New Hampshire at the age of 96. Koop, who was both a pediatric surgeon and evangelical Christian, will be remembered for a number of things—his high-profile crusade against smoking; his role as Life Alert spokesman—but the part of his legacy that will likely last the longest is his efforts to draw attention to the then-emerging AIDS epidemic. As the New York Times reminds us, AIDS had just been discovered in the United States when Koop was awaiting confirmation in 1981, but it would soon sweep the country with more than 100 cases reported in the weeks that followed:
[Koop] said he realized later that the Reagan administration had been slow to address the disease because the election had brought to power people who were antithetical to gay people, then thought to be its only victims. As the epidemic worsened, reaching drug addicts infected with contaminated needles and hemophiliacs who had received a contaminated blood-clotting factor, Reagan, in 1986, asked Dr. Koop to prepare a special report. Dr. Koop proceeded cautiously, knowing the report would be unpopular with many in the administration, with conservatives in Congress and with church groups opposed to homosexuality. He wrote 17 drafts.
In that 1986 report Koop didn't mince words, promoting the use of condoms for safe sex and calling for sex education to begin in school as early as third grade. While Koop personally opposed homosexuality and premarital sex, he nonetheless insisted, in the words of the Associated Press, that "Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted." That explicit information about homosexuality, anal sex, condoms, and intravenous drug use was all the more noteworthy because it came at a time, as the Washington Post explains, "when almost nobody in the Reagan administration would even utter the word 'AIDS.' "
As part of his educational outreach, Koop went on to author a groundbreaking seven-page brochure, "Understanding AIDS," that provided many Americans for the first time with specific information about a disease that was poorly understood and rarely discussed. Despite some opposition from within the Reagan administration, Koop found a way to mail that pamphlet to all 107 million households in the country in 1988, making it the largest public health mailing ever. (For a little context, Magic Johnson's announcement that he had HIV wouldn't happen for three more years.)
In hindsight, that brochure may not be perfect, but it represented the best available information the country had about AIDS at the time. Perhaps most importantly, it made sure to refute the notion that it was an epidemic that only some communities had to worry about. "The male homosexual population was the first in this country to feel the effects of the disease," Koop wrote matter-of-factly. "But in spite of what you may have heard, the number of heterosexual cases is growing. People who have died of AIDS in the U.S. have been male and female, rich and poor, white, Black, Hispanic, Asian and American Indian."
The full brochure (via the the National Institutes of Health archives, by way of Gawker—who I should note dug it up before I did) is below. Think of it as a snapshot of the times, as well as a fitting reminder of Koop's fulfilled promise to lawmakers that he wouldn't let his religious ideology get in the way of doing his job as America's doctor. (Meanwhile, if you want to honor Koop's legacy, head on over to the NIH's website to read up on the most up-to-date information on AIDS and HIV.)