Personal Health

The 10 Greatest Villains of the AIDS Epidemic

The history of the AIDS epidemic is littered with people who, through malice or cowardice, made an unimaginably awful situation even worse.

Thirty years ago this week, the Centers for Disease Control’s Morbidity and Mortality Weekly Report reported five cases of Pneumocystis carinii pneumonia among previously healthy gay men. It was not for another year that these deaths were attributed to gay-related immune deficiency -- a name that exacerbated the homophobic positioning of the disease -- and then, mercifully, Acquired Immune Deficiency Syndrome. 

Twenty-five million have since died of AIDS. Put another way, the population of Texas has been raptured off the map. Still, as we’re told ad nauseum, the disease is no longer a death sentence; millions are taking HIV antiretroviral therapy for the first time; Magic Johnson is alive and well; and according to UNAIDS figures, expanded access to treatment led to a 19 percent decline in deaths among people living with HIV between 2004 and 2009.

It gets even better! Three weeks ago, we learned that men and women who take antiretrovirals while their immune systems are still “relatively healthy” are unlikely to transmit the disease.

If you grew up listening to stories of the skeletal Rock Hudson and the doomed Ryan White, as I did, such developments seem gloriously improbable. Against such darkness, it’s almost possible, amid the current revelry, to ignore the millions already dead and the 1.8 million who continue to die each year. For a non-death sentence, AIDS sure does kill a lot people. You can’t assign blame for this to just one person, but Ronald Reagan really does deserve an outsized heap of opprobrium. Despite what you may hear from his defenders, the Gipper, when you get down to it, really did care more about UFOs than the new plague.

The numbers: 3,700 dead after his first term, 46,344 after the second.

Reagan was hardly alone in his deficiency. The history of the AIDS epidemic is littered with people who, through malice or cowardice, made an unimaginably awful situation even worse. America’s collective memory being what it is, it’s worth identifying them.

Jerry Falwell, Religiohuckster

Crime: As co-founder of the Moral Majority, Falwell and his merry band of Gantrys helped foist Reagan on the country and then connived to remain close to the Oval Office. Proximity to the powerful allowed Falwell to smite the meek. One of the more repulsive instances was a 1983 debate with activist Gary Walsh -- a PWA, in the parlance of the time -- during which the preacher told the dying man, “When you violate moral, health, and hygiene laws, you reap the whirlwind.” And on live television, no less!

Last Known Whereabouts: Christopher Hitchens, to his credit, shouldered the burden of eulogizing Falwell while the body was still warm, and he properly bid the corpulent monster adieu: “The empty life of this ugly little charlatan proves only one thing,” he told CNN: “That you can get away with the most extraordinary offenses to morality and to truth in this country if you will just get yourself called ‘reverend’.” To C-SPAN’s audience Hitchens observed that, had Falwell “been given an enema, he could have been buried in a matchbox.”

Dr. David Sencer, New York City health commissioner

Crime: Contra Falwell, Sencer’s sin is complacency. He had been burned once before; in 1976, a swine flu outbreak at Fort Dix killed 14. The CDC, headed by Sencer, ordered widespread vaccinations that led to the deaths of as many as 32 people. Sencer was fired. This incident may explain his Chinatown approach as health commissioner: do as little as possible. When the city became racked with AIDS he refused to widely educate New Yorkers or to close the bath houses. In the beautiful words of Ronald Bayer, Sencer believed -- as did many other public health officials -- that “the exercise of caution was a reflection of wisdom.

Last Known Whereabouts: He’s dead too, as of a month ago. The Times’ obit was so loaded with treacle there wasn't space to include Sencer’s 1983 claim that new cases of AIDS “appears pretty much to have leveled off,” though such a belief would have helped readers understand his lethal stasis. Nor did the Times see fit to quote him, also in 1983, saying he could “see no reason why we would close the bath houses” -- as if New York being home to half the country’s AIDS cases (71 percent of whom were gay men) was not reason enough.

Ed Koch, New York City mayor

Crime: It bothered Koch terribly, he told New York in 1988, “that militants among gays believe that San Francisco has done more for treating AIDS patients … than New York City. It’s totally untrue.” It totally isn’t. San Francisco’s response to the AIDS epidemic wasn’t perfect, but it far exceeded all other cities -- funding for hospice beds, AIDS wards and clinics. Koch, on the other hand, refused to authorize hospice care for the afflicted homeless, and when asked by Gay Men’s Health Crisis for use of an abandoned high school as an "AIDS service center" demanded $2 million. A full two years into the epidemic, New York City hadn’t spent a cent on education or services -- “despite,” observed Randy Shilts, “being home to 45 percent of the nation's AIDS victims.”

Last Known Whereabouts: Koch went full-tilt wingnut boogie, endorsing Bush in 2004. He maintains, against all available evidence, that his record on gay rights is solid, and told the New York Post it’s a “fucking outrage” to suggest otherwise. He maintains a Youtube channel on which he occasionally reviews movies. How’s he doing? Pretty shitty.

Dr. Joseph Bove, Officer of the American Association of Blood Banks

Crime: Bove, a member of the FDA’s blood safety committee, prioritized the business of blood banking above safety. By 1983, scientists were fairly certain that AIDS could be spread through blood transfusions, citing the rising number of cases among hemophiliacs and drug addicts as evidence. The American Red Cross endeavored to publicize a plan to carefully screen donors, and Bove flipped. “We have no medical or scientific evidence that justifies such a course right now,” he said. “I think it’s an overreaction.” In August 1983 Bove testified before Congress and famously said that if AIDS could be transmitted via a blood transfusion, the chance was one in a million. This line was repeated again and again, and wasn’t remotely true. As a result, the ELISA test wasn’t adopted for blood screening until February 1985, by which time tens of thousands had died.

Last Known Whereabouts: In 1996, New Jersey's Supreme Court ruled that the American Association of Blood Banks had been negligent when it refused to rigorously screen donated blood. The court upheld a $405,000 jury award to William Snyder, who in 1984 contracted HIV from a blood transfusion during open-heart surgery at New Jersey’s St. Joseph's Hospital. “The foreseeability, not the conclusiveness, of harm suffices to give rise to a duty of care," the judge wrote. “By 1983, ample evidence supported the conclusion that blood transmitted the AIDS virus.”

Margaret Heckler, Secretary of Health and Human Services

Crime: In 1983, four months into her term, Heckler told a congressional committee that she “[didn’t] think there is another dollar that would make a difference” for federal AIDS researchers. That was news to the CDC, whose staff had to steal equipment from the other labs, and who were appalled at Heckler’s repeated assertion that AIDS was the administration’s “number-one health priority.” One attempt to paper over her boss’s failures was particularly awful -- a photo-op with an AIDS patient from Cabrini Medical Center. A dozen hospitals wisely said no. A decent gauge of Heckler’s competence was her famous 1984 prediction: “We hope to have such a vaccine ready for testing in approximately two years.”

Last Known Whereabouts: Reagan repaid Heckler for her failures with an ambassadorship to Ireland, a job for which she was apparently better suited. A couple of months ago, the Department of Health and Human Services celebrated Heckler during Women’s History Month as “a pioneer,” which is sort of true.

Andrew Sullivan, Pundit

Crime: Before calling the American coasts a “fifth column” for not humping the Iraq war; before endorsing Paul Ryan’s plan to dismantle Medicare as “serious”; before he made his living posting photos of reader windowscapes -- before all this, Andrew Sullivan was arguably the most influential gay writer in America. And in 1996, in the wake of the introduction of protease inhibitors, he -- along with less notable opinion-shapers -- was happy to tell readers of the New York Times Magazine that “this plague” -- the AIDS epidemic -- “is over.” Gabriel Rotello wrote despairingly about what happened next: “As the meds came into use, people began celebrating. … Mainstream journalists took their cue and largely dropped the subject.”

Last Known Whereabouts: Sullivan is blogging for the Daily Beast and contributing to Newsweek. He has since mea culpa’d his Iraq war advocacy, but he’s stood his ground on the notorious Times article: “And yet, 10 years on,” he wrote in 2007, “everything in it was right.” Yes, everything except for the plague being over.

Abe Rosenthal, New York Times executive editor

Crime: True, Walter Duranty praised Joseph Stalin, but at least he covered him! The Times, under Rosenthal, ignored AIDS and wouldn't even use the word “gay” to denote homosexuals. Nor would it cover a benefit thrown by Gay Men’s Health Crisis, even though it took place in the Times’ backyard at Madison Square Garden, was sold out and boasted a “Star Spangled Banner” conducted by Leonard Frickin’ Bernstein. The paper only published an important series on AIDS after Max Frankel replaced Rosenthal -- whose reign was notoriously unfriendly to gays.

Last Known Whereabouts: Rosenthal was a “weeper and egomaniac, womanizer and homophobe, chauvinist and tyrant” -- under his editorship everything was not fit to print. When he died in 2006, it was widely agreed that Rosenthal’s tenure was a low point in the history of the great paper.

The Pope(s), Vicars of Jesus Christ

Crime: It took the Vatican 29 years to admit that condoms may be necessary to reduce the spread of disease -- only 12 years after church leaders in El Salvador spearheaded a law “requiring condoms to carry warnings that they do not protect against AIDS.” The Church has an unmatched record of ensuring -- or at best ignoring -- the destruction of the gay community. In 1986, the loving and compassionate John Paul II warned his bishops that homosexuality -- an “objective disorder,” he said -- was clearly a threat to the lives of straight people. Meanwhile, he continued, those damn gays “remain undeterred and refuse to consider the magnitude of the risks involved.

Last Known Whereabouts: John Paul II is dead but his legacy lives on, mainly in the form of the Republican Party. Eight conservative senators --  McConnell, Coburn, DeMint, Burr, Bunning, Chambliss, Sessions and Vitter -- refused to support a bill that expanded AIDS funding to China and India. Christine O’Donnell, a recent Tea Party flavor of the month, opined that the government spent too much money on AIDS and oh by the way condoms don’t stop the spread of the virus. She’s such a smart lady.

Jesse Helms, senator

Crime: “I think somewhere along the line we are going to have to quarantine,” said Helms, “if we are really going to contain this disease.” (A position, by the way, shared by erstwhile Arkansas governor, Mike Huckabee.) He was venomous toward American AIDS victims and denied funding at every turn. Possibly this was because Helms believed that homosexuals were “perverted human beings.” He allowed insurance companies to deny coverage to victims and voted against AIDS education. In fairness to Helms, he didn’t just hate gays, he also railed against the use of funds to distribute sterile needles to drug addicts.

Last Known Whereabouts: Fearing an eternity of hellfire, Helms adopted AIDS in Africa as a hobbyhorse. "Perhaps,” he wrote in the Washington Post, “I am too mindful of soon meeting Him, but I know that … we cannot turn away when we see our fellow man in need.” Can and did! This was the last gasp of an awful man. When it counted, Helms was worse than ineffectual -- he actively sought to damage a community he loathed. At his passing, conservatives praised him as a statesman, which is just as well.

Elon Green is a writer living in Brooklyn.
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