In Memoriam: C. Everett Koop

Former U.S. Surgeon General C. Everett KoopThe public health world, especially those of us who work in the HIV/AIDS arena, mourn the passing of former Surgeon General C. Everett Koop.

Surgeon General Koop was an inspirational public health leader and a voice for frank and open conversation about HIV/AIDS at a time when the disease was shrouded in fear and misinformation. Dr. Koop served as surgeon general from 1982 to 1989, under Presidents Ronald Reagan and George H.W. Bush. CDC had just reported the first cases of what later became known as AIDS as Dr. Koop was nominated as Surgeon General in 1981.

In 1986, President Reagan asked Dr. Koop to prepare a report on the new and deadly disease. In response, Dr. Koop developed the Surgeon General’s Report on AIDS (PDF 2MB), writing much of it himself. Released on October 22, 1986, the report provided accurate, nonjudgmental, and comprehensive information on the HIV/AIDS epidemic, educating Americans in plain language about how the virus could and could not be spread and how individuals could protect themselves. The report said that the best protection against AIDS was abstinence and monogamy, but that for those who practiced neither, condoms were a necessary precaution. Dr. Koop’s office distributed 20 million copies of the report to local governments, schools and physicians.

In his introduction to the Report, Dr. Koop famously cautioned against the terrible stigma associated with the disease, writing: “We are fighting a disease, not people. Those who are already afflicted are sick people and need our care as do all sick patients. The country must face this epidemic as a unified society. We must prevent the spread of AIDS while at the same time preserving our humanity and intimacy.”

As a follow up to the report, Dr. Koop launched the U.S.’s first coordinated HIV/AIDS education campaign by mailing a booklet, Understanding AIDS (PDF 1.1MB), to all 107 million households in the United States in 1988. It remains the largest public health mailing ever done.

In his writings and public speeches, Dr. Koop called for early sex education, urging parents and schools to start frank, open discussions about AIDS and condom use, presaging the call of the National HIV/AIDS Strategy for age-appropriate HIV education across the lifespan.

Months after the July 2010 release of the National HIV/AIDS Strategy, which observed that “Our Nation is at a crossroads: the urgency associated with combating the epidemic appears to be declining as people with HIV live longer and more productive lives,” Dr. Koop called HIV/AIDS the “forgotten epidemic” and urged Americans to end complacency about AIDS and put the deadly disease back on the radar screen. Speaking at the 2010 National Summit on HIV Diagnosis, Prevention, and Access to Care, Dr. Koop warned, “This is not the time to declare victory. The war against HIV/AIDS is far from over.” The growing sense of complacency, Dr. Koop said, is “as dangerous as the irrational fear in the early days of the AIDS controversy.”

Dr. Koop will be remembered as a powerful voice for public health who worked to shatter the stigma associated with HIV/AIDS and helped to catalyze the Federal government’s—and, indeed, the nation’s—response to this ongoing epidemic.

Read more about Dr. Koop at:

• the Office of Surgeon General’s website
• the NIH National Library of Medicine’s The C. Everett Koop Papers: AIDS, the Surgeon General, and the Politics of Public Health

Read Dr. Koop’s personal account, “The Early Days of AIDS, As I Remember Them”Exit Disclaimer (PDF 566KB), published in the Annals of the Forum for Collaborative HIV Research.