Facing Up to the Problem

In the summer of 1983, the IOM Council first took up the matter of AIDS at the urging of its members. One call to IOM President Fred Robbins came from Dr. Robert Ebert, the head of the Milbank Memorial Fund and later an influential figure in mobilizing the Sproull committee, who suggested that the IOM review the current research in the field. When Robbins raised this suggestion with Ed Brandt, the Assistant Secretary for Health at the Department of Health and Human Services (HHS), Brandt told him that there was little the IOM could do, even though Brandt had called AIDS the nation's number one priority in public health. Because Robbins had no desire to embarrass or upstage Brandt, who was an important supporter of the IOM within the Reagan administration, he assured Brandt that the IOM would do nothing until it received a specific request from the government. Council members requested that Robbins press Brandt on the matter and Robbins did so, only to receive the same response. The two agreed that the IOM would postpone any activity related to AIDS.3

This enforced passivity did not sit well with either Robbins or the IOM Council. In the spring of 1985, the IOM decided, on its own initiative and with Fred Robbins' strong endorsement, to dedicate its annual fall meeting to the subject of AIDS. By this time, many IOM Council members, such as John J. Burns, a chemist with a distinguished background as a researcher in the pharmaceutical industry, wanted the IOM to become more involved in public policy toward AIDS. Although Robbins sensed and shared the members' restiveness on this issue, he continued to believe that there was nothing the IOM could do "without the support and encouragement of the Public Health Service."4

Robbins did all he could to keep the pressure on the Public Health Service (PHS), and near the end of his presidency he sensed that the PHS attitude toward working with the IOM was gradually shifting. Sometime over the summer of 1985, he heard from James Mason, the director of the Centers for Disease Control (CDC), who suggested that the IOM examine the issues surrounding school admission policies for children with AIDS. At the time, the school attendance of children infected with what later became known as human immunodeficiency virus (HIV), the causative agent of AIDS, was a sensitive issue capable of igniting mass hysteria in an affected community. At the end of August 1985, the Public Health Service issued a set a recommendations on this matter in which the CDC stated flatly that "casual person-to-person contact as would occur among schoolchildren



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