patients. The differences between the two situations illustrated how history could confound expectations. Few people could have predicted in 1968 that the IOM would gain its greatest fame for its efforts to come to grips with an infectious disease for which there was no apparent cure or clear medical treatment.

AIDS Workshops

Having gotten the nation's attention, the IOM had to decide what to do with it. In November 1986, the IOM Council agreed, with no hesitation, that it wanted the IOM to continue its efforts in the area of AIDS. The consensus was for the IOM to form a small group that would monitor the implementation of the committee's recommendations and help facilitate international activities in the AIDS field and activities involving private pharmaceutical companies. In the spring of 1987, Thier and Press once again joined together to form an AIDS oversight committee.

In the fall of 1986 and the first months of 1987, the IOM waited to see how the Reagan administration and Congress would react to the 1986 report. At the end of June 1987, President Ronald Reagan announced that he would create a Presidential Commission on the Human Immunodeficiency Virus Epidemic. When the IOM Council learned in July who would be named to this commission, it expressed a collective sense of dismay. As Thier delicately expressed it, "The number of individuals on the commission with in-depth knowledge of AIDS was very modest." The Council decided nonetheless to adopt a "respectful and communicative attitude" toward the commission, "without being co-opted."

The presence of the Presidential Commission on the HIV Epidemic spurred the IOM to move ahead with its own AIDS oversight committee. The primary mission of this committee would be to review and update the 1986 report. In addition, the IOM hoped that the oversight committee would help focus the AIDS activities of the entire NAS complex, serving in a similar manner to the boards that guided the various IOM divisions. 28

Even before the oversight board started its work, the IOM initiated limited projects in the areas of epidemiology and AIDS drug and vaccine development. At the end of August 1987, the IOM held a Conference on Promoting Drug Development Against AIDS and HIV Infection. The conference followed directly from a recommendation in the 1986 report to "convene researchers from industry, academia, and the government to improve the development of drugs against AIDS



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