the challenges posed by the HIV/AIDS epidemic. Yet the IOM realized that such recommendations were indeed warranted and that to formulate rational public health policy in this area, national leadership was critical. As a result, in early 1986, the presidents of the National Academy of Sciences (NAS) and IOM, with the approval of their respective governing councils, initiated a special effort to examine the extent of the problems arising from AIDS, assess the nation's response to this epidemic, and propose an appropriate course of action. Reflecting the urgency of the HIV/AIDS epidemic, the expert committee that conducted this study was asked to produce a report within 6 months following its initial meeting. The resulting landmark publication, Confronting AIDS: Directions for Public Health, Health Care, and Research (IOM/NAS, 1986a), was one of the first published volumes to provide a comprehensive scientific and policy analysis of current efforts to address this epidemic. It also proposed strategies for meeting the scientific, public health, and social challenges that arise in developing rational AIDS policy. Among the report's most significant recommendations was the call for $1 billion in annual federal spending, by fiscal year (FY) 1990, for AIDS-related education and other public health expenditures, as well as $1 billion in AIDS research funding.

Confronting AIDS received extensive coverage by all the major news media and was described 2 years later by the New York Times as having “provided a benchmark by which many members of Congress and analysts judged the effectiveness of the nation's efforts to combat AIDS” (Boffey, 1988). During a time in which strong national leadership on the AIDS epidemic was lacking, the 1986 release of Confronting AIDS was viewed by many as a powerful turning point in national AIDS public policy-making. It heightened the awareness of Americans and brought national attention to the HIV/AIDS epidemic, highlighting the importance of continued biomedical research and vigorous public health efforts to contain the epidemic.

In June 1988, the IOM released its second comprehensive AIDS policy document, Confronting AIDS: Update 1988. This report of the IOM/NAS AIDS Activities Oversight Committee was a supplement to the original 1986 report and provided an assessment of the nation's progress in the intervening years in fighting the epidemic. The update conveyed new information in epidemiology and biomedical research and provided recommendations for future action in the areas of health care, public health, research, and federal policy-making. Like its predecessor, this report also received wide media and public attention, and once again underscored the need for strong federal leadership in formulating coherent national AIDS policy.



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