12. Minutes of AIDS Working Group Meeting1

ATTENDEES

  • Ambassador Negroponte OES, Chair
  • Dr. Ken Bart AID/ST/H
  • Neil Boyer IO/T
  • Marvin Brown CA
  • Robert Brexler EAP/RA
  • Bryce Grelach NEA/EX
  • Paul Goff M/MED
  • June Heil CA/VA
  • Rich Kauzlarich IO
  • Peter Knecht PA/OAP
  • Bill Long OES/ENR
  • Dave Lyon AF/RA
  • Burnie Pixley M/MED
  • William Robertson
  • Georgia Rogers CA/OCS
  • Ann Rose HHS
  • Scott Thayer OES
  • William Walker ARA
  • Hal Weeks OES/ENR
  • Frank Wisner

State has three principle objectives in developing a USG foreign policy response to AIDS:

1) to protect the health of the US overseas community

2) to promote a coordinated international response to the situation

3) to support US health community efforts to solve the problem here and abroad.

Over the next month or so, OES will coordinate the effort to develop a strategy/policy paper.2 From this paper, DOS should be able to:

1. identify relevant foreign policy interests impacted or generated by the AIDS epidemic

2. develop responses to situations

3. generate periodic guidance cables to foreign posts.

Bill Long will chair a small drafting group composed of representatives of AID, IO, M/MED and HHS.3 Representatives present should notify Bill Long of who they will have participating in this group within [Page 35]the next two days. The target for the first draft of this policy paper will be the first week in January. The full working group will then meet to discuss the draft during the second week in January. This schedule eliminates the need for the meeting on 17 December as originally planned by Mr. Benedick.

The group then went through the strategy elements for the proposed policy paper (attached)4 to get the views of the participants.

1. Guidance to Embassies

a. Medical Aspects

—should include the most recent available epidemiology.

—should note the prevalence of the virus in prostitutes and the growing indications of heterosexual transmission. Dave Lyon (CAF) noted that the African Bureau has sent a cable addressing this.5 The problem is to show AIDS as a world wide problem so as not to exacerbate African nation sensitivities.

—there followed a question and brief discussion of testing protocol and reliability.

b. Consular/visa issues

—the question was raised whether it is advisable to issue a travel advisory on AIDS, and if so, how to treat it.

—travel advisories are usually country specific none have been issued so far pertaining to AIDS. If one is issued, it would have to be worded very carefully, taking into account both African nation sensitivities and US citizen response.

—if we advise State employees, shouldn’t we advise everyone? Ambassador Negroponte (OES) asked if DOS obligation as an employer (to inform its employees) doesn’t extend to the citizenry as a whole? Dave Lyon (AF) pointed out we need to be aware of the public relations aspect of any form of advisory and that U.S. citizens, while aware of the disease, generally don’t think of it as being passed by prostitutes/heterosexual contact. Paul Goff (M/MED) suggested the regional aspect could be sidestepped by making advice to travelers world-wide. Addi[Page 36]tional information on risk factors could be incorporated into publications going to travel agents (e.g. Morbidity and Mortality Weekly Report, or Bureau of Quarantine).

c. Political dimensions

This point was skipped over for discussion in detail. Certain propaganda points will be made and uncomplimentary things will likely be in the press. USIA should have good notions of how to handle it. We do not have fact sheets on AIDS incidence, again due to the reluctance of some nations to publicly address the issue. Ken Bart suggested we rely on the WHO for our information—they are apolitical and have access to information unavailable to DOS.

d. Reporting Requirements

Are there capabilities to intensify surveillance and reporting on AIDS? Ann Rose (HHS) noted that WHO has an aggressive program of lining up collaborating centers which provides a mechanism to enhance surveillance.

2 & 3 International Programs and Initiatives/Use of International and Institutional Mechanisms

Are we satisfied with the epidemiology being done? What can be done to stimulate the international community?

Neil Boyer (IO/T) pointed out that WHO is active with an expanding list of collaborating centers. It appears to him that WHO is far ahead on this issue. The problem is that they have to walk a politically fine line: they can’t say there are X cases in Zaire, if the GOZ won’t officially report that.

Ann Rose (HHS) noted that WHO lacks the infrastructure to get some of this information.

Ken Bart pointed out that we can’t assist people who don’t want assistance. He notes that thus far there has only been one request to AID for assistance to another country, which was turned down.

R. Kauzlerich (IO) asked Neil Boyer about WHO programs on AIDS. Boyer said there is nothing formal described, as this is in the middle of their budget cycle. He expects the program structure to reflect AIDS efforts at the start of their new budget period in January.

Ken Bart noted that we need our own reporting as long as politics interferes with other reporting mechanisms. Education, and not pointing blame, should help reporting.

Ambassador Negroponte asked R. Kauzlerich how we can best get a handle on WHO activities—and an idea of how/where these should be intensified? Boyer noted that the lead contact with WHO in U.S. is HHS, especially through the CDC.

[Page 37]

The meeting concluded with Ambassador Negroponte reminding reps from IO, AID, HHS and M/MED to inform Bill Long of the names of their representatives to the drafting group.

  1. Source: Department of State, AIDS, 1984–1987, Lot 89D137, AIDS: Cables, Meetings + Misc. No classification marking. Drafted by Weeks on December 14.
  2. See Document 18.
  3. See Document 13.
  4. Not attached. See footnote 2, above.
  5. In telegram 364624 to all African diplomatic posts, November 28, the Department reported: “I want to bring your attention to the fact that we now have our first confirmed case of Acquired Immune Deficiency Syndrome (AIDS) in a USG employee recently returned from Africa.” The cable further stated, “If your employees have not yet been apprised of the epidemic proportions of this disease and the avenues currently available for testing and treatment, I ask that you bring this to their attention on an urgent basis.” (Department of State, Central Foreign Policy File, D850854–0741)