Foreign Relations of the United States, 1981–1988, Volume XLI, Global Issues II

13. Minutes of AIDS Drafting Group Meeting¹

Washington, December 12, 1985, 9:30–11:15 a.m.

ATTENDEES

• Bill Long OES/ENR, chair
• Dr. Ken Bart AID/ST
• Vick Barbero AID/ST
• Neil Boyer IO/T
• Dave Lyon AF/RA
• Dr. Burnie Pixley M/MED
• Dr. Ann Rose HHS
• Hal Thompson PHS/OIH
• Hal Weeks OES/ENR

Task of drafting group is to develop a policy paper² which will describe the current situation and set forth recommendations on how to proceed, to present to the Secretary sometime in January. The attached outline of policy objectives served as the basis for initial discussion of the organization of the paper.

1. Policy Objectives

Ken Bart suggested an additional policy objective be to allay anxiety.

a. Protect Americans Abroad

Medical—Burnie Pixley will provide copies for the drafting group of State Department advice for official travelers. He suggested guidance to provide travelers be done through the Bureau of Quarentine; Dr. Rose suggested this be done via MMWR (Mortality and Morbidity Weekly Report—put out by the CDC).

Ken Bart suggested we include the executive summary of the Surgeon General’s report on AIDS³ (to be issued in January) as a summary background document describing U.S. efforts to understand and deal with the spread of this disease.

b. Defuse Political Problems

Ann Rose noted that a possible reaction to the incidence of AIDS in the U.S. may be an increasing movement to screen U.S. travelers. Dave Lyon suggested that Public Affairs might work with the drafting group—and pointed out an upcoming U.S. News and World Report article. (This article, written by a reporter named Carey⁴ is apparently based on a World Bank/IMF discussion centered around the Lawrence Altman articles in the N.Y. Times.⁵ The World Bank has apparently pointed out to Mr. Carey that the numbers used in this discussion are not based on a scientific survey. There is apparently no World Bank report as mentioned briefly at the meeting) Peter Knecht of PA/OAP is our contact there.

c. International Response

Bill Long felt we should identify the extant international mechanisms dealing with AIDS, and evaluate their scope and magnitude vis-a-vis what the medical community feels should be done. Recommendations could then be developed to fill these ‘gaps’.

Ken Bart pointed out that a major problem on the international level would be the inefficiency of duplication of effort resulting from poor communication among the organizations involved. He suggests that when we develop a perspective on what is being done that State consider among its options the role of coordinator or a ‘no-go’ option if that is appropriate. A number of questions arose on how CDC relates to WHO in work on AIDS (CDC is a collaborating center which also works bilaterally with other governments, e.g. Zaire), and whether NATO/CCMS involvement is ‘appropriate’ or should it be directed into the WHO mosaic? Dave Lyon pointed out that a firm recommendation on whether to have things occur or not with U.S. foreign affairs groups (e.g. NATO) should be developed as a part of our paper. Ken Bart countered that the important thing vis-a-vis countries getting together—on whatever basis—is the sharing of information and enhancement of surveillance on the AIDS situation—and that in this sense they are all useful.

Foreign Post responses to AIDS cable

Hal Weeks will be the central repository for incoming cables and will work with the regional bureaus on analysis. These cables will not be viewed as a source of medical, scientific information, but will provide a flavor for the situation at the originating center. Because of the unscientific nature of the data, it should be held very carefully.

Specific Drafting Assignments

1. International Response: tasked to Neil Boyer

a. identify the principal multilateral vehicles and mechanisims involved

—summarize their activities

—recommend others which might be approached or engaged

b. Ken Bart offered to make contacts on the health level and share this info.

c. identify international program gaps

Walt Dowell is the key CDC person with an overview on WHO (236–3401)

NIH contacts would be Tony Fouche or Meg Donahue

2. U.S. Bilateral Activities: tasked to AID Bart and/or HHS Rose

—describe U.S. bilateral activities focusing on the magnitute of demand for U.S. assistance and U.S. response

3. International Aspects of Surveillance and Epidemiology: PHS/OIH (Thompson)

—What is our state of knowledge and what more needs to be done?

4. Current AIDS situation

Medical: tasked to HHS (Rose). This will focus on U.S. efforts which may not reflect the world-wide situation. International information will come primarily from WHO. However, most of the public information is anecdotal and verification of the disease (internationally) will be difficult.

Political: task to OES to work with regional bureaus.

5. Protecting Americans Abroad: task to M/MED (B. Pixley) in consultation with AID. D. Lyon will contribute a portion on protection of unofficial American travelers. Ken Bart offered to formulate recommendations based on AID’s point of view.

1. Source: Department of State, Subject Files, Other Agency and Channel Messages and Substantive Material—World Health Organization (WHO), 1985, Lot 89D136, 85 HLTH WHO Programs AIDS. No classification marking. Drafted by Weeks on December 16.
2. See Document 18.
3. Reference is to the “Surgeon General’s Report on Acquired Immune Deficiency Syndrome,” United States, Public Health Service, Office of the Surgeon General, January 1986.
4. J. Carey, “How Medical Sleuths Track Killer Diseases,” U.S. News and World Report, October 14, 1985, pp. 69–70.
5. Lawrence K. Altman, “The Doctor’s World; In Africa, Problems Change but the Frustrations Go On,” New York Times, December 10, 1985 (late edition), C1.