PDF《The Launch of炉he烫ontrol》

17 rich nations could handle adequately on their own.5 Even after Projet SIDA and other observers began reporting the pandemic'

s spread inAfrica in 1984,Assaad felt AIDS did not merit the attention of other global health concerns: Fakhry, for some reason, after this group had done the studies in Africa, didn'

t want to deal with this. He said he had enough on his plate recalled Joshua Joe Cohen, who had joined WHO in the early 1970s and who in the mid-1980s was serving as Senior Health Policy Advisor to Director-General Halfdan Mahler.6 Admittedly, some of Assaad'

s reluctance sprang in part from his ambivalence about the morality associated with AIDS: [Assaad] was a deep puritan, his wife, Fawsia (a long time human rights advocate), explained, and he had the feeling that [AIDS] was a first world disease for very dissolute people.

7 More importantly, Assaad and many of his WHO colleagues did not think that WHO could do much to address AIDS.?In 1984, renowned University of Washington epidemiologist and sexually transmitted disease (STD)8 specialist, King Holmes, approached Assaad to motivate him to create an AIDS program at WHO.? According to Holmes, Assaad explained WHO'

s inaction with an analogy to a tuberculosis screening pro- gram?that Assaad had launched in Egypt: [Assaad] had identified a large number of people who had tuberculosis and [his boss asked] '

Now that you are finding all these people with tuberculosis, what are you going to do with them?'

9 Assaad appeared to be saying that WHO'

s initial decision not to start an AIDS program was based on the belief that, even if AIDS was a growing problem, it would be unhelpful to iden- tify all those infected since WHO had little to offer them. Assaad seems not to have been comfortable with that position for very long, however. Sometime in 1984, Assaad changed his mind about WHO'

s approach to AIDS.?We suspect there were a number of reasons for this. Assaad had a keen inter- est in virology, so perhaps the change started in May of that year, when Robert Gallo and his team at the National Institutes for Health (NIH) clearly showed a virus to be the causative agent for AIDS. Assaad had a deep commitment to fighting dis- eases in low- and middle-income countries, so maybe a more definitive shift came that summer when he met Jonathan Mann for the first time in Geneva while Mann was engaged in the early stages of Projet SIDA in Zaire.10 Additionally, Assaad dur- ing this time was very much in touch with the staff at the Centers for Disease Control

5 ?Memorandum of Fakhry Assaad, Director of WHO Communicable Diseases Division to Halfdan Mahler, Director-General of the WHO, July 1983, cited in Katarina Tomasevski, Sofia Gruskin, Zita Lazzarini, and Aart Hendriks, AIDS and Human Rights, in Jonathan Mann, Daniel J.?M. Tarantola, and Thomas W.?Netter, eds., AIDS in the World: A Global Report, Cambridge, MA: Harvard University Press, 1992, p.?567.

6 ?Joshua Cohen, Interviewed by Michael Merson, New Haven, CT, August, 2002.

7 ?Fawsia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

8 ?For the purposes of this text we use the term sexually transmitted disease(s) and the abbreviation STD rather than the other term sexually transmitted infection(s) or STIs.

9 ?King Holmes, Interview by Michael Merson, New Haven, CT, September, 2002.

10 ? Jonathan M. Mann Oral History, Interviewed by Jake Spidle, New Mexico Health Historical Collection, UNM Health Sciences Library and Informatics Center, 1996. 2? The Launch of?the?Control Programme?on?AIDS