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The Launch of the Control Programme on AIDS

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Abstract

The World Health Organization (WHO) finally began moving forward on AIDS under the leadership of Fakhry Assaad, the Director of WHO’s Division of Communicable Diseases. WHO Director-General Halfdan Mahler had initially thought that AIDS was outside of WHO’s mandate, but external pressure and emerging evidence on the extent of the disease convinced him to the contrary. This chapter explains how the rapid increase in AIDS cases across the world put extraordinary pressure on Assaad’s time and energy. It describes the early actions he took to assist countries, including the establishment of WHO Collaborating Centers and the formation of the WHO Control Programme on AIDS. Assaad eventually recruited Jonathan Mann to join the program, positioning WHO to lead the global response to the pandemic.

Within this chapter the singular pronouns I and my refer to Michael Merson alone, whereas the plural pronouns we and us generally refer to Michael Merson and Stephen Inrig jointly. Where we or us refers to Michael Merson and his colleagues at WHO, the object of the pronoun is clarified by context.

The original version of this chapter was revised to correct misspellings.

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Notes

  1. 1.

    For the purposes of this text, we will use the term AIDS to encompass both AIDS and HIV unless otherwise specified.

  2. 2.

    Meeting attendees included Vilimirovic, Dittman, Aswall, Ralph Henderson, and Assaad, among others. Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

  3. 3.

    Ibid.

  4. 4.

    “Acquired Immune Deficiency Syndrome (AIDS),” Weekly Epidemiological Record, April 8, 1983, 58(14):1–2.

  5. 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. 6.

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

  7. 7.

    Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

  8. 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. 9.

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

  10. 10.

    Jonathan M. Mann Oral History, Interviewed by Jake Spidle, New Mexico Health Historical Collection, UNM Health Sciences Library and Informatics Center, 1996.

  11. 11.

    Walt Dowdle, Interview by Michael Merson, New Haven, CT, August, 2002.

  12. 12.

    Jo Asvall, Interview by Michael Merson, January, 2002.

  13. 13.

    Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

  14. 14.

    Ibid.

  15. 15.

    Ibid.

  16. 16.

    Walt Dowdle, Interview by Michael Merson, New Haven, CT, August, 2002.

  17. 17.

    Ibid; Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC . New York: Barnes & Noble Books, 1999, p. 187.

  18. 18.

    Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

  19. 19.

    Ibid.

  20. 20.

    Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC . New York: Barnes & Noble Books, 1999, p. 187.

  21. 21.

    Lars Kallings, Interview by Michael Merson, New Haven, CT, September, 2002.

  22. 22.

    Walt Dowdle, Interview by Michael Merson, New Haven, CT, August, 2002.

  23. 23.

    Times of Zambia, 11 September 1985, cited in John Iliffe, The AIDS Epidemic: A History p. 68.

  24. 24.

    Suzanne Cherney, Interview (email) by Michael Merson, August 13, 2013.

  25. 25.

    Halfdan Mahler, Interview by Michael Merson, Geneva, October, 2001.

  26. 26.

    “The Acquired immunodeficiency syndrome (AIDS): Memorandum from a WHO Meeting,” Bulletin of the WHO, 63 no. 4, 667–672, 1985; Boris Bytchenko. “Travel Report Summary on World Health Organization European Consultation on AIDS,” Atlanta Georgia, 18–19 April 1985; WHO Division of Communicable Diseases, “WHO Consultation on AIDS, 18–19 April 1985, Atlanta, Georgia, USA,” WHO Unpublished document, p. 1.

  27. 27.

    Katherine E. Bliss. The International AIDS Conference Returns to the United States : Lessons from the past and opportunities for July 2012. Washington, DC: Center for Strategic and International Studies, 2012, 5.

  28. 28.

    Boris Bytchenko. “Travel Report Summary on World Health Organization European Consultation on AIDS,” Atlanta Georgia, 18–19 April 1985.

  29. 29.

    “The Acquired immunodeficiency syndrome (AIDS): Memorandum from a WHO Meeting,” Bulletin of the WHO, 63 no. 4, 667–672, 1985; Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, June 1986, p. 5.

  30. 30.

    “The Acquired immunodeficiency syndrome (AIDS): Memorandum from a WHO Meeting,” Bulletin of the WHO, 63 no. 4, 667–672, 1985.

  31. 31.

    Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, June 1986, p. 6.

  32. 32.

    Ibid.

  33. 33.

    William Parra, Interview with Stephen Inrig, October 14, 2010.

  34. 34.

    Ibid.

  35. 35.

    Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC . New York: Barnes & Noble Books, 1999, p. 189–190.

  36. 36.

    Thomas W. Netter, “U.N. Agency Announces Steps To Coordinate Fight Against AIDS,” The New York Times, September 23, 1985, A14.

  37. 37.

    Ibid.; Alan McGregor, “World experts meet to reassess Aids data The Times of London, September 25 1985. The new centers included the National Institute for Biological Standards and Control, London; Faculty of Medicine, University of Singapore, Singapore; Laboratory Centre for Disease Control, Ottawa; Institut Pasteur, Bangui; Central Public Health Laboratory, London’s Institute for Viral Research, Kyoto University, Kyoto; National Bacteriological Laboratory, Stockholm; and the Center for Drugs and Biologics, Food and Drug Administration (FDA) in Bethesda.

  38. 38.

    Before being assigned the universally agreed upon designation of HIV, the virus that causes AIDS had at least two designations, depending on who the designee considered the discoverer of the virus to be. Those supporting the French called the virus. Lymphadenopathy Associated Virus (LAV), while those supporting the Americans called it the human T-lymphotropic virus (HTLV)-III.

  39. 39.

    Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 5. Alan McGregor, “World experts meet to reassess AIDS data.” The Times, September 25 1985; Ibid, “Health experts attempt to lessen fear of Aids,” The Times, September 27 1985.

  40. 40.

    Thomas W. Netter, “U.N. Agency Announces Steps To Coordinate Fight Against AIDS,” The New York Times, September 23, 1985, A14.

  41. 41.

    DCS Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 6; Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC , New York: Barnes & Noble Books, 1996, 1999, p. 188.

  42. 42.

    WHO, “Workshop on AIDS in Central Africa: Bangui, Central African Republic,” WHO/CDS/AIDS/85.1, 22–25 October 1985; “Revision of the case definition of AIDS for national reporting—United States,” MMWR, 1985, 34(25):373–375; DCS Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 6; “WHO/CDC Case definition for AIDS,” WER, 1986, 61:69–76.

  43. 43.

    “Rwanda: In Brief: AIDS not yet a public health problem,” BBC Summary of World Broadcasts, January 24, 1986; “African AIDS Conference Ends,” The Associated Press, January 24, 1986; “Is nobody safe from AIDS?” The Economist, February 1, 1986, p. 91; Lawrence K. Altman, “New Fear On Drug Use And AIDS,” The New York Times, April 6, 1986, 1:1.

  44. 44.

    DCS Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 6.

  45. 45.

    WHO Executive Board, “WHO activities for the prevention and control of AIDS: Report by the Director-General,” EB77/42, 25 November 1985.

  46. 46.

    Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 5.

  47. 47.

    “Second Meeting of the WHO Collaborating Centres on AIDS,” 2nd draft, December 16–18, 1985, Geneva.

  48. 48.

    Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002; “India launches AIDS education campaign,” United Press International, May 9, 1986.

  49. 49.

    Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC . New York: Barnes & Noble Books, 1999, p. 189.

  50. 50.

    Jonathan M. Mann Oral History, Interviewed by Jake Spidle, New Mexico Health Historical Collection, UNM Health Sciences Library and Informatics Center, 1996. p. 3.

  51. 51.

    Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC , New York: Barnes & Noble Books, 1996, 1999, pp. 189–190.

  52. 52.

    CDS Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 6; Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC , New York: Barnes & Noble Books, 1996, 1999, p. 188.

  53. 53.

    Joseph B. McCormick and Susan Fisher-Hoch, Level 4: Virus Hunters of the CDC , New York: Barnes & Noble Books, 1996, 1999, pp. 189–190.

  54. 54.

    Fawzia Assaad, Interview by Michael Merson, New Haven, CT, July, 2002.

  55. 55.

    Walt Dowdle, Interview by Michael Merson, New Haven, CT, August, 2002.

  56. 56.

    Thomas Quinn , Interview by Michael Merson, New Haven, CT, August, 2002.

  57. 57.

    James Curran, Interviewed by Michael Merson, September 3, 2002; Walt Dowdle, Interview by Michael Merson, New Haven, CT, August, 2002.

  58. 58.

    “More than 20,000 Cases Worldwide, U.N. Agency Reports,” The Associated Press, January 16, 1986.

  59. 59.

    Jonathan M. Mann Oral History, Interviewed by Jake Spidle, New Mexico Health Historical Collection, UNM Health Sciences Library and Informatics Center, 1996. pp. 3–4.

  60. 60.

    World Health Organization, “Executive Board, Seventy-Seventh Session Agenda, Geneva, 8 January 1986.” EB 77/1.

  61. 61.

    WHO Executive Board, “WHO activities for the prevention and control of AIDS,” EB77/12, Geneva, 8–17 January 1986.

  62. 62.

    John Iliffe, The African AIDS Epidemic: A History. Ohio University Press, 2006, p. 68.

  63. 63.

    “Acquired Immunodeficiency Syndrome (AIDS): WHO Programme on AIDS,” Weekly Epidemiology Record, January 31, 1986, 5:35; See also “WHO board reviews ‘health for all by year 2000’ strategy,” UN Chronicle, April 1, 1986, 23:88–90.

  64. 64.

    WHO Executive Board, “WHO activities for the prevention and control of AIDS,” EB77/12, Geneva, 8–17 January 1986.

  65. 65.

    WHO, “Summary of financial requirements for the WHO strategy for the prevention and control of AIDS,” AIDS/CPA/86.2, June 1986.

  66. 66.

    John Iliffe, The African AIDS Epidemic: A History. Ohio University Press, 2006, p. 68. WHO, “Summary of financial requirements for the WHO strategy for the prevention and control of AIDS,” AIDS/CPA/86.2, June 1986; “AIDS: Plan of action for control in the African region,” WER, 61, 93, 1986.

  67. 67.

    John Iliffe, The African AIDS Epidemic: A History. Ohio University Press, 2006, p. 68; DCS Control Programme on AIDS, “Global WHO Strategy For the Prevention And Control of Acquired Immunodeficiency Syndrome: Projected Needs For 1986–1987,” World Health Organization AIDS/CPA/86.2, April 1986, p. 6; WHO, “Summary of financial requirements for the WHO strategy for the prevention and control of AIDS,” AIDS/CPA/86.2, June 1986; “AIDS: Plan of action for control in the African region,” WER, 61, 93, 1986.

  68. 68.

    CDS Control Program on AIDS, “Meeting of Donors For the Prevention and Control of Acquired Immunodeficiency Syndrome, Geneva, 21–22 April 1986.” World Health Organization, AIDS/CPA/86.1, 5.

  69. 69.

    Ibid.; Ofelia T. Monzon, “Profiles of Famous Educators: Jonathan Mann, 1947–98,” UNESCO International Bureau of Education, 2001. http://www.ibe.unesco.org/fileadmin/user_upload/archive/publications/ThinkersPdf/manne.pdf Accessed on July 29, 2009; DCD Control Programme on AIDS, “Meeting on Educational Strategies for the Prevention and Control of AIDS, Geneva, 17–19 June 1986,” World Health Organization, AIDS/CPA/86.4, Annex 1, p. 12.

  70. 70.

    WHO Executive Board, “WHO Activities for the Prevention and Control of Acquired Immunodeficiency Syndrome, Seventy-ninth Session, Provisional agenda item 7.2,” World Health Organization, November 25, 1986, EB79/12, p. 7; “New Test Developed for AIDS Detection,” Japan Economic Newswire, April 16, 1986.

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Authors and Affiliations

  1. Duke Global Health Institute, Duke University, Durham, NC, USA

    Michael Merson (Wolfgang Joklik Professor of Global Health)

  2. Mount Saint Mary’s University, Los Angeles, CA, USA

    Stephen Inrig (Director, Health Policy and Management Program)

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Merson, M., Inrig, S. (2018). The Launch of the Control Programme on AIDS. In: The AIDS Pandemic. Springer, Cham. https://doi.org/10.1007/978-3-319-47133-4_2

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  • DOI: https://doi.org/10.1007/978-3-319-47133-4_2

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