Speaker 1: Hey, this is Leon Napok. I'm the host of Fiasco,
Speaker 1: but you may also know me from the podcasts Slowburn,
Speaker 1: Think Twice, Michael Jackson, and Backfired the Vaping Wars. I'm
Speaker 1: excited to be sharing with you the next season of Backfired,
Speaker 1: titled Attention Deficit, which is now available exclusively on Audible.
Speaker 1: Backfired is a podcast about the business of unintended consequences.
Speaker 1: In the first season, my co host Ril Pardess and
Speaker 1: I dove deep into the world of vaping and how
Speaker 1: the well intentioned quest for a safer cigarette went awry.
Speaker 1: Now we're tackling ADHD and how the push to destigmatize
Speaker 1: this hard to define childhood diagnosis has led to an
Speaker 1: explosion of stimulant use in kids as well as adults.
Speaker 1: It's a story about the promise of psychiatry to fix
Speaker 1: our brains and the power of the pharmaceutical industry to
Speaker 1: shape how we and our doctors think about what's wrong
Speaker 1: with us. To hear both seasons of Backfired, go to
Speaker 1: audible dot com slash Backfired and start a free trial
Speaker 1: that's audible dot com slash backfired. Fiasco is intended for
Speaker 1: mature audiences. For a list of books, articles and documentaries
Speaker 1: we used in our research. Follow the link in the
Speaker 1: show notes. Previously on Fiasco, AIDS is infecting more and
Speaker 1: more heterosexuals, men and women, teens and babies.
Speaker 2: The Surgeon General today prescribed education children he feels need
Speaker 2: to be yarned in school about the danger of AIN.
Speaker 3: Now many people are not receiving information that is vital
Speaker 3: to their future health and well being.
Speaker 4: Researchers say, a new class of drugs are working.
Speaker 2: A cure for AIDS may soon be a possibility.
Speaker 1: Felt like some grand act of mercy made manifest when
Speaker 1: we decided to make a season of Fiasco about the
Speaker 1: AIDS epidemic. The arrival of the Triple Cocktail in nineteen
Speaker 1: ninety six seemed like a natural place to end our story.
Speaker 2: The most optimistic note since the terrible disease was first recognized.
Speaker 1: These new so called to wonder drugs, the Triple Cocktail
Speaker 1: represented a monumental turning point, a bookend to the era
Speaker 1: when HIV meant certain death.
Speaker 2: A new combination of drugs, including a new class called
Speaker 2: proteation inhibitors.
Speaker 1: From the discovery of the earliest cases of AIDS, people
Speaker 1: had been imagining, dreaming of something like the Triple Cocktail,
Speaker 1: a medicine that could overpower the disease. It was easy
Speaker 1: to assume that the war on AIDS would be one
Speaker 1: with the development of a successful treatment.
Speaker 5: I've really had about as close to a miraculous recovery,
Speaker 5: certainly more so than I ever imagined I would see.
Speaker 1: But the Triple Cocktail did not end the epidemic. While
Speaker 1: it helped people who were already sick, new people kept
Speaker 1: getting infected, about fifty thousand the year after the Triple
Speaker 1: Cocktail became available, in fifty thousand more the year after that.
Speaker 1: In the decades since the treatment was introduced, nearly one
Speaker 1: million people in the United States have been diagnosed with HIV.
Speaker 1: And So, in this final episode of Fiasco, season five,
Speaker 1: I want to get into some of the reasons why
Speaker 1: the epidemic is still with us. What needed to happen
Speaker 1: that didn't, and what could have been done that wasn't.
Speaker 6: I want you to believe that we can make America
Speaker 6: work again.
Speaker 1: To tell this part of the story, I want to
Speaker 1: go back to the early nineties, when a Democrat from
Speaker 1: Arkansas was running for president and promising a new approach
Speaker 1: to the AIDS crisis.
Speaker 7: I think most Americans still don't know how many people
Speaker 7: are out there who are HIV positives.
Speaker 1: If nothing else, Bill Clinton was willing to talk about HIV.
Speaker 1: Unlike his Republican predecessors, Clinton seemed less inclined to minimize
Speaker 1: or ignore the problem.
Speaker 7: The president should type responsibility or the problems of the
Speaker 7: country and be honest enough to say, we might not
Speaker 7: solve them in a year or two, we may not
Speaker 7: solve them all in four years, but at least we're
Speaker 7: going to roll off our sleeves.
Speaker 8: And go to work.
Speaker 1: Let's get to work, Clinton for people for a change.
Speaker 1: At this point, scientists were still years away from developing
Speaker 1: what became the triple cocktail, but that didn't mean there
Speaker 1: was no progress to be made. After all, treating people
Speaker 1: who already had HIV was only one front in the
Speaker 1: war on AIDS. The other was preventing people from getting
Speaker 1: it in the first place, and that was hard for
Speaker 1: reasons that had nothing to do with science or medical research.
Speaker 1: By the time Clinton took office, public health experts already
Speaker 1: had a bunch of good ideas for how to prevent
Speaker 1: more people from getting infected. Those ideas all had one
Speaker 1: thing in common. They required talking openly, explicitly and pragmatically
Speaker 1: about how HIV was spread, and because that meant talking
Speaker 1: about sex and drugs, it ensured that AIDS would continue
Speaker 1: haunting the country and threatening people's lives long after the
Speaker 1: medical mystery was effectively solved. I'm Leon Nafok from Audible
Speaker 1: Originals and Prologue Projects. This is fiasco.
Speaker 9: Anytime you're talking about sex and drugs.
Speaker 8: It's a moral issue.
Speaker 10: We need to crack down on drug abuse, not promote
Speaker 10: more drug addiction.
Speaker 11: But we don't want people to use drugs. Well, that's great,
Speaker 11: there's no easy way to do that.
Speaker 5: We had a strategy that would save people from getting infected.
Speaker 10: And the question is why aren't they acting.
Speaker 1: On this week's season finale, a new administration promises to
Speaker 1: turn the page on the HIV AIDS epidemic and instead
Speaker 1: gets wrapped up in old arguments about sex, drugs, and morality.
Speaker 1: Ricky Blutenthal was living in Oakland, California, studying sociology at Berkeley,
Speaker 1: and he came face to face with HIV. The year
Speaker 1: was nineteen ninety.
Speaker 11: I was getting a PhD because I was interested in
Speaker 11: the problems of what we were then calling interstiti black people.
Speaker 1: Blutenthal had started his research with a focus on gangs
Speaker 1: and drug distribution. Now he was part of a team
Speaker 1: that was studying the prevalence of HIV in people who
Speaker 1: used drugs in the Bay Area. Their data collection effort
Speaker 1: was centered on a neighborhood about twelve miles outside Oakland
Speaker 1: called the Iron Triangle.
Speaker 11: And it's called Iron Triangle because it's there's a triangle
Speaker 11: formed by rail lines that cut through the community. It's
Speaker 11: like a very common thing that happens to historic African
Speaker 11: American neighborhoods, where they get split up and divided by
Speaker 11: undesirable infrastructure.
Speaker 1: Blutenthal knew that racial disparities and health outcomes were structural
Speaker 1: and that if properly understood, they could be undone. By
Speaker 1: studying drug use and HIV and the Iron Triangle, he
Speaker 1: saw an opportunity to use social science to actually help people.
Speaker 11: I had an advantage in that, you know, I'm African American,
Speaker 11: so I felt comfortable working in the community and being
Speaker 11: respectful engaged with people. So I didn't come in with
Speaker 11: a lot of hard attitudes about any of it, about
Speaker 11: drug use, about HIV, and so that gave me a
Speaker 11: chance to learn and then try to be responsive to
Speaker 11: the problems people were confronting.
Speaker 1: As part of the study, the researchers administered HIV tests
Speaker 1: to lots and lots of people who used injecting drugs.
Speaker 1: At one point, it fell to Blutenthal to give a
Speaker 1: group of study participants the results.
Speaker 11: You know, I had like a series of seven or
Speaker 11: eight counseling results that I had to share, and everyone
Speaker 11: was positive, and I just started crying. Remember, you know,
Speaker 11: this was a context of you know, it was five
Speaker 11: years before we had effective treatments for HIV, so essentially
Speaker 11: we were handing what felt like death sentences. I mean
Speaker 11: it chacks me up now, you know. And it was
Speaker 11: one of those moments where you you know, your rubber
Speaker 11: meets the road, right, you know, you have to decide
Speaker 11: are you going to do something about it.
Speaker 1: What Blutenthal decided to do about it was help start
Speaker 1: a program in Oakland where people who used injecting drugs
Speaker 1: like heroin could obtain clean syringes for free instead of
Speaker 1: sharing contaminated ones with other people. It was a model
Speaker 1: that first gained traction in the Netherlands and crossed over
Speaker 1: into the United States in the mid eighties.
Speaker 4: There are some cities where groups of individuals have set
Speaker 4: up privately run exchanges.
Speaker 8: Me a heroin addict is a bad nothing.
Speaker 4: I don't really feel I want to get AIDS to say,
Speaker 4: the clean needles work for me.
Speaker 1: The premise of needle exchange was straightforward. When people who
Speaker 1: are using drugs together syringes, they end up sharing blood
Speaker 1: and if one of those people has HIV, the rest
Speaker 1: are at extreme risk for getting it to The reason
Speaker 1: so many people were sharing syringes was that they were
Speaker 1: hard to get, and the reason for that goes back
Speaker 1: to the War on drugs, which began under Richard Nixon
Speaker 1: in nineteen seventy one.
Speaker 2: America's public enemy Number one in the United States is
Speaker 2: drug abuse. In order to fight and defeat this enemy,
Speaker 2: it is necessary to wage a new, all out offensive.
Speaker 1: Nixon's offensive led to a host of new laws around
Speaker 1: the country aimed at making it harder for people to
Speaker 1: use drugs.
Speaker 11: There was a bit of a cannabis or marijuana panic
Speaker 11: in the late seventies, so the Department of Justice developed
Speaker 11: a model drug paraphernalia law that was really focused on cannabis.
Speaker 10: Marijuana has become so widespread that virtually anyone is likely
Speaker 10: to be a user upon its site.
Speaker 3: There was no such thing a safe.
Speaker 11: Marijuana, So they wanted to get rid of roach clips
Speaker 11: and shut down the smoke shops. But in the course
Speaker 11: of doing that they added other things, right, and one
Speaker 11: of those other things they added was syringes.
Speaker 1: Selling syringes became illegal in most states, and some states
Speaker 1: even banned possession before long. Syringes were extremely hard to
Speaker 1: come by, and those who needed access to them multiple
Speaker 1: times a day started sharing them with each other. Unsurprisingly,
Speaker 1: that had some major health consequences, and as heroin use
Speaker 1: rose over the course of the seventies, some injecting drug
Speaker 1: users in New York City started coming down with a
Speaker 1: respiratory disease nicknamed junkie pneumonia. Others developed a condition that
Speaker 1: was referred to as the dwindles because the people getting
Speaker 1: sick looked like they were wasting away. More recent research
Speaker 1: has revealed that these conditions were most likely caused by aids,
Speaker 1: which circulated among drug users in New York for years
Speaker 1: before crossing over into other populations. As you heard in
Speaker 1: our first episode, researchers only identified it as a new
Speaker 1: disease in nineteen eighty one, after it started showing up
Speaker 1: in gay men.
Speaker 11: In the United States, the focus was on sexual minority men,
Speaker 11: and for good reason. The problem we had then we
Speaker 11: still have a problem now, which is that people who
Speaker 11: inject drugs aren't a particularly sympathetic group, and unlike sexual
Speaker 11: minority men, they're not able to mobilize politically at the
Speaker 11: same level.
Speaker 1: The earliest needle exchange activists in the US knew that
Speaker 1: what they were doing was illegal. They were distributing drug paraphernalia.
Speaker 1: Their hope was that local governments would see the good
Speaker 1: in it and potentially even take over the exchanges themselves,
Speaker 1: but that wasn't going to happen without a struggle.
Speaker 12: Handing out needles is illegal throughout most of the country.
Speaker 1: Many people believe that keeps attics addicted. To many politicians
Speaker 1: and government officials, change sounded a lot like enabling drug use.
Speaker 13: It sends a terrible message that we are encouraging people,
Speaker 13: or we are at least accepting the fact that these
Speaker 13: people are are drug users and not doing very much
Speaker 13: to get them offer.
Speaker 11: It's almost like throwing in the town.
Speaker 1: In nineteen eighty eight, President Reagan signed a law that
Speaker 1: banned federal agencies from providing funding for needle exchange programs.
Speaker 1: Here is Reagan's Surgeon General see Everett Coop explaining the
Speaker 1: politics around the decision.
Speaker 3: It's very difficult even with people who are quite reasonable
Speaker 3: about the problems associated with AIDS, they can bring themselves
Speaker 3: to countenance a program that seems to aid and a
Speaker 3: bet an illegal and an mral practice, namely IVY drug abuse.
Speaker 1: The funding ban put a very low ceiling on how
Speaker 1: widespread needle exchange could become. According to the text of
Speaker 1: the law, the ban could be overturned, but not until
Speaker 1: there was definitive evidence that needle exchange reduced the bread
Speaker 1: of HIV without simultaneously increasing drug use. As public health
Speaker 1: experts set about conducting that research, small locally funded exchanges
Speaker 1: continued to pop up around the country. The program, co
Speaker 1: founded by Ricky Bluthenthal, was among them. In nineteen ninety two,
Speaker 1: he and his team set up shop in West Oakland,
Speaker 1: near an area where drugs were sold. They were supported
Speaker 1: by tiny grants from community organizations and sourced their supplies
Speaker 1: from another more established exchange in the Bay Area.
Speaker 11: So we just set up a table. We have educational
Speaker 11: information condoms, clean cotton, and then there'd be a big
Speaker 11: red bucket to collect the use syringes in, and then
Speaker 11: we'd have our cases of clean syringes.
Speaker 1: That was the system. Bring used syringes, toss them in
Speaker 1: the big red bucket, and leave with one clean syringe
Speaker 1: for each one you brought with you. Bluthenthal and his
Speaker 1: team distributed thousands of syringes during the first few months
Speaker 1: of the Oakland program. Through it all, they got no
Speaker 1: support from any government agency. In fact, they did their
Speaker 1: work knowing they could be arrested at any time. Until
Speaker 1: government officials at the local, state, and federal levels embraced
Speaker 1: need to exchange, that would be the status quo. Then
Speaker 1: Bill Clinton became president, and suddenly there was reason to
Speaker 1: hope that needle exchange could come out from the shadows.
Speaker 7: I was born in a little town called Hope, Arkansas.
Speaker 1: After twelve years of Reagan and Bush, many AIDS activists
Speaker 1: thought there was at least a chance that the Clinton
Speaker 1: presidency could be different, to.
Speaker 7: Change all our people's lives for the better and bring
Speaker 7: hope back to the American dream.
Speaker 1: After he was elected, Clinton took steps to signal his
Speaker 1: commitment to public health one was to task his wife
Speaker 1: Hillary with shaping his administration's approach to healthcare. Another was
Speaker 1: to nominate an unapologetically progressive doctor named Joycelyn Elders as
Speaker 1: surgeon General.
Speaker 9: I was a sophomore in colleague when I realized that
Speaker 9: I wanted to be a doctor.
Speaker 1: Growing up in rural Shawl, Arkansas, population ninety.
Speaker 8: Nine ninety eight, when I'm in little Rock.
Speaker 1: Elders didn't know anyone who was a doctor, and she
Speaker 1: got very little health education at school, you know.
Speaker 9: For I learned the most about sex education of really
Speaker 9: more about menstruation and now was from the leaflet that
Speaker 9: co Texts put in the cotext box.
Speaker 1: Elders went to medical school and became a pediatric endochronologist.
Speaker 1: In nineteen eighty seven, while Clinton was governor of Arkansas,
Speaker 1: he put her in charge of the state's Department of Health.
Speaker 1: By that point, AIDS was affecting people of color at
Speaker 1: twice the rate of white people. Black women, in particular,
Speaker 1: were twelve times as likely to contract HIV as white women.
Speaker 1: From her position in the state government, Elders tried to
Speaker 1: do something about the disparities by pushing for comprehensive sex
Speaker 1: ad and free condoms.
Speaker 9: I began called the condom Queen, and in fact I
Speaker 9: had condom tree on my desk.
Speaker 1: Wait, what's a condom tree?
Speaker 9: Well, it was a rubber tree, a tree that the
Speaker 9: nurses made for me, the public health nurses condoms of
Speaker 9: all different colors, Christmas tree, and sat in the middle
Speaker 9: of my conference table.
Speaker 1: And so you could take what if you wanted to one.
Speaker 8: No, they couldn't take them off my tree.
Speaker 9: But then there was plenty of them sitting out in
Speaker 9: the condom bow out in the office that you could
Speaker 9: just reach in and grab them.
Speaker 1: Elders made it a point to try to reach people
Speaker 1: who had been overlooked in a lot of HIV prevention messaging.
Speaker 1: She found that most of her ideas, particularly on sex
Speaker 1: ad and the distribution of condoms, were wildly unpopular in Arkansas.
Speaker 9: Anytime you're talking about sex and drugs, it's a moral
Speaker 9: issue rather than a public health issue.
Speaker 6: And that has made doctor Joycelne Elders Arkansas's most controversial woman.
Speaker 9: That wanted to tell me how God was going to
Speaker 9: strike me dead and stuff like that.
Speaker 11: This nation, not just our exult.
Speaker 1: Sex education is chronography, and.
Speaker 9: I felt that they were concerned about what they were
Speaker 9: concerned about. What I was concerned about, the young black
Speaker 9: girls that I was seeing lost in the Delta, that
Speaker 9: was being abused because of lack of education. Nothing could
Speaker 9: keep me from worrying about it and doing everything I
Speaker 9: could to make a difference. I had trouble sleeping at night,
Speaker 9: but I was determined that we were going to do
Speaker 9: something to make a difference.
Speaker 1: Governor Clinton at least seemed to appreciate Elder's willingness to
Speaker 1: dive headfirst into controversial issues, and when he became president,
Speaker 1: he once again called on her to serve in his administration.
Speaker 14: Doctor Joycelyn Elders, the former health commissioner of Arkansas now
Speaker 14: President Clinton's choyce for Surgeon General of the United States.
Speaker 1: Almost immediately, Elders became a lightning rod for scandal. A
Speaker 1: few months into her tenure, she caused a media frenzy
Speaker 1: by suggesting that the legalization of drugs could be good
Speaker 1: for society.
Speaker 9: And I do feel that we would marketly reduce our
Speaker 9: crime rate if drugs were legalized.
Speaker 1: And conservatives immediately jumped on Elders' comments. A right wing
Speaker 1: lobbying group circulated petitions to request her dismissal. Eighty seven
Speaker 1: House members signed a letter calling on Elders to resign.
Speaker 1: Rush Limbaugh mocked her on his show.
Speaker 15: Your Time Off for a Little Comic Relief, America's number
Speaker 15: one national embarrassment speaks for herself. Here's Joycelynd Elders and
Speaker 15: her theories on legalizing drugs.
Speaker 1: Here's Elders responding to the criticism at the time.
Speaker 16: Despite many of the comments and editory and reports that's
Speaker 16: been about me, I'm still grateful because you see, if
Speaker 16: I was walking around not saying anything that was at
Speaker 16: all controversial and that was all neutral, first of all,
Speaker 16: you wouldn't write about me. Secondly, if it was something
Speaker 16: that was right and simple and easy and everybody accepted
Speaker 16: it as a matter of fact, it would already be done.
Speaker 1: Legalization may have been a pipe dream, but need to
Speaker 1: exchange was at least a somewhat more realistic policy idea.
Speaker 1: To Elders, It's potential for slowing the spread of HIV
Speaker 1: was obvious.
Speaker 9: If somebody who has HIV uses the needle and then
Speaker 9: you use the same needle because she does say you
Speaker 9: can't afford to buy them, well, then you were injecting
Speaker 9: the virus into your body and you may not know
Speaker 9: that for a year, two or ten.
Speaker 8: So that was why Baby.
Speaker 9: Bolt needle exchange program, and then that reduced a lot
Speaker 9: of the HIV spread in a community.
Speaker 1: As Surgeon General Elders says, she always supported needle exchange
Speaker 1: and understood what it meant for programs to have to
Speaker 1: operate without support from the federal government.
Speaker 9: Some communities had really gotten tiny little grants, like from
Speaker 9: churches and other places, and they were passing out train
Speaker 9: needles from the trunk ofbec car.
Speaker 1: During the campaign, Bill Clinton had indicated that he was
Speaker 1: open to lifting the Reagan era funding ban on needle
Speaker 1: exchange programs, but if the model was going to win
Speaker 1: the administration's blessing, activists would need other players in Clinton's
Speaker 1: orbit to push him on it. That included Donna Shalela,
Speaker 1: Clinton's Secretary of Health and Human Services.
Speaker 5: We saw needle exchange as a mitigation strategy to reduce
Speaker 5: the incidents of AIDS and to save lives. Excuse me
Speaker 5: if I could interrupt for one moment. I've got to
Speaker 5: let him in here. He is you should know. My
Speaker 5: dog is named Fauci. Really yeah, he's a rescue dog.
Speaker 1: Hi Fauchi.
Speaker 5: When I went to pick him up, they said he
Speaker 5: had run into an Italian restaurant and he needed an
Speaker 5: Italian name, and I said, I'll call him Fauci. Tony
Speaker 5: said he'd been called worse.
Speaker 1: Before she joined the administration, Donna Shalala had been the
Speaker 1: chancellor of the University of Wisconsin. She says the job
Speaker 1: prepared her for the pressure she faced from AIDS activists
Speaker 1: as HHS secretary.
Speaker 5: I knew that we were going to be pushed by
Speaker 5: act UP and all of the groups who were in
Speaker 5: a desperate state, So that was expected as part of
Speaker 5: the job.
Speaker 8: I was a political scientist.
Speaker 5: I have been leading major research universities, so people getting
Speaker 5: into my face was something that was expected.
Speaker 1: During Clinton's first term, Salela enraged AIDS activists by suggesting
Speaker 1: that more research was needed to determine whether the Needle
Speaker 1: Exchange Funding Band should stay in place. The administration's stance
Speaker 1: on the issue became a kind of litmus test for
Speaker 1: a lot of activists, a sign that Clinton was willing
Speaker 1: to slow walk certain policies that posed a political risk.
Speaker 1: Here is a protester confronting Clinton about it at an
Speaker 1: AIDS event.
Speaker 17: There's been steps taken here advocated to be taken, like
Speaker 17: legalizing needles have been talked about for three years?
Speaker 7: Where have you been? Didn't you listen to what we
Speaker 7: said before about what we've done?
Speaker 18: Last night?
Speaker 1: Skeptics of needle exchange continued to insist there wasn't enough
Speaker 1: empirical evidence that the model worked and that it didn't
Speaker 1: result in more people using drugs, But the opposition was
Speaker 1: often about more than just data. For many, was rooted
Speaker 1: in a fundamental concern at the core of American drug policy.
Speaker 1: Agreeing to provide people with drug paraphernalia would mean acknowledging
Speaker 1: that the zero tolerance, just say no approach to drugs
Speaker 1: didn't work. It would basically mean throwing out the philosophical
Speaker 1: underpinnings of the whole drug war.
Speaker 14: There's no question that the right signal for the government
Speaker 14: of the United States to send is to say to somebody,
Speaker 14: if you're a drug addict and you need to use
Speaker 14: intravenos drugs, come into a center and let us help
Speaker 14: you get off drugs.
Speaker 1: This is former House Speaker Knut Gingrich weighing in on
Speaker 1: the needle exchange debate at a press conference.
Speaker 14: That is the only message, we should give drug addicts,
Speaker 14: but the government's job is to help you get off drugs.
Speaker 14: It is not the government's job to try to make
Speaker 14: killing yourself marginally safer as you do it.
Speaker 1: It wasn't only Republicans who opposed the idea of undoing
Speaker 1: the ban. Members of Clinton's own party were apprehensive too.
Speaker 5: There was a debate within the Democratic Party. I mean,
Speaker 5: you cannot say that this was just the Republicans. The
Speaker 5: party itself was torn on the issue because of drug
Speaker 5: addiction and because of crime related to drugs.
Speaker 1: Not all prevention measures were so fraught, as HHS Secretary
Speaker 1: Donna Shalala focused a lot on public health messaging through
Speaker 1: popular culture.
Speaker 19: Thank you all for coming AIDS is often thought of
Speaker 19: as a hopeless problem. Today we are here to talk
Speaker 19: about solutions.
Speaker 1: In early nineteen ninety four, Shalala announced a prevention initiative
Speaker 1: at the Clinton administration had developed with the CDC. It
Speaker 1: would include a series of PSAs starring celebrities like Jason
Speaker 1: Alexander and Martin Lawrence.
Speaker 19: This campaign is focused on young adults because studies tell
Speaker 19: us that young Americans are more sexually active than ever before,
Speaker 19: and they are not taking proper precautions.
Speaker 5: So it was very important for us to approach young people.
Speaker 5: So we went to the entertainment industry, but mostly to
Speaker 5: the raps and to the music industry. We literally needed
Speaker 5: everybody the communicated with young people to educate the entire
Speaker 5: society about AIDS.
Speaker 17: I'm Anthony Ketis of the Red Hot Chili Peppers, and
Speaker 17: I've been naked on stage. I've been naked on magazine covers.
Speaker 17: In fact, I was born naked, And of course I'm
Speaker 17: naked whenever I have six. And what I have here
Speaker 17: is a condom, a latex condom. I wear one whenever
Speaker 17: I have six, not whenever it's.
Speaker 1: The Clinton administration's media push coincided with another leap in
Speaker 1: the growing public awareness of HIV and AIDS. Much like
Speaker 1: Rock Hudson years earlier, several famous people disclosing their diagnoses
Speaker 1: changed the public understanding of what HIV was and whom
Speaker 1: it could affect. The most famous of these was NBA
Speaker 1: legend Magic Johnson, who had revealed his diagnosis back in
Speaker 1: nineteen ninety one.
Speaker 6: I think sometimes we think, well, only gay people can
Speaker 6: get it, only is not going to happen to me.
Speaker 1: And here I am saying that it can happen to anybody.
Speaker 1: Even later, there was easy E from NWA, just.
Speaker 11: Like Magic Josson when he thought it. You know well,
Speaker 11: stuff like this happened.
Speaker 20: Agency to come out speak and let other people wherever.
Speaker 20: So you know what I'm saying, we can try to
Speaker 20: contain this stuff that was getting bad, you know what.
Speaker 1: There was also Pedro Zamora, the activist who appeared as
Speaker 1: a housemaid on MTV is the Real World in nineteen
Speaker 1: ninety four.
Speaker 8: I will probably not see the AH thirty.
Speaker 10: I will probably die.
Speaker 1: As Elay dying. Even the President called, I just want
Speaker 1: to tell you.
Speaker 11: I was thinking about you, and tryan for He might
Speaker 11: not be able to answer, but he understands everything.
Speaker 17: Okay.
Speaker 1: All these disclosures went a long way towards educating the
Speaker 1: public about HIV risk and prevention, but activists were frustrated
Speaker 1: that the policy changes Clinton had seemed to support as
Speaker 1: a ended it weren't materializing faster in his presidency, and
Speaker 1: after the nineteen ninety four midterm swept in a new
Speaker 1: conservative Congress, the political possibilities seemed even more limited. As
Speaker 1: the activist Sean Strube wrote at the time in his
Speaker 1: magazine for people with HIV. This administration's priority is all
Speaker 1: about image and media. As I write this, they are
Speaker 1: cynically trying to have a press flurry of pseudo action
Speaker 1: prior to World Aid's Day. As it turned out, World
Speaker 1: Aid's Day in nineteen ninety four would end up generating
Speaker 1: a lot of press for the Quinton administration, just not
Speaker 1: in the way they had hoped.
Speaker 4: This is World Age Day. There were ceremonies and observances
Speaker 4: around the world, but very little in the way I've encouragement.
Speaker 1: The seventh annual World Aid's Day took place on December one,
Speaker 1: nineteen ninety four. As part of the event, Surgeon General
Speaker 1: Joycelyn Elders was invited to speak and answer questions from
Speaker 1: the press at a United Nations forum.
Speaker 8: Yeah.
Speaker 9: I don't think the speech I gave was necessarily that earthshaking.
Speaker 9: But a psychiatrist asked me about masturbation.
Speaker 21: I think that that is something that it's a part
Speaker 21: of human sexuality that perhaps should be taught, and I
Speaker 21: feel that we have tried ignorance for a very long time,
Speaker 21: and it's time we try education reguard to masturbation.
Speaker 1: Elders didn't think anything of it. It was the kind
Speaker 1: of thing she said all the time to all kinds
Speaker 1: of audiences.
Speaker 4: Doctor Joycelyn Elders proved once too often that speaking your mind,
Speaker 4: especially on issues as sensitive a sex, education and sexuality,
Speaker 4: could be very bad politics, especially with the Republicans breathing
Speaker 4: down the President's neck as they are.
Speaker 1: Within days, Elders was being pummeled in right wing media.
Speaker 8: Why does the president keeper? I assume he shares our values.
Speaker 14: I assume he thinks it's okay.
Speaker 1: For Clinton and his political advisors. It was the last straw.
Speaker 1: A little more than a week after she made the
Speaker 1: comments about masturbation, Elders was forced to resign.
Speaker 4: Doctor Elders was fired today by President Clinton. In a
Speaker 4: letter to the Health Secretary Donachileela late this afternoon, doctor
Speaker 4: Elders writes, President Clinton and I maintain our strong mutual
Speaker 4: respect for each other. She also says that as a
Speaker 4: private citizen, she intends to continue speaking out on the
Speaker 4: public health causes that are as she puts it, dear
Speaker 4: to her.
Speaker 1: Here's Elders talking about her firing the week it happened
Speaker 1: on this day show.
Speaker 18: Yeah, I really thought that all of the comments I
Speaker 18: made were true and you know, I think that the
Speaker 18: country needs to approach many of these issues. And the
Speaker 18: longer we wait, I feel, the more children we are
Speaker 18: going to lose. And I don't feel that, you know,
Speaker 18: I should start second guess in my life self today.
Speaker 1: After she left Washington, Elders returned to her home state.
Speaker 1: She became a professor at the University of Arkansas and
Speaker 1: toured the country as a speaker and educator.
Speaker 8: You know how I was.
Speaker 9: I never tiptoed around very much. I just said what
Speaker 9: I thought and believed. I was sorry, you know, to
Speaker 9: have lost the position. Now I'm not saying that, but
Speaker 9: the next five years so I was all over this country,
Speaker 9: talks it all over the time.
Speaker 8: Yeah.
Speaker 9: In fact, that was all I did, was running around
Speaker 9: running my mouth.
Speaker 1: On one occasion, Elders told an audience that she regretted
Speaker 1: not advocating more firmly for needle exchange while she was
Speaker 1: in government. Politicians, she said, should drop all this crap
Speaker 1: about not using federal money for needle exchange programs because
Speaker 1: they don't want to support IVY drug use. Is it
Speaker 1: all right? She asked to support death.
Speaker 3: Good morning, and welcome.
Speaker 1: In nineteen ninety five, the year, after Joycelyn Elders was fired,
Speaker 1: Clinton appointed a brand new, twenty three member Advisory Council
Speaker 1: on HIV and AIDS.
Speaker 6: I'd like to begin by thanking all of you for
Speaker 6: your service on this advisory council. We need your advice,
Speaker 6: your wisdom, your enthusiasm. You're urging an American najor service,
Speaker 6: and I thank you for it very much.
Speaker 1: As you know, both the Reagan and Bush administrations had
Speaker 1: appointed their own advisory councils to make recommendations about the epidemic,
Speaker 1: and both times members had resigned publicly because so little
Speaker 1: of their advice was taken. Clinton's new council was meant
Speaker 1: to signal that he was going to do things right
Speaker 1: this time, and that, unlike his predecessors, he would actually
Speaker 1: listen to the experts. One of the members of the
Speaker 1: new AIDS council was a lawyer from Chicago who had
Speaker 1: been a fundraiser for Clinton's ninety two campaign. His name
Speaker 1: was Bob Fogel.
Speaker 10: I was just a regular person. I've loved politics all
Speaker 10: my life, and I had met Clinton and.
Speaker 11: Really thought he was terrific.
Speaker 1: After Clinton won, Fogel thought about trying to become an
Speaker 1: ambassador but his wife nixed the idea of a family move.
Speaker 10: So I looked at boards and commissions, and AIDS was
Speaker 10: a big issue, and I thought, you know, I can
Speaker 10: pivot away from being the trial lawyer guy. I can do,
Speaker 10: hopefully something that would be useful and contributory to the
Speaker 10: well being of our country. So I figured I would
Speaker 10: ask if I could be appointed to the President's Advisory
Speaker 10: Council and HIV AIDS.
Speaker 1: When Fogel showed up to a hotel in Washington for
Speaker 1: the council's first meeting, he realized right away that he
Speaker 1: was the odd man out.
Speaker 10: The night before our first official meeting and swearing in,
Speaker 10: we made a circle in the little meeting room in
Speaker 10: the basement area and introduced ourselves. I was almost a
Speaker 10: little embarrassed at how little I really knew compared to
Speaker 10: everybody else.
Speaker 1: The other council members were medical professionals or had long
Speaker 1: personal histories with AIDS activism. The person who introduced himself
Speaker 1: right before Fogel was an activist with HIV who had
Speaker 1: spoken at the Democratic National Convention.
Speaker 10: One of the things he said was, you know what,
Speaker 10: you know, we've been pushing Clinton to do stuff related
Speaker 10: to AIDS make it a focus of his administration, and frankly,
Speaker 10: he figured, he'll give the straight white guys in the
Speaker 10: suits one more opportunity to get it, and if they don't,
Speaker 10: then he would be done with them.
Speaker 1: Then it was Fogel's turn to speak.
Speaker 10: And I said, well, I'm one of those people, and
Speaker 10: I'm here to learn, and if I end up getting it,
Speaker 10: then there's really no reason why the straight white guys
Speaker 10: in the suits in the White House shouldn't get it either.
Speaker 1: As part of his work on the Advisory Council, Fogel
Speaker 1: was briefed on the connection between intravenous drug use and HIV.
Speaker 1: It was clearly a huge problem. By that point, ivy
Speaker 1: drug use accounted for about a third of new HIV
Speaker 1: cases in the US, But when Fogel learned about needle exchange,
Speaker 1: he was extremely skeptical.
Speaker 10: When I first heard about needle exchange, it was like,
Speaker 10: are you kidding me? You want to give needles to
Speaker 10: drug addicts. Aren't you promoting the use of drugs? There
Speaker 10: must be a different or better way to deal with
Speaker 10: this issue.
Speaker 1: But as Fogel learned more, he started to take a
Speaker 1: different view. Back home in Chicago, he met with an
Speaker 1: activist and drug user who ran in exchange.
Speaker 10: You know, I asked my I would say, straight white
Speaker 10: guy in the suit sort of questions, you know, gosh,
Speaker 10: you know, why are you doing this? And why does
Speaker 10: this work? And what are the benefits? And aren't you
Speaker 10: afraid of you know, those sorts of things, and so,
Speaker 10: you know, it began to make sense. It wasn't just
Speaker 10: giving needles to drug addicts. It was perhaps getting some
Speaker 10: of them into drug treatment, and it was certainly counseling
Speaker 10: them on the dangers and risk of age and if
Speaker 10: they had aids, perhaps into some treatment programs for that
Speaker 10: as well.
Speaker 1: Back in Oakland, Ricky Bluthenthal continued to run his needle exchange.
Speaker 1: Over time, he had become an expert on harm reduction,
Speaker 1: the idea that drug policy should be focused on reducing
Speaker 1: the negative consequences of drug use as much as possible,
Speaker 1: rather than trying to punish or restrict people out of addiction.
Speaker 1: Bluthenthal felt that the scientific evidence and the moral imperative
Speaker 1: were aligned, and if other people couldn't see that, then
Speaker 1: it wasn't necessarily worth trying to engage with them.
Speaker 11: The people arguing against these programs aren't even in the
Speaker 11: same universe as far as I'm concerned. They're dealing with
Speaker 11: a set of problems that have nothing to do with
Speaker 11: the individual that I'm talking to. Cross the way. They're
Speaker 11: living in a world that's full of moral fictions and
Speaker 11: fear that misunderstand the harm that's done by substances and communities.
Speaker 1: From Bluthenthal's perspective, those who opposed needle exchange on moral
Speaker 1: grounds were simply not interested in HIV prevention.
Speaker 11: The people arguing against us were fine with people dying
Speaker 11: from HIV AIDS. There's no a solution, right, so they're like, oh,
Speaker 11: we don't want people to use drugs. Well that's great,
Speaker 11: you know, there's no easy way to do that. And
Speaker 11: the things that you've been doing at that point for
Speaker 11: twenty years we now know definitively don't help.
Speaker 1: But as long as the laws didn't change, need to
Speaker 1: exchange volunteers continued to risk arrest. In nineteen ninety five,
Speaker 1: Bluthenthal and several of his colleagues went on trial for
Speaker 1: distributing drug paraphernalia. Blutenthal says he was confident the jurors
Speaker 1: would find him to be a sympathetic defender.
Speaker 11: I was a young African American man getting a PhD
Speaker 11: at UC Berkeley, and I had a bunch of evidence
Speaker 11: on my side, So you know, I think there were
Speaker 11: a lot of people in the jury box you're reading
Speaker 11: for me.
Speaker 1: After deliberating for four hours, the jury found Luthenthal and
Speaker 1: his colleagues not guilty on the basis that their work
Speaker 1: was a benefit to society. It was the third time
Speaker 1: the County DA had tried and failed to prosecute needle
Speaker 1: exchange activists. For all the worry that needle exchange was
Speaker 1: politically deadly, it seemed to have grassroots support within the
Speaker 1: communities that actually had programs, but reversing the ban on
Speaker 1: federal funds still didn't seem to be a priority.
Speaker 6: Never again, should Washington put politics and party above law
Speaker 6: and order.
Speaker 1: From the start of his presidency, Clinton had always gone
Speaker 1: to great lengths to position himself as a proponent of
Speaker 1: law and order, not some hippie, as he was often portrayed,
Speaker 1: but someone who took the drug war seriously, just like
Speaker 1: Reagan and Nick and had. After Republicans took control of
Speaker 1: the House and Senate, Clinton felt he had even less
Speaker 1: room to take chances on progressive policies. As he prepared
Speaker 1: to run for a second term, he decided to appoint
Speaker 1: a new DRUGSAR, a retired general named Barry McCaffrey, who
Speaker 1: was a hardliner on drug policy. For now, at least,
Speaker 1: Reagan's ban on funding for needle exchange would remain firmly
Speaker 1: in place.
Speaker 5: Are scientists on the verge of making AIDS a manageable disease.
Speaker 1: There was positive news on that issue, but some caution too.
Speaker 1: When the Triple Cocktail was announced in nineteen ninety six,
Speaker 1: the whole outlook of the AIDS epidemic shifted. Over the
Speaker 1: following year, the mortality rate for people with AIDS in
Speaker 1: the US dropped by almost fifty percent.
Speaker 6: We have a lot to celebrate. For the first time
Speaker 6: since the epidemic began, deaths due to AIDS in the
Speaker 6: United States have declined for the first time. Therefore, there
Speaker 6: is hope that we can actually defeat AIDS.
Speaker 1: And yet, there were still more than fifty thousand new
Speaker 1: cases diagnosed that year, and the racial disparities were only
Speaker 1: getting more stark. In nineteen ninety six, forty one percent
Speaker 1: of infections were diagnosed in Black Americans, even though they
Speaker 1: only made up about thirteen percent of the country's population.
Speaker 14: More and more African American women are being infected through
Speaker 14: heterosexual contact.
Speaker 1: Their children are also at risk. In nineteen ninety seven,
Speaker 1: the CDC released a major study concluding that IV drug
Speaker 1: use was the primary driver of new HIV infections. Expanding
Speaker 1: needle exchange and reversing the ban on federal money had
Speaker 1: never seemed more urgent. Here again is Bob Fogel, the
Speaker 1: trial lawyer who served on Clinton's Council on HIV and AIDS.
Speaker 10: The benefits of federal funding is that bypasses the states,
Speaker 10: the governors or the legislatures, and programs could be set
Speaker 10: up where needed in cities and states where it otherwise
Speaker 10: wouldn't occur. And the federal government has the deepest pockets
Speaker 10: you know. For the federal government to put five hundred
Speaker 10: million dollars or one hundred and fifty million dollars into
Speaker 10: natal exchange programs would have been huge. I mean, they
Speaker 10: could have started programs and a lot of major cities
Speaker 10: across the country.
Speaker 1: The President's Advisory Council on HIV AIDS was in complete
Speaker 1: agreement that the federal government should fund needle exchange. They
Speaker 1: had said as much in a formal recommendation, but the
Speaker 1: White House made no moves to follow through. Fogel was
Speaker 1: losing his patients, and.
Speaker 10: The question is, why aren't they doing something so important?
Speaker 10: Why aren't they acting? Why aren't they responding? I mean,
Speaker 10: are we just you know, in my head, are we
Speaker 10: just a phony front? And you know, at that point,
Speaker 10: it's like, are we wasting our time?
Speaker 12: You know?
Speaker 10: And if they're not going to follow our recommendations, let
Speaker 10: alone this one in particular, then let's just quit wasting
Speaker 10: you know, time and money. So yeah, I was pissed.
Speaker 1: Frustrations reached a boiling point at a council meeting in
Speaker 1: July of nineteen ninety seven. Members of Act UP interrupted
Speaker 1: the meeting, demanding faster movement on a wide variety of issues.
Speaker 1: After the protest subsided, Fogel spoke up in solidarity.
Speaker 10: And I raised my hand and I said, look, we've
Speaker 10: made multiple recommendations on this that appear to be ignored.
Speaker 10: No action is being taken. There's no good reason for
Speaker 10: not taking action, and perhaps maybe what we ought to
Speaker 10: do is just resign on mass in protest, and somebody
Speaker 10: across the room yelled, I second the motion. The press
Speaker 10: people that covered our meetings, you know, jumped up like
Speaker 10: holy shit. You know, Fogel has just moved that the
Speaker 10: council resign and protest over their failure to certify needle
Speaker 10: exchange programs.
Speaker 1: After the meeting ended, the council chairman pulled Fogel aside.
Speaker 10: And said, great job. This is terrific. You know, the
Speaker 10: press is going to run with this. This is really
Speaker 10: going to put pressure on them.
Speaker 5: Some harsh criticism today for the President and it comes
Speaker 5: from his own advisors on AIDS.
Speaker 2: Especially critical of the administration's failure to fund programs for
Speaker 2: drug addicts to exchange dirty syringes for clean ones to help.
Speaker 10: I remember my mother called me a few days later.
Speaker 10: She told me she read about me in the Springfield
Speaker 10: Union and which is in Springfield, Massachusetts, and she was
Speaker 10: so proud of me. I said, Mom, I want to
Speaker 10: give needles to drug addicts. She said, well, if you
Speaker 10: think it's the right thing to do, I'm for it.
Speaker 1: In the spring of nineteen ninety eight, the year's long
Speaker 1: pressure campaign on Clinton to reverse the funding ban appeared
Speaker 1: to finally be working. It had been almost a decade
Speaker 1: since the ban was put in place and it was
Speaker 1: set to expire soon. If the administration wanted to make
Speaker 1: a change, it seemed like the perfect moment. HHS Secretary
Speaker 1: Donna Shalela was ready to certify the research required to
Speaker 1: change the policy to confirm that needle exchange programs did
Speaker 1: reduce the spread of HIV and that they didn't increase
Speaker 1: drug use. In private, Shalalela tried to convince the President
Speaker 1: that the scientific basis for the policy was unimpeachable.
Speaker 5: I made every argument I possibly could. He knew what
Speaker 5: the arguments were. He had a letter in his hand
Speaker 5: from all the scientific leaders and public health leaders of
Speaker 5: the department.
Speaker 1: Still Clinton wouldn't commit. At one point, Shilela says the
Speaker 1: White House urged her to hold off on certifying the research. Instead,
Speaker 1: they wanted her to suggest that the efficacy of needle
Speaker 1: exchange was still up for debate.
Speaker 5: Someone from the White House called over and said, tell
Speaker 5: Schalela to announce that we needed more research. And I said,
Speaker 5: I will not repeat on this program what I said,
Speaker 5: but basically I said, no, that was ridiculous. I was
Speaker 5: not going to say the researchers we needed more research.
Speaker 5: When they said the research was clear. This was a
Speaker 5: matter of integrity for the apartment and for me personally.
Speaker 1: Shalela was confident that the President understood the science just
Speaker 1: as clearly as she did. If anything was preventing him
Speaker 1: from embracing needle exchange, it wasn't the quality of the research.
Speaker 1: It was politics.
Speaker 8: Delay.
Speaker 5: Delay meant to me they we were making a political calculation.
Speaker 5: It wasn't substantive, and the call that maybe Shililah should
Speaker 5: say we need more research was the tip off.
Speaker 1: Shaleala was resolved to publicly validate the idea of needle exchange,
Speaker 1: regardless of what Clinton decided to do, so her office
Speaker 1: scheduled the press conference from Monday, April twentieth. Schalela's hope
Speaker 1: was that by the time she took the podium, Clinton
Speaker 1: would have made up his mind to undo the ban.
Speaker 4: The President could lift that ban if he could certify
Speaker 4: with scientific evidence that such programs reduced the rate of
Speaker 4: HIV infection without encouraging drug use.
Speaker 1: Scientists and activists who had been advocating for needle exchange
Speaker 1: were told to expect good news, but Shilala says she
Speaker 1: wasn't sure what the president's decision would ultimately be.
Speaker 5: The press conference was one or the other. I warned
Speaker 5: everybody before the press conference that it was possible the
Speaker 5: President would say no.
Speaker 1: It turned out that Shilala was right to temper expectations.
Speaker 1: Less than an hour before the press conference, HHS was
Speaker 1: contacted by the White House to say that the President
Speaker 1: would be keeping the ban in place. The department scrambled
Speaker 1: to adjust its plans, delaying its announcement by three hours.
Speaker 1: That day, Bob Vogel was with his brother at a
Speaker 1: Red Sox game in Fenway Park when he received a
Speaker 1: page to join a conference call. He took it in
Speaker 1: the parking lot.
Speaker 10: We got on the call and the news was broken
Speaker 10: that the final decision had been made that there would
Speaker 10: not be a formal certification. And I would say I
Speaker 10: was shocked. I mean, it just seemed like, and I
Speaker 10: hate to use this word so but like a flip flop.
Speaker 10: We were heading down this road and suddenly they chickened out.
Speaker 10: I guess is how I would describe it. It was
Speaker 10: very disappointing.
Speaker 1: At the press conference, Secretary Shalala did what she had
Speaker 1: come to do and certified the research findings required to
Speaker 1: overturn the ban, but as she explained to reporters, the
Speaker 1: ban itself was staying put.
Speaker 4: In Washington to day, the Clint administration has decided to
Speaker 4: maintain the ban on using federal funds to pay for
Speaker 4: needle exchange programs. Those are the ones designed to prevent
Speaker 4: the spread of AIDS.
Speaker 5: It was painful. It was painful because the evidence was
Speaker 5: so clear. It was heartbreaking for me to face the
Speaker 5: scientist and say. The President said, no, I didn't like it.
Speaker 5: I didn't like transmitting it, but he made the decision.
Speaker 4: The Secretary of Health and Human Services, Dona Chalela, said
Speaker 4: there is evidence that the programs do reduce the transmission
Speaker 4: of HIV without significantly increasing drug use, but she said
Speaker 4: that state and local governments have to pay for the programs.
Speaker 10: I suppose it was a compromise, you know. I was shocked.
Speaker 10: I wished they had bigger balls than that, but that
Speaker 10: was better than silence.
Speaker 1: Journalists reported that scientists seated next to Shalala looked visibly uncomfortable.
Speaker 1: I wish I could play you some audio from the
Speaker 1: event itself, but it was limited to print reporters only.
Speaker 1: Here's Chilela explaining the compromise A few days later.
Speaker 5: Federal money doesn't pay for everything that's important in this country,
Speaker 5: and in this case, the administration made the decision not
Speaker 5: to make this ineligible activity under prevention funds. The most
Speaker 5: important message today is that the science is now there
Speaker 5: so that local communities ought to look at their strategies
Speaker 5: and they can then consider using a needle exchange program
Speaker 5: as part of that overall strategy. It was the worst
Speaker 5: moment in my HHS leadership in terms of a policy decision.
Speaker 5: I thought it was the most dangerous thing that Congress
Speaker 5: and the President could do. I mean, we had a
Speaker 5: strategy that would save lives, save people from getting infected,
Speaker 5: and we ought.
Speaker 10: To use it.
Speaker 1: There are a few different theories about why Clinton came
Speaker 1: out against needo exchange at the last minute. One blames
Speaker 1: his drugs are Barry McCaffrey, who cornered the President on
Speaker 1: Air Force one just before the press conference and made
Speaker 1: the case that changing the rule would condone drug use.
Speaker 1: Clinton would later say he believed Congress would simply pass
Speaker 1: a new funding ban if he lifted the old one,
Speaker 1: but according to Donna Shalela, his decision had more to
Speaker 1: do with pressure from Senate Democrats than anything else.
Speaker 5: Bill Clinton did it under political pressure because Democrats thought
Speaker 5: they were going to have trouble getting re elected. There
Speaker 5: were Democrats that bought the argument that it would enable
Speaker 5: drug use.
Speaker 1: Clinton's waffling led to a significant increase in national media
Speaker 1: coverage of needle exchange miss America. In nineteen ninety eight,
Speaker 1: Kate Shindle spoke publicly about her personal evolution on the issue.
Speaker 8: I was very much against these pro when I first
Speaker 8: became Miss America.
Speaker 1: It's a really had issue as far as.
Speaker 19: Government is concerned right now, because there is that catchphrase
Speaker 19: needle exchange, and unfortunately there are a lot of people
Speaker 19: that don't read past the headlines.
Speaker 1: And I was sort of guilty of that. But then
Speaker 1: I was enlightened.
Speaker 20: I guess.
Speaker 1: Four years later Quinton said he had been wrong not
Speaker 1: to lift the ban, and about fourteen years after that,
Speaker 1: in twenty sixteen, Congress quietly got rid of it. The
Speaker 1: new policy made it possible for federal funds to be
Speaker 1: used for anything a needle exchange program needed, except the
Speaker 1: syringes themselves. As we finish our work on this podcast,
Speaker 1: there's still no vaccine for HIV, and there's still no
Speaker 1: cure for AIDS. More recent medical innovations like PREP made
Speaker 1: it much easier for people to have sex safely, and
Speaker 1: treatments for people with HIV and AIDS have allowed many
Speaker 1: to live with undetectable viral levels. And yet the UN
Speaker 1: estimates that of the nearly forty million people worldwide who
Speaker 1: were living with HIV in twenty twenty, a quarter did
Speaker 1: not have access to effective treatment. The trends that emerged
Speaker 1: in the nineties have also deepened the racial disparities and
Speaker 1: the disproportionate impact on drug users. Meanwhile, most of us
Speaker 1: move through the world not thinking very much at all
Speaker 1: about AIDS. It's kind of like the Ozone layer or
Speaker 1: Save the Whales, an issue people used to think it
Speaker 1: was important to care about. One thing that's become obvious
Speaker 1: to me during the COVID pandemic is how big a
Speaker 1: difference visibility makes if someone you know gets sick. If
Speaker 1: you can hear the ambulances in the street, you pay
Speaker 1: more attention, You're more willing to take precautions. Then as
Speaker 1: soon as the disease is out of sight, it becomes
Speaker 1: incredibly easy to pretend it's not happening at all. The
Speaker 1: people we spoke to for this podcast the ones who
Speaker 1: witnessed the beginning of AIDS from up close don't need
Speaker 1: to be reminded that the story does not yet have
Speaker 1: an ending. Many of them told us they hoped to
Speaker 1: live long enough to see the next big breakthrough. You know,
Speaker 1: the work is essentially interminable until we have a cure
Speaker 1: in a vaccine.
Speaker 8: So we're still working on those same things.
Speaker 10: Forty years later.
Speaker 7: I'm still here and got the treatments, waiting for that cure,
Speaker 7: waiting for that vaccine, but still hopeful and still curious.
Speaker 8: We've come a long way.
Speaker 9: We've made a lot of progress on this disease, so
Speaker 9: we can eradicate the spars. So back to me is
Speaker 9: what I would really that would be my dream. That's
Speaker 9: what I've like happened.
Speaker 20: We've lost so many people, We've lost so many lives.
Speaker 20: We have to remember this. We have to remember the struggle,
Speaker 20: because it's only in remembering the struggle that you understand
Speaker 20: that you can fight, that you must fight.
Speaker 13: What patients are asked on and asked me because I
Speaker 13: start having a lot of gray hair, white hair, whatever.
Speaker 13: They're getting nervous that I may have a retirement in
Speaker 13: my future, and so what I try to do to
Speaker 13: assuage their concerns and fear is that You've got me
Speaker 13: from the very first case in New York. You've got
Speaker 13: me until hopefully the very last case, after a cure
Speaker 13: has developed and I get to administer it to all
Speaker 13: of my patients, and then I'll be happy to step down.
Speaker 10: And that's the way I leave it.
Speaker 13: It's a I guess it's a fantasy.
Speaker 1: For all the people who survived those years. There are
Speaker 1: so many who didn't. I want to leave you with
Speaker 1: a c from the funeral of Bobby Campbell. He was
Speaker 1: the first person with AIDS you heard in the series,
Speaker 1: the nurse from San Francisco who turned himself into a
Speaker 1: poster boy for the disease. When Campbell died in nineteen
Speaker 1: eighty four, he was remembered with a memorial service attended
Speaker 1: by a thousand friends, family members, and neighbors. One of
Speaker 1: the people who spoke was Campbell's partner, Bobby Hilliard.
Speaker 12: When Bobby was an intensive care I left my backpack
Speaker 12: out in the waiting room and I was in the
Speaker 12: room with him. After he died, I went back to
Speaker 12: the waiting room and sitting on top of the backpack
Speaker 12: was a little bell that I had never seen before,
Speaker 12: and someone left there and I've been carrying it around
Speaker 12: in my pocket since then, and I'd like to say
Speaker 12: one more thing before ringing it. Love after Death for Bobby.
Speaker 1: Fiasco is presented by Audible Originals and Prologue Projects. The
Speaker 1: show is produced by Andrew Parsons, Sam Graham Felsen, Madeline
Speaker 1: kaplan Ulla Culpa and me Leon Nafock. Our researcher is
Speaker 1: Francis Carr. Editorial support from Jessica Miller and Norah waswas
Speaker 1: archival research by Michelle Sullivan. This season's music is composed
Speaker 1: by Edith Mudge. Additional music by Nick Silvester of God Mode,
Speaker 1: Joel Saint, Julian and Dan English, Noah Hect and Joe Valley.
Speaker 1: Our theme song is by Spatial Relations, Music licensing courtesy
Speaker 1: of Anthony Roman. Audio mixed by Erica Wong with additional
Speaker 1: support from Selina Urabe. Our artwork is designed by Teddy
Speaker 1: Blanks at Chips and Y. David Blum is the editor
Speaker 1: in chief of Audible Originals. Mike Charzik is the Vice
Speaker 1: president of Audible Studios. Zach Ross is Head of Acquisition
Speaker 1: and Development for Audible. Thanks to Peter Yassi, Percy Everlin,
Speaker 1: Arlene Arevelo, Michael Helquist, Carrie Baker, Alice Gregory, Jannis Kolpa,
Speaker 1: Chris Robi, Stephen Fisher, and everyone at Audible