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  •   Ruling Shows How Far Nation Has Come on Epidemic

    By Justin Gillis
    Washington Post Staff Writer
    Friday, June 26, 1998; Page A16

    They came by subway and taxi. At dawn, they swarmed the doors of the Food and Drug Administration to demand access to experimental AIDS drugs. Held back for nine hours by police wearing rubber gloves and carrying riot shields, the protesters smashed windows, chanted slogans, staged "die-ins" and burned President Ronald Reagan in effigy.

    The protesters on that autumn day in 1988 wanted more than treatments. They sought an end to the fear and discrimination surrounding AIDS, a climate that led to people being firebombed out of their houses, dismissed from school and fired from their jobs. They wanted to highlight Reagan's refusal to talk about the disease even as thousands fell ill.

    What a difference a decade makes.

    The Supreme Court ruled yesterday that infection with the AIDS virus ought to be treated like any other serious disease. It was, in one sense, a narrow issue of the law. But in a larger sense the ruling signified just how far the country has come in the past decade in coping with the worst epidemic of modern times.

    The despair of those early days has been replaced, to a great extent, by hope. The kinds of treatments the protesters were demanding a decade ago are now on sale at the local drugstore. Death rates from AIDS have plummeted in the United States and other industrialized countries. The protesters who once smashed windows at the FDA now sit on government committees that oversee AIDS research. Special programs permitting early access to promising drugs have been in place for years.

    And the climate of fear surrounding AIDS has largely dissipated. Large numbers of people now know how the human immunodeficiency virus (HIV) is contracted and how to avoid it. The firebombings and firings have largely stopped. When they still happen, the law in most states is poised to come down like a hammer.

    The contrast with the attitudes that prevailed in the mid-1980s could not be more striking.

    When the disease that would eventually be called AIDS first emerged in 1981, a few officials within agencies like the federal Centers for Disease Control and Prevention realized that a new infectious agent was almost certainly at work and that it could well be spreading rapidly. They tried to sound the alarm, but the nation was not ready to talk about subjects like sex, needles and condoms.

    Among those most heavily in denial were gay men, who were most at risk. They were still enjoying the sexual liberation won in the 1970s, and nobody was in a mood to call the party off, even as young friends began falling ill.

    New York playwright Larry Kramer finally broke through this denial in early 1983 with an article in a widely read gay magazine. Headlined "1,112 and Counting," Kramer's polemic warned: "If this article doesn't rouse you to anger, fury, rage and action, gay men may have no future on this Earth."

    As they turned their fear into political engagement, the activists confronted a Washington that resisted action. Blood banks denied that any extra precautions were needed to prevent transmission. AIDS was buried deep inside newspapers, seldom mentioned on television.

    The death of movie star Rock Hudson in 1985 finally put AIDS on the front pages. But still, three young hemophiliacs, Ricky, Robert and Randy Ray, were firebombed out of their Florida home when their neighbors learned they were HIV-positive two years later. While there was already convincing evidence that AIDS could not be transmitted by casual contact, people were nevertheless fired from their jobs across the country because of fears that they posed a threat to co-workers.

    Mark King, an AIDS educator in Atlanta, recalls the day in 1985 that he tested positive for the virus. On a news program that same day, he heard that two people in Alabama had tested positive – and promptly shot themselves. Around the country, people with the virus were jumping out of windows or taking overdoses of sleeping pills.

    "I had fellow gay men who were afraid of me, much less conservative people," King recalled. "It was this really nightmarish existence."

    People afflicted with AIDS began their own support groups, eventually building a new social service network. Prodded by Kramer and others, activists besieged the federal scientific establishment, Congress and the White House.

    Slowly, the country did respond. Research money began to flow. Scientists discovered many of the chinks in HIV's armor, and they turned their attention to designing new drugs to exploit them. The FDA, under pressure, devised ways to speed access to new treatments.

    Public perceptions got a big jolt in 1991, when basketball star Earvin "Magic" Johnson announced that he had contracted the virus. "Here I am saying that it can happen to anybody, even me, Magic Johnson," he told a shocked nation. And the next year, heiress Mary Fisher electrified the Republican National Convention when she announced she had the virus and called for compassion for everyone fighting AIDS.

    AIDS was clearly no longer a "gay disease."

    As new treatments finally came onto the market, death rates began to fall, and people began to rise from their sick beds to return to active lives. Yet for all the changes, the social history of AIDS is far from over.

    More and more, AIDS is showing up not in gay men but in poor women. Many do not know they need to be tested and do not have insurance to pay for treatments that could prolong their lives. On a vastly larger scale, that situation is mirrored around the world. Most victims live in poor countries where new treatments are largely unavailable.

    "I have to look at the body count more than whatever social progress has been made," Kramer, the playwright, said yesterday. "It's eradicating whole portions of the globe, and we sit here and sort of watch it silently."

    Even in the United States, new treatments have only dented the epidemic, not stopped it. While the death rate may have slowed dramatically, the rate of new infections has not. At last report, the toll of AIDS cases diagnosed in this country stood at 641,086, and counting.

    © Copyright 1998 The Washington Post Company

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