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Nancy Reagan’s Real Role in the AIDS Crisis

In mid-1981 the U.S. Centers for Disease Control noticed a set of medical curiosities: an alert from Los Angeles that five previously healthy young men had come down with a rare, fatal lung infection; almost simultaneously, a dermatologist in New York saying that he had seen a cluster of unusually aggressive cases of Kaposi’s sarcoma, an obscure skin cancer. These seemingly unconnected occurrences had two things in common. First, all of the victims were sexually active gay men. Second, their maladies pointed to a catastrophically compromised immune system.

About a month after those reports, a San Francisco weekly wrote that something it called “gay men’s pneumonia” was going around. By September 1982, there was a medical name for it: acquired immunodeficiency syndrome, or AIDS. The following May, scientists identified the retrovirus that was causing it: human immunodeficiency virus. HIV. It would take longer before it became clear who was at risk, how far the disease could spread, or what needed to be done to stop it.

“At first, we thought it was gay men, and then it was intravenous drug users, and then that it was Haitians—which was a mistake,” said Anthony Fauci, who was a senior investigator at the National Institute of Allergy and Infectious Diseases (NIAID) until he became its director in 1984. As the number of cases mounted, Fauci submitted an editorial to The New England Journal of Medicine in which he warned against assuming that AIDS would stay confined to the populations in which it had first appeared. But at that point, not even scientists were ready to accept how ominous the signs were. Fauci’s article was rejected because a reviewer for the medical field’s most prestigious publication deemed it to be too alarmist. It subsequently appeared in the June 1, 1982, issue of the Annals of Internal Medicine.

Nor was the story of dying gay men getting much traction in the mainstream media. Though more than half of those stricken were residents of New York City, The New York Times wrote only three stories about AIDS in 1981 and three more in 1982—all of which went on the inside pages.

The Reagan administration responded with massive budget cuts to public-health agencies, including the Centers for Disease Control. The National Institutes of Health (NIH), the nation’s main backer of biomedical research, was also struggling with a funding squeeze.

The president of the United States did not so much as publicly utter the name of the disease until September 1985. Even then, it was only because a reporter brought it up at a news conference. Not until the spring of 1987 did Reagan give a major speech about AIDS. By that time, the disease had already struck 36,058 Americans, of whom 20,849 had died.

The Reagan administration’s unwillingness to recognize and confront the AIDS epidemic has gone down in history as one of the deepest and most enduring scars on its legacy. What wasn’t known at the time was that, as the death toll mounted, a pitched battle ensued within the Reagan White House—and within the Reagan family—as First Lady Nancy Reagan and her son, Ron, tried to shake the president out of his complacency. It was a battle that pitted the two of them and a handful of allies against his hard-right advisers, who believed that AIDS should be dealt with as a moral and religious challenge, rather than a health crisis.