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    Putting public health first

    C. Everett Koop was nominated as US surgeon general in 1981.
    The New York Times file
    C. Everett Koop was nominated as US surgeon general in 1981.

    C. Everett Koop, who died this week at the age of 96, was the most famous surgeon general this country has ever known, for a reason as relevant today as it was in the 1980s: He put science and public health above ideology. A renowned pediatric surgeon in Philadelphia, Koop came to the attention of the incoming Reagan administration because of his public stance against abortion. His nomination in 1981 was vigorously opposed by Senator Ted Kennedy, who said Koop’s personal politics perpetuated a “cruel, outdated and patronizing stereotype of women.” The Globe editorial board acridly condemned the nomination, contending that the “fanatical” Koop was a “dogmatic Christian fundamentalist with the kind of tunnel vision that limits bureaucrats of any ideological stripe.”

    How wrong this appraisal was! Once in office, Koop defied the powerful tobacco lobby by linking second-hand smoke and cancer, sparking a national wave of smoking restrictions in offices, restaurants, public spaces, and transportation facilities. More courageous still was his declaration that abortions — which he once characterized as being on a slippery slope to the kind of dehumanization that had led to Auschwitz — were medically safe for women.

    Yet his finest hour was his special report on HIV/AIDS. When President Reagan ordered the report in 1986, the disease was still shrouded in mystery, and its prevalence among gay men had prompted conservative religious leaders to condemn its victims. But drug addicts, recipients of contaminated blood transfusions, and heterosexual partners of infected people were also at risk. Koop’s recommendations, reflecting the views of public-health experts, included the use of condoms for prevention. The 20 million government-printed copies of his report testified to his willingness to stand up to White House aides and right-wing activists who wanted no mention of condoms.


    The political fight, Koop knew, wasted time and threatened lives. But he could take pride in the lives that were saved as greater awareness helped Americans protect themselves against AIDS and fueled medical research for better drugs.

    In arguing against Koop’s nomination in 1981, this editorial page declared that the “public health community is rightly troubled by his limited understanding of a range of national health issues.” Instead, Koop vastly extended the nation’s understanding of some of the most crucial health issues. And he did so by letting science trump ideology, an act of courage that was praiseworthy then — and is desperately needed in today’s Congress.