Confronting AIDS in the Early 1980s: Biomedicine, Public Health, and the Fourth Estate.

Detection of a mysterious and fatal disease among young, previously healthy, homosexual men in spring 1981 warranted a rapid and effective response. An adequate response failed to materialize during the first 5 years of the AIDS pandemic. The failure of biomedicine, public health, and The Press to stop the outbreak was attributed by Randy Shilts to institutional failures. This commentary considers the possibility that organizations, agencies, and authorities failed to safeguard the public's health because they succeeded in carrying out their appropriate tasks of (1) meticulously conducting systematic, scientific, research, (2) cautiously reporting evidence-based observations and alternative interpretations, and (3) carefully exercising rigorous controls over unauthorized and potentially wasteful spending. As practiced in the early 1980s by the National Institutes of Health, Centers for Disease Control and Prevention, and major newspapers and other media outlets, essential features of biomedicine, public health, and The Press inhibited a rapid and effective response.