The response to AIDS

Almost every decision taken by government contains some element of risk, uncertainty and ignorance. But it is important to notice that the extent of the unknown varies between decisions. Whereas the uncertainties contained in abolishing the Civil Service Department (chapter seven) were confined to only a few aspects of the decision, uncertainty pervades every aspect of the decision to counter AIDS (Acquired Immune Deficiency Syndrome). Initially, nothing was known about AIDS’ existence; then nothing was known about its transmission; then nothing was known about its cause; then nothing about its incidence; and then nothing about how people could be stopped from acquiring it. And even though major gains in knowledge about AIDS have been made since the early 1980s, there remain substantial gaps in understanding of both key medical and sociological aspects of the disease. The Minister for Health, David Mellor, told Parliament in early 1989, ‘we are all on a learning curve in this matter’. 1