In the mid 1980s there was a mystery illness laying waste to young, gay men – there was no treatment or cure and doctors were unsure how to cope with a disease which carried a certain death sentence.
By the end of 1985, 275 patients had contracted what we now know as Aids, 144 of whom had died. And the Department of Health projected that on current trends by the end of 1988, 20,000 people would be infected with HIV.
The disease was labelled the “gay plague” and misinformation and hysteria were rife. There were fears it could be spread by touching and even some doctors and nurses refused to treat patients over concerns they would catch the deadly disease.
But help was at hand in the unlikely form of Norman Fowler, the seemingly strait-laced Conservative health secretary. Now Lord Fowler, and the Speaker of the House of Lords, he realised that the only way to combat the disease was through prevention – and a mass public information campaign was needed.
Lord Fowler and other health workers involved in the early days of the fight against Aids have now taken part in an oral history project, recounting the stigma patients suffered and the despair that they felt in the face of the devastating disease.
In an interview to mark the launch of the interviews in the palatial surroundings of the Lord Speaker’s office – where a poster from the 1980s campaign is propped up in the fireplace – Lord Fowler has vivid memories of a public health crisis like no other.
“It was probably a unique position, the disease was very rapid, knowledge was limited, there were no remedial drugs of any kind and there was certainly no cure. It was a horrendous disease as well. It was about a bleak an outlook for a condition as I can remember,” he says.
In the face of fierce opposition from his boss, prime minister Margaret Thatcher, and other cabinet ministers Lord Fowler signed off a year-long advertising campaign featuring the now infamous Don’t Die of Ignorance slogan and the apocalyptic tombstone images.
The advertisements, voiced in doom-laden tones by actor John Hurt, ran on TV and in newspapers and a leaflet was delivered to every household in the UK, warning of the dangers of the disease and encouraging safe sex. TV shows aimed at young people featured earnest discussions about how to put on a condom.
Lord Fowler is reluctant to say that what he did was in any way groundbreaking – more that it was something that needed to be done.
“What could we do in the circumstances? The only thing you could do was to actually try to prevent new people from contracting the virus. And that was our number one priority,” he says.
Attitudes towards gay people and to the disease were backward to say the least in the mid 1980s. The chief constable of Manchester James Anderton said that gay people, prostitutes or drug addicts who had contracted the disease were “swirling in a cesspit of their own making”. There was even a proposal to corral everyone who was diagnosed with the disease in a camp.
In his 2014 book, Aids: Don’t Die of Prejudice, Lord Fowler describes himself as a child of the 1960s – although it is hard to imagine him smoking dope and engaging in the free love of the day – so was less squeamish about talking about sex than some of his cabinet colleagues.
He felt that being straightforward was paramount and the advertisements and leaflets featured warnings about risky sex.
“[Mrs Thatcher] objected to that. Her argument was that if we put down this risky sex we would be telling people – young people – things they had never thought about before. The assumption was that once they had been told, although it was a warning, they would go out and experiment,” he says.
Some felt that the government should be promoting a moral message of abstinence but Lord Fowler followed the advice of the chief medical officer, Sir Donald Acheson, who cautioned that moral crusades had failed to prevent high rates of what was then known as venereal disease in troops during the First World War. Practical measures to dole out contraceptives were far more successful.
“I never thought that government ministers were the right people to go out and preach a totally moral message on this,” he says.
Lord Fowler felt that the first government minister unmasked by the tabloids for some sexual transgression would have seen “the whole campaign go up in smoke”.
He believes that such attitudes still prevail and a reluctance about not wanting to be seen to promote promiscuity could be partly behind the failure of the current government to fully fund access to pre-exposure prophylaxis (PrEP) - a preventive treatment that has been shown to reduce the chances of someone picking up HIV through unprotected sex by nearly 90 per cent.
In England PrEP is available to those at high risk of contracting the disease but only on a trial basis.
“Frankly we don’t need a trial to discover whether PrEP is useful and has had a transforming effect – we know that. Other countries have been doing it for years,” says Lord Fowler.
The campaign is widely credited as having had a profound impact on rates of both HIV and other sexually transmitted diseases in the years that followed.
According to official figures there were about 3,000 new diagnoses of HIV in 1985, before the start of the campaign, which fell to less than 2,000 in 1988. The numbers then began to slowly rise before shooting up in the late 1990s – peaking at nearly 8,000 new diagnoses in 2005.
The reasons for the rise are complex - but Lord Fowler believes that one reason is that the public information campaign stopped and complacency crept in.
“What we should have done was to keep going with other public information campaigns. No commercial company would do one massive campaign over 12 months and go off the air for the next 10 years,” he says.
Lord Fowler has seen huge progress made against the disease but warns that it still kills nearly 800,000 people a year and 1.7million are newly infected.
“We are going forward. But the one thing we mustn’t do is become complacent,” he says.
After serving as health secretary he was moved to education but has always kept his interest in Aids, serving on the boards of various charities. He believes that they like having an establishment figure such as him in their corner.
He also believes that he gained a lot from them.
“It made me much more outward looking and I have met whole ranges of people I hadn’t really come across too much before,” he says.
Mrs Thatcher warned him that he was spending too much time on the issue and urged him not to become “minister for Aids” but he believes his important role in the early fight against the disease is not too shabby a legacy.
“Oh yes, I’m very happy with that,” he says.
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