When the question of how to deal with AIDS in the UK arose in the mid-1980s, it seemed to me there were very few policy options. We could have ignored it, and there were plenty of people in government saying just that. I had little connection with either the LGBT community or drug users, among whom the disease was spreading fastest, but I could not understand the arguments of those who said it was nothing to do with us. As Health Secretary, I felt we had a duty to get the message out to as many people as possible that this was a terrible condition and a public health issue. There was no vaccine and there was no cure. 

 

The man who did most to bring it home to me was Donald Acheson, who was the Chief Medical Officer. If Donald said this was a serious issue and likely to worsen, you could be sure he was right. He predicted that if infection rates continued to rise, within a couple of years there would be 20,000 people with HIV in the UK – which then meant 20,000 deaths. 

 

There were some who believed this was not a public health issue but one of public morality. The Chief Rabbi was one of the most vociferous, telling me my policy should be to say plainly that AIDS was the consequence of sexual deviation, marital infidelity, social irresponsibility and a generation who put pleasure before duty and discipline. Frankly, my view was that if a government is so foolish as to run a moral campaign, the first time a Minister is caught with their pants down or putting cocaine up their nose, the 

whole campaign goes up in smoke. I was proved right a few years later when John Major’s Back to Basics campaign, an appeal for a return to traditional values, was ridiculed after a series of scandals involving Conservative politicians. 

 

Our only weapon to fight the disease was publicity, and I was determined to get a strong campaign going – “Don’t die of ignorance” – with a leaflet sent to every household in the country. But Margaret Thatcher, though she showed a good appreciation of the science when I took Donald Acheson to brief her, was convinced I was becoming obsessed: “Norman,” she said, “you mustn’t just be known as the Minister for AIDS.” I thought for a moment that might mean I would next be promoted to Chancellor of the Exchequer, but no such luck. The subtext was: Norman, you’re spending far too much time on this subject, kindly go and do something else. Though she might not have put it in quite the same terms as the Chief Rabbi, her view was in some respects very similar: if we gave out explicit information about what kinds of sexual activity were risky, we could expose young people to the shock of knowing things they would be much better off not knowing.

 

The way I always handled Margaret was that, if there was likely to be a point of conflict, it was safest to go round her, rather than through her. I had a number of opponents in the Cabinet as a whole, so getting agreement on anything was time-consuming and difficult. Lord Hailsham, a grand old man of politics, criticised me for the phrase ‘having sex’ in one of our advertisements. “Quite inappropriate,” he huffed. “Is there no limit to vulgarity?” 

 

Robert Armstrong, the Cabinet Secretary, Ken Stowe, my Permanent Secretary in the DHSS, and Donald Acheson hatched a plan with me to set up a separate committee within Cabinet to hammer out policy for AIDS and HIV. To my great relief, the efficient and broadly sympathetic William Whitelaw was appointed to chair it – I’d recently had an exhausting experience trying to get policy through a Cabinet committee on Social Security with Margaret in the chair. We managed to ensure neither Lord Hailsham nor Norman Tebbit, another fierce opponent of AIDS policy, were on the committee. 

 

The leaflet was quickly endorsed by the committee, as were most of the proposals we discussed, though by no means all. Donald was an advocate of practical health initiatives. His great-grandfather was a medical man at the time of the First World War. There was a terrible problem of venereal disease among the troops. A campaign was run: “Think of Queen and Country.” Hardly surprisingly, it had little effect. Only when someone had the bright idea of issuing the troops with the forerunner to condoms did the incidence of VD began to fall. It was a lovely example of practical public health policy and we wanted to try something similar to combat high rates of HIV among injecting drug users, by distributing clean needles to addicts. But though I had the backing of almost every independent committee that looked at the issue, I ran into serious opposition. The view was that giving out free needles effectively condoned crime, whereas I felt that was hardly the issue: we should not leave drug users to continue sharing dirty needles. After a great deal of argument, it was approved, but I am convinced that if William Whitelaw had put it to a vote, instead of simply summing up in our favour, we might well have lost. 

The advertising campaign attracted a lot of criticism. It was accused of being overdramatic, with its tombstones and icebergs and John Hurt’s marvellous voice-over, but I make no apologies. We had tried discreet little paragraphs in the newspapers, to absolutely no effect whatsoever. If we were to have any impact at all we needed to wake people up. Fortunately, the committee agreed. We put up posters, we ran television and cinema commercials, aiming for language that was both forceful and 

getting agreement on anything was time- consuming and difficult …” scientifically accurate. Later we did a follow-up poll and over 90% of the public agreed with the way it was done. To be honest, I am not used as a politician to getting 90% support, so it felt like a vindication. The infection rate of HIV went down and, interestingly, so did the incidence of other sexually transmitted diseases. 

 

In 1987,I flew to the United States to see if there was anything we could learn from them. But the Federal Government was doing very little, leaving it to state administrations, who weren’t doing much either: any progress was achieved by activists in the gay community. I visited a hospital in San Francisco and was photographed shaking hands with a young man who had AIDS – this was some months before Princess Diana created a far greater stir by doing the same. When I returned, Margaret Thatcher and Norman Tebbit, the Party Chairman, were outraged a British Minister had been photographed meeting, as they thought, unsavoury characters. I suspect my successor at the Health Ministry, John Moore, was told in no uncertain terms he should concentrate on other matters and not follow in my footsteps. 

 

A senior Cabinet minister said to me not so long ago: “Well, no one dies from AIDS anymore.” That shows the lack of understanding among even intelligent people. Globally, we have now lost 36 million people to AIDS according to UNAIDS.I am somewhat sympathetic to people who knock down statues of slave owners because I think we should take a lesson from it and ask ourselves what future generations might say about us too. Will they ask why we allowed 36 million to die? Couldn’t we have done something to prevent it? And, of course, we could. We could stand up against the prejudice against gay people and the stigma of HIV worldwide, especially in some parts of Africa and certain countries in Eastern Europe. We could do more for the families of those who die and those who suffer an impoverished old age. 

 

By far the most persuasive factor in removing stigma and the wall of silence that allows infections to go on rising, is for people to come out and say they are HIV+, telling us what it has been like for them. These stories need to be told, because it is all too easy to forget. I would hope that people in future will be able to learn from them and make better decisions as a result. “We could stand up against the prejudice against gay people and the stigma of HIV worldwide, especially in some parts of Africa and certain countries in Eastern Europe. We could do more for the families of those who die and those who suffer an impoverished old age.

 

By far the most persuasive factor in removing stigma and the wall of silence that allows infections to go on rising, is for people to come out and say they are HIV+, telling us what it has been like for them. These stories need to be told, because it is all too easy to forget. I would hope that people in future will be able to learn from them and make better decisions as a result.