Remembering and thinking critically about the ‘Don’t Die of Ignorance’ campaign
An ‘It’s more complicated than that’ blog post
In 1986 the Department of Health and Social Security (DHSS) launched the AIDS-education campaign, ‘Don’t aid AIDS’, often recollected as the ‘Don’t Die of Ignorance’ campaign or ‘Tombstone’ campaign. The misrecollection of its official name is indicative of the two elements of this campaign which seem to stick in our minds and command the most column inches: the ‘Don’t Die of Ignorance’ leaflets; and the ominous TV advert which featured a large tombstone . These are the elements of the campaign I want to discuss.
The question, ‘Was the Tombstone campaign successful?’ is one which has reoccurred throughout my academic career. I tell people I’m a historian of HIV and AIDS, and people mention it in response. They remember the ‘Don’t Die of Ignorance’ campaign, were frightened by it, and some people may have even changed their behaviour in response to it, but how can we know if it was a success?
There has been a lot of press coverage looking back at the Tombstone campaign. The narrative offered up, in memories of the fear it conjured and through interviews with the advertisers and politicians who created it, generally paint it as a brave controversial intervention, something new, and as generally successful.
See for example the recent Guardian article which offers Norman Fowler’s perspective on the campaign:
https://www.theguardian.com/culture/2017/sep/04/how-we-made-dont-die-of-ignorance-aids-campaign
Or last May’s BBC radio 4 documentary which explores the campaign from the perspective of advertising:
http://www.bbc.co.uk/programmes/b08pfnqj
The campaign, and the histories which echo its narrative, present the social factors which lead to AIDS stigma and transmission as boiling down to one essential problem: ignorance, the antithesis of ignorance being education. Such simple messages are useful in advertising, but aren’t nuanced enough for understanding what happened and why.
Indeed, by writing the history of AIDS as one of ignorance being replaced by education we forget the charities and activists who had began the fight against AIDS before the 1986 launch of the campaign. We can fail to ask the complicated questions of who the campaign was for exactly, and what it really contained and said about AIDS and those affected by it. We also sometimes forget to question when and why it was launched in the first place. Without these questions the narrative of success becomes too simple and leaves little space for those who were left unaffected, or adversely affected, by the efforts of the government to halt the spread of HIV through this campaign.
Okay so let’s think briefly about these big questions:
Who – It is tempting to suggest that the campaign was for everyone, but really the main targets were sexually active consenting adults and intravenous drug users. This leaves out huge swathes of the population, including some who might be HIV-affected. Public health campaigns are a blunt (and relatively cheap) tool, but those left out by the campaign still deserve to be remembered. In my PhD, which investigated the representation of HIV to children and adolescents, I came across families affected by HIV who were struggling to get the help they needed to tackle the emotional and educational demands HIV placed upon them. Parents scared by the media’s representation of AIDS and unsure how to tell their children about the disease, or where to find the resources to facilitate such a disclosure. They were not dying of ignorance, but living with a real illness and the dearth of resources with which to explain it to their children.
What – What did the TV ad really say about AIDS and those affected by it? Watch the video.
The focus on death, which conjures the fear remembered by many, created a narrative of doom, effective if the aim was to prevent new infections by scaring people into not having sex (or practising safer-sex), but not great at calming the fears of those living with the illness already. Many people affected by HIV were (and are) fighting to rewrite this pessimistic narrative to one of living with, rather than dying from, this disease.
When – The campaign is often pointed to as being an early and timely intervention. This is perhaps because it is often compared favourably with interventions in the US, and other Western European countries. But how quick was it? The Terrance Higgins Trust began its work in 1983, which included raising funds for research and to raise awareness. British newspapers began discussing AIDS in earnest in 1983. Teenage magazines had been discussing AIDS, and in a much calmer and more informative tone than the tabloid adult media, since 1985. So in 1986 the government campaign was one among many sources attempting to inform the public about AIDS. As histories and contemporary media coverage explains, the health educators behind ‘Don’t Die of Ignorance’ faced difficulty within government as they tried to launch this campaign, which accounts for the delay.
Where – The key remembered elements of the campaign were on television and delivered through leaflets. While leaflets and TV had been used as part of public health campaigns before, this was an impressive undertaking. But why use both TV and leaflets? The leaflets said what the short television advert couldn’t, one reinforcing the other. But the leaflet was perhaps also easier to ignore, somewhat less accessible and could be placed out of sight of children.
Why – With no cure, very little prospect of a cure on the horizon, prevention through education was seen as the only defence against the spread of AIDS. Moreover, people were frightened and public health campaigns are very visible signs of the government acting to combat a threat to public health. Cynically, they can be viewed as a relatively cheap and uncontroversial performance of governance in a health crisis when limited options are available. Then again, we might ask what else the government could have done?
What other mainstream media interventions, besides ‘Don’t Die of Ignorance’ should we remember?
Well besides teenage magazines, which continuously ran sympathetic and informative stories on AIDS and published safer-sex guides from 1985 until the mid-1990s, we should perhaps remember the EastEnders 1990 storyline about Mark Fowler’s experience of HIV and Grange Hill’s 1995 storyline about Lucy Mitchell’s mother who dies from AIDS-related complications. Both storylines followed heterosexual characters affected by HIV and worked hard to represent the way this disease affected families rather than individuals. Indeed research shows that the EastEnders AIDS storyline resulted in a spike in requests for HIV antibody testing, demonstrating the powerful influence public health messages have when embedded within an entertaining long-running soap.[1]
In saying all this, I do not wish to deny the importance of the ’Don’t Die of Ignorance Campaign’. Clearly it was a significant and memorable intervention. However, in remembering it we must examine it critically and we must not allow it to overshadow the many other significant messages which were communicated about HIV and AIDS in the 1980s and 1990s.
[1] J D Ross and G R Scott, ‘The Association between HIV media campaigns and number of patients coming forward for HIV antibody testing’, Genitourin Med, 63 1993, pp. 193-195, p. 195.