ABSTRACT
The institutionalisation of public health management and administration first took place in the late nineteenth and the early twentieth century when the control of tuberculosis and sexually transmitted diseases gave rise to the legal elaboration of medico-administrative methods, including the identification and compulsory treatment of the ‘carriers’ of disease. The application of these methods to AIDS was immediately controversial and was therefore finally rejected. Bypassing established public health procedures constituted the heart of the so-called ‘AIDS exceptionalism’ (Bayer, 1991). The mobilisation initiated by the gay communities against homophobia and the conservative social order provided the intellectual ground on which this exceptionalism developed. The horror scenario, so widely forecast in the early years of the epidemic, did not occur. On the contrary, in western democracies where individual freedom is recognised as an unquestionable part of citizenship, the epidemic was seen as offering a potential threat to the entire social system. AIDS policies became organised around a ‘solidarity with the victims’ in line with the fundamental principles of health in the European welfare states.
