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Tuskegee Experiment: The Infamous Syphilis Study

By: Elizabeth Nix

Updated: June 13, 2023 | Original: May 16, 2017

The Tuskegee experiment began in 1932, at a time when there was no known cure for syphilis, a contagious venereal disease. After being recruited by the promise of free medical care, 600 African American men in Macon County, Alabama were enrolled in the project, which aimed to study the full progression of the disease.

The participants were primarily sharecroppers, and many had never before visited a doctor. Doctors from the U.S. Public Health Service (PHS), which was running the study, informed the participants—399 men with latent syphilis and a control group of 201 others who were free of the disease—they were being treated for bad blood, a term commonly used in the area at the time to refer to a variety of ailments.

The men were monitored by health workers but only given placebos such as aspirin and mineral supplements, despite the fact that penicillin became the recommended treatment for syphilis in 1947, some 15 years into the study. PHS researchers convinced local physicians in Macon County not to treat the participants, and instead, research was done at the Tuskegee Institute. (Now called Tuskegee University, the school was founded in 1881 with Booker T. Washington as its first teacher.)

In order to track the disease’s full progression, researchers provided no effective care as the men died, went blind or insane or experienced other severe health problems due to their untreated syphilis.

In the mid-1960s, a PHS venereal disease investigator in San Francisco named Peter Buxton found out about the Tuskegee study and expressed his concerns to his superiors that it was unethical. In response, PHS officials formed a committee to review the study but ultimately opted to continue it—with the goal of tracking the participants until all had died, autopsies were performed and the project data could be analyzed.

Buxton then leaked the story to a reporter friend, who passed it on to a fellow reporter, Jean Heller of the Associated Press. Heller broke the story in July 1972, prompting public outrage and forcing the study to finally shut down.

By that time, 28 participants had perished from syphilis, 100 more had passed away from related complications, at least 40 spouses had been diagnosed with it and the disease had been passed to 19 children at birth.

In 1973, Congress held hearings on the Tuskegee experiments, and the following year the study’s surviving participants, along with the heirs of those who died, received a $10 million out-of-court settlement. Additionally, new guidelines were issued to protect human subjects in U.S. government-funded research projects.

As a result of the Tuskegee experiment, many African Americans developed a lingering, deep mistrust of public health officials and vaccines. In part to foster racial healing, President Bill Clinton issued a 1997 apology, stating, “The United States government did something that was wrong—deeply, profoundly, morally wrong… It is not only in remembering that shameful past that we can make amends and repair our nation, but it is in remembering that past that we can build a better present and a better future.”

During his apology, Clinton announced plans for the establishment of Tuskegee University’s National Center for Bioethics in Research and Health Care .

The final study participant passed away in 2004.

Tuskegee wasn't the only unethical syphilis study. In 2010, then- President Barack Obama and other federal officials apologized for another U.S.-sponsored experiment, conducted decades earlier in Guatemala. In that study, from 1946 to 1948, nearly 700 men and women—prisoners, soldiers and mental patients—were intentionally infected with syphilis (hundreds more people were exposed to other sexually transmitted diseases as part of the study) without their knowledge or consent.

The purpose of the study was to determine whether penicillin could prevent, not just cure, syphilis infection. Some of those who became infected never received medical treatment. The results of the study, which took place with the cooperation of Guatemalan government officials, were never published. The American public health researcher in charge of the project, Dr. John Cutler, went on to become a lead researcher in the Tuskegee experiments.

Following Cutler’s death in 2003, historian Susan Reverby uncovered the records of the Guatemala experiments while doing research related to the Tuskegee study. She shared her findings with U.S. government officials in 2010. Soon afterward, Secretary of State Hillary Clinton and Secretary of Health and Human Services Kathleen Sebelius issued an apology for the STD study and President Obama called the Guatemalan president to apologize for the experiments.

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About the USPHS Syphilis Study

Where the Study Took Place

The study took place in Macon County, Alabama, the county seat of Tuskegee referred to as the "Black Belt" because of its rich soil and vast number of black sharecroppers who were the economic backbone of the region. The research itself took place on the campus of Tuskegee Institute.

What it Was Designed to Find Out

The intent of the study was to record the natural history of syphilis in Black people. The study was called the "Tuskegee Study of Untreated Syphilis in the Negro Male." When the study was initiated there were no proven treatments for the disease. Researchers told the men participating in the study that they were to be treated for "bad blood." This term was used locally by people to describe a host of diagnosable ailments including but not limited to anemia, fatigue, and syphilis.

Who Were the Participants

 A total of 600 men were enrolled in the study. Of this group 399, who had syphilis were a part of the experimental group and 201 were control subjects. Most of the men were poor and illiterate sharecroppers from the county.

What the Men Received in Exchange for Participation

The men were offered what most Negroes could only dream of in terms of medical care and survivors insurance. They were enticed and enrolled in the study with incentives including: medical exams, rides to and from the clinics, meals on examination days, free treatment for minor ailments and guarantees that provisions would be made after their deaths in terms of burial stipends paid to their survivors.

Treatment Withheld

There were no proven treatments for syphilis when the study began. When penicillin became the standard treatment for the disease in 1947 the medicine was withheld as a part of the treatment for both the experimental group and control group.

How/Why the Study Ended

On July 25, 1972 Jean Heller of the Associated Press broke the story that appeared simultaneously both in New York and Washington, that there had been a 40-year nontherapeutic experiment called "a study" on the effects of untreated syphilis on Black men in the rural south.

Between the start of the study in 1932 and 1947, the date when penicillin was determined as a cure for the disease, dozens of men had died and their wives, children and untold number of others had been infected. This set into motion international public outcry and a series of actions initiated by U.S. federal agencies. The Assistant Secretary for Health and Scientific Affairs appointed an Ad Hoc Advisory Panel, comprised of nine members from the fields of health administration, medicine, law, religion, education, etc. to review the study.

While the panel concluded that the men participated in the study freely, agreeing to the examinations and treatments, there was evidence that scientific research protocol routinely applied to human subjects was either ignored or deeply flawed to ensure the safety and well-being of the men involved. Specifically, the men were never told about or offered the research procedure called informed consent. Researchers had not informed the men of the actual name of the study, i.e. "Tuskegee Study of Untreated Syphilis in the Negro Male," its purpose, and potential consequences of the treatment or non-treatment that they would receive during the study. The men never knew of the debilitating and life threatening consequences of the treatments they were to receive, the impact on their wives, girlfriends, and children they may have conceived once involved in the research. The panel also concluded that there were no choices given to the participants to quit the study when penicillin became available as a treatment and cure for syphilis.

Reviewing the results of the research the panel concluded that the study was "ethically unjustified." The panel articulated all of the above findings in October of 1972 and then one month later the Assistant Secretary for Health and Scientific Affairs officially declared the end of the Tuskegee Study.

Class-Action Suit

In the summer of 1973, Attorney Fred Gray filed a class-action suit on behalf of the men in the study, their wives, children and families. It ended a settlement giving more than $9 million to the study participants.

The Role of the US Public Health Service

In the beginning of the 20th Century, the U.S. Public Health Service (PHS) was entrusted with the responsibility to monitor, identify trends in the heath of the citizenry, and develop interventions to treat disease, ailments and negative trends adversely impacting the health and wellness of Americans. It was organized into sections and divisions including one devoted to venereal diseases. All sections of the PHS conducted scientific research involving human beings. The research standards were for their times adequate, by comparison to today's standards dramatically different and influenced by the professional and personal biases of the people leading the PHS. Scientists believed that few people outside of the scientific community could comprehend the complexities of research from the nature of the scientific experiments to the consent involved in becoming a research subject. These sentiments were particularly true about the poor and uneducated Black community.

The PHS began working with Tuskegee Institute in 1932 to study hundreds of black men with syphilis from Macon County, Alabama.

Compensation for Participants

As part of the class-action suit settlement, the U.S. government promised to provide a range of free services to the survivors of the study, their wives, widows, and children. All living participants became immediately entitled to free medical and burial services. These services were provided by the Tuskegee Health Benefit Program, which was and continues to be administered by the Centers for Disease Control and Prevention in their National Center for HIV, STD and TB Prevention.

1996 Tuskegee Legacy Committee

In February of 1994 at the Claude Moore Health Sciences Library in Charlottesville, VA, a symposium was held entitled "Doing Bad in the Name of Good?: The Tuskegee Syphilis Study and Its Legacy." Resulting from this gathering was the creation of the Tuskegee Syphilis Study Legacy Committee which met for the first time in January 18th & 19th of 1996.  The committee had two goals; (1) to persuade President Clinton to apologize on behalf of the government for the atrocities of the study and (2) to develop a strategy to address the damages of the study to the psyche of African-Americans and others about the ethical behavior of government-led research; rebuilding the reputation of Tuskegee through public education about the study, developing a clearinghouse on the ethics of scientific research and scholarship and assembling training programs for health care providers. After intensive discussions, the Committee's final report in May of 1996 urged President Clinton to apologize for the emotional, medical, research and psychological damage of the study. On May 16th at a White House ceremony attended by the men, members of the Legacy Committee and others representing the medical and research communities, the apology was delivered to the surviving participants of the study and families of the deceased.

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Tuskegee Syphilis Experiment

These unidentified men were among hundreds of African American men subjected to medical experimentation over the course of four decades in Tuskegee, Alabama.

In 1932, the United States Public Health Service launched an experiment in Macon County, Alabama, to observe untreated syphilis. They enlisted 600 black men, 399 of whom had syphilis, by concealing the experiment’s purpose and the infected men’s diagnosis. Farmer Herman Shaw lived in poverty and, like many others, joined the study for promised hot meals, free medical exams, and burial insurance.

Researchers told participants they were receiving treatment for “bad blood,” while administering only iron tonic and aspirin. For decades after penicillin was established as a cure for syphilis in 1947, researchers not only continued to experiment on the men but also barred them from treatment.

The experimentation ended in 1972 after a whistleblower exposed it. Attorney Fred Gray filed suit on behalf of the victims and won a multi-million dollar settlement. The money funded medical care for survivors and their families, but could not undo the harm: 128 participants died of syphilis or related complications, 40 wives were infected, and 19 children were born with congenital syphilis. Many families also suffered under the stigma. “People think it’s the scourge of the earth to have [syphilis] in your family,” explained Albert Julkes, whose father was a victim of the experiment.

After the study was exposed, Congress passed the National Research Act to prevent human exploitation in research. The federal government did not issue a formal apology to participants and their families until 1997, and no one was prosecuted for the deaths and injuries the experiment caused. Today, an undisclosed portion of the settlement money remains in court-controlled accounts with an uncertain fate.

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Tuskegee Syphilis Experiment

The official title was “The Tuskegee Study of Untreated Syphilis in the Negro Male.” It is commonly called the Infamous Tuskegee Syphilis Experiment. Beginning in 1932 and continuing to 1972 the United States Public Health Services lured over 600 Black men, mostly sharecroppers in Tuskegee, Alabama, into this diabolical medical experiment with the promise of free health care. For 40 years, hundreds of African American men with syphilis went untreated, given placebos and other ineffective treatments, so that scientists could study the effects of the disease, even after there was a cure. None of the men who had syphilis were ever told they had it. Instead they were only told that they had “bad blood.” They were also never given penicillin, despite the fact that it had become a standard treatment by 1947.

The last survivor of the study died in 2004. This was not that long ago.

The Hippocratic Oath is used as a symbolic gesture that binds physicians to their patient’s well-being. Those who choose to take the oath makes an affirmation about treatment of those entrusted in their care, “I will do no harm or injustice to them.” It is commonly simply rephrased as, "First, do no harm." That was not the case with healthcare providers in Tuskegee, AL.

Below is an excerpt from an official admission of systematic racial discrimination issued by the United States President in 1997:

The President’s words confirmed the institutionally and racially discriminatory practices that have spanned not just decades as in this case, but centuries. Medical malfeasance is nothing new. Currently, amends are being made symbolically. In 2018, New York City finally removed an offensive statue from high atop a pedestal in Central Park. The statue depicted an infamous 19th-century gynecologist who experimented on enslaved women named Anarcha, Lucy and Betsey. He was part of a medical apartheid system that treated Black subjects as sub-human. He inflicted unimaginable torture because he operated under the ridiculous notion that Black people did not feel pain.

Remarkably, present day studies reveal that a frightening number of healthcare providers believe the myth that Black people have thicker skin and therefore need less pain management. The University of Virginia reported that racial bias partially explains research documenting how Black Americans are systemically undertreated for pain.

The Tuskegee Experiment was relatively recent and at least partially impacts the reactions to the current Novel Coronavirus pandemic. Black Americans have this recent example, in addition to a long history of other examples, explaining why it is reasonable to be suspicious of governmental medical information.

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About The Untreated Syphilis Study at Tuskegee

• The 40-year Untreated Syphilis Study at Tuskegee ended in 1972 and resulted in drastic changes to standard research practices.
• Read on to learn about the impact of the study on the lives of those involved.

The U.S. Public Health Service (USPHS) Untreated Syphilis Study at Tuskegee was a study conducted between 1932 and 1972. The study was supposed to observe the natural history of untreated syphilis. As part of the study, researchers did not collect informed consent from participants. They also did not offer treatment, even after it was easily available. The study ended in 1972 on the recommendation of an Ad Hoc Advisory Panel. The panel was convened by the Assistant Secretary for Health and Scientific Affairs, following publication of news articles about the study.

In 1997, President Clinton issued a formal Presidential Apology . In his apology he announced an investment to establish what became The National Center for Bioethics in Research and Health Care at Tuskegee University . Many records can be found in the National Archives .

After the study, sweeping changes to standard research practices were made. Efforts to promote the highest ethical standards in research are ongoing today.

Subjects and participation

Tuskegee community members were aware of the study but thought it was a special government health care program 1 .

According to the Assistant Secretary for Health and Scientific Affairs' Ad Hoc Advisory Panel's published report , "...the Macon County Health Department and Tuskegee Institute were cognizant of the study."

Resource‎

The National Archives, Southeastern Region, maintains a list of Tuskegee patient medical files .

The National Archives maintains photos related to the study .

No women were included in the study. The study was limited to Black men 25 years of age or older. However, as a result of lack of treatment, some women contracted syphilis from men who participated in the study’s syphilitic group.

Featured stories

Family members and public health officials share their memories and reflections of the United States Public Health Service Study of Untreated Syphilis in the Negro Male at Tuskegee and Macon County, Alabama, 1932 -1972.

Were men purposefully infected for the study?

No. According to a journal article about the study, published in 1936, the 399 men in the syphilitic group were initially recruited because they already had late-latent syphilis. The 201 men in the control group did not have the disease.

Why was the U.S. Public Health Service’s Untreated Syphilis Study at Tuskegee unethical?

There is no evidence that researchers obtained informed consent from participants. Also, the participants were not offered available treatments, even after penicillin became widely available.

You can learn more about changes made to standard research practices after Tuskegee in Research Implications .

How much money did the study participants receive from the 1974 out of court settlement?

The $10-million settlement was divided into four categories:

• Living syphilitic group participants received $37,500.
• Heirs of deceased syphilitic group participants received $15,000.
• Living control group participants received $16,000.
• Heirs of deceased control group participants received $5,000 2 .

50th anniversary event

This event was held Wednesday, November 30, 2022. Watch our recorded session and related videos below.

This event acknowledged the 50th anniversary of the end of the United States Public Health Service Study of Untreated Syphilis in the Negro Male at Tuskegee and Macon County, Alabama, 1932 -1972. The intention was to create a space for authentic, accurate storytelling. It was also meant to encourage discussion regarding current and future opportunities for public health leaders to move from trust to trustworthiness.

The program examined what happened, how and why it happened, lessons learned, the noticeable effects still felt today, and CDC's on-going role in addressing health equity.

Participants included experts in the fields of public health, ethics, history, and journalism. In addition to our speakers, we featured moderated panel discussions. The program was a hybrid event, available both virtually and in-person.

United States Public Health Service Study of Untreated Syphilis in the Negro Male at Tuskegee and Macon County, Alabama, 1932 -1972 Download now

Featured speakers

Xavier Becerra United States Secretary, Health and Human Services

Rochelle Walensky, MD, MPH Director, Centers for Disease Control and Prevention (CDC)

Debra Houry, MD, MPH Acting Principal Deputy Director, Centers for Disease Control and Prevention (CDC)

Robin D. Bailey Jr., MA Chief Operating Officer, CDC

Termika Smith, Ed.D, MPA Associate Director for Policy, Communications, and Strategy, Division of Adolescent and School Health, CDC

Susan K. Laird, DNP, MSN Training and Health Education Lead, Division of Communication Science and Services, CDC

Jo Valentine, MSW Associate Director, Office of Health Equity, Division of STD Prevention, CDC

Paul Rashad Young, MD Commander, U.S. Public Health Service and Regional Associate Director, The Americas and Kenya, Division of Global HIV & TB, Center for Global Health, CDC

Discussants

James A. Curran, MD, MPH Dean Emeritus, Emory Rollins School of Public Health

Daniel E. Dawes, JD Executive Director, Satcher Health Leadership Institute at Morehouse School of Medicine

Vanessa Northington Gamble, MD, PhD University Professor of Medical Humanities, Professor of Medicine, Health Policy, and American Studies at the George Washington University.

Fred Gray, Esq. President, Tuskegee Human & Civil Rights Multicultural Center

Lillie Tyson Head, MS, EdS President, Voices for Our Fathers Legacy Foundation

Jean Heller Author, Journalist

Robert Benjamin Johnson Former Deputy Assistant to the President and Deputy Director of the Office of Public Liaison

James H. Jones, PhD Author, Bad Blood

Chris Koller President, Milbank Memorial Fund

Paul Lombardo, PhD, JD Regents' Professor and Bobby Lee Cook Professor of Law, Georgia State University College of Law

Mary Leinhos, PhD Acting Team Lead, Public Health Ethics and Strategy Unit, Office of Scientific Integrity, CDC

Ted Pestorius, MPA Deputy Director of Management and Overseas Operations, Center for Global Health, CDC

Susan Reverby, PhD Author; Marion Butler McLean Professor Emerita in the History of Ideas and Professor Emerita in Women's and Gender Studies, Wellesley College

Diane Rowley, MD, MPH Professor Emerita, Maternal and Child Health Department, Gillings School of Global Public Health, University of North Carolina at Chapel Hill

David Satcher, MD, PhD Founding Director and Senior Advisor, Satcher Health Leadership Institute; Former Director, CDC

Dixie E. Snider Jr., MD, MPH Former Chief Science Officer, Office of the Director, CDC

Rueben C. Warren, DDS, MPH, DrPH, MDiv Professor/Director of the National Center for Bioethics in Research and Health Care at Tuskegee University, Tuskegee, AL

• Voices for Our Fathers Legacy Foundation
• The National Archives – USPHS Untreated Syphilis Study at Tuskegee
• Facts & Information about Syphilis
• STD Health Equity
• Tuskegee University National Center for Bioethics in Research and Health Care
• Vonderlehr to Clark, October 20, 1932, Records of the USPHS Venereal Disease Division, Record Group 90, National Archives, Washington National Record Center, Suitland, Maryland.
• Gray, Fred D. The Tuskegee Syphilis Study: An Insider’s Account of the Shocking Medical Experiment Conducted by Government Doctors against African American Men. Montgomery: Fred D. Gray, 2013.

Syphilis Study

The Untreated Syphilis Study at Tuskegee was conducted between 1932 and 1972 to observe the natural history of untreated syphilis.

Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States

• PMID: 29311536
• PMCID: PMC10565021
• DOI: 10.13081/kjmh.2017.26.545

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of "the American race" against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.

Keywords: Bad Blood; Eugenics; Progressive Empire; Racial Pathology; the Public Health Service; the U.S. Surgeon General; Tuskegee Syphilis Experiment.

Publication types

• Historical Article
• Black or African American / history*
• History, 20th Century
• Military Medicine / history
• Nontherapeutic Human Experimentation / ethics
• Nontherapeutic Human Experimentation / history*
• Racism / history*
• Research Subjects / history
• Syphilis / history*
• United States
• United States Public Health Service / history*
• Withholding Treatment / history

How the Public Learned About the Infamous Tuskegee Syphilis Study

A s the fight over reforms to the American health-care system continues this week, Tuesday marks the 45th anniversary of a grim milestone in the history of health care in the U.S.

On July 25, 1972, the public learned that, over the course of the previous 40 years, a government medical experiment conducted in the Tuskegee, Ala., area had allowed hundreds of African-American men with syphilis to go untreated so that scientists could study the effects of the disease.

“Of about 600 Alabama black men who originally took part in the study, 200 or so were allowed to suffer the disease and its side effects without treatment, even after penicillin was discovered as a cure for syphilis,” the Associated Press reported , breaking the story. “[U.S. Public Health Service officials] contend that survivors of the experiment are now too old to treat for syphilis, but add that PHS doctors are giving the men thorough physical examinations every two years and are treating them for whatever other ailments and diseases they have developed.”

By the time the bombshell report came out, seven men involved had died of syphilis and more than 150 of heart failure that may or may not have been linked to syphilis. Seventy-four participants were still alive, but the government health officials who started the study had already retired. And, because of the study’s length and the way treatment options had evolved in the intervening years, it was hard to pin the blame on an individual — though easy to see that it was wrong, as TIME explained in the Aug. 7, 1972, issue:

At the time the test began, treatment for syphilis was uncertain at best, and involved a lifelong series of risky injections of such toxic substances as bismuth, arsenic and mercury. But in the years following World War II, the PHS’s test became a matter of medical morality. Penicillin had been found to be almost totally effective against syphilis, and by war’s end it had become generally available. But the PHS did not use the drug on those participating in the study unless the patients asked for it. Such a failure seems almost beyond belief, or human compassion. Recent reviews of 125 cases by the PHS’S Center for Disease Control in Atlanta found that half had syphilitic heart valve damage. Twenty-eight had died of cardiovascular or central nervous system problems that were complications of syphilis. The study’s findings on the effects of untreated syphilis have been reported periodically in medical journals for years. Last week’s shock came when an alert A.P. correspondent noticed and reported that the lack of treatment was intentional.

About three months later, the study was terminated, and the families of victims reached a $10 million settlement in 1974 (the terms of which are still being negotiated today by descendants). The last study participant passed away in 2004.

Tuskegee was chosen because it had the highest syphilis rate in the country at the time the study was started. As TIME made clear with a 1940 profile of government efforts to improve the health of African Americans, concern about that statistic had drawn the attention of the federal government and the national media. Surgeon General Thomas Parran boasted that in Macon County, Ala., where Tuskegee is located, the syphilis rate among the African-American population had been nearly 40% in 1929 but had shrunk to 10% by 1939. Serious efforts were being devoted to the cause, the story explained, though the magazine clearly missed the full story of what was going on:

In three years, experts predict, the disease will be wiped out. To root syphilis out of Macon County, the U. S. Public Health Service, the Rosenwald Fund and Booker T. Washington’s Tuskegee Institute all joined forces. Leader of the campaign is a white man, the county health officer, a former Georgia farm boy who drove a flivver through fields of mud, 36 miles a day to medical school. Last month, deep-eyed, sunburned Dr. Murray Smith began his tenth year in Macon County. “There’s not much in this job,” said he, “but the love and thanks of the people.” At first the Negroes used to gather in the gloomy courthouse in Tuskegee, while Dr. Smith in the judge’s chambers gave them tests and treatment. Later he set up weekly clinics in old churches or schoolhouses, deep in the parched cotton fields. Last fall the U. S. Public Health Service gave him a streamlined clinic truck. The truck, which has a laboratory with sink and sterilizer, a treatment nook with table and couch, is manned by two young Negro doctors and two nurses. Five days a week it rumbles over the red loam roads. At every crossroads it stops. At the toot of its horn, through the fields come men on muleback, women carrying infants, eager to be first, proud to have a blood test. Some young boys even sneak in to get a second or third test, and many come around to the truck long after they have been cured. One woman who had had six miscarriages got her syphilis cured by Dr. Smith with neoarsphenamine. Proudly she named her first plump baby Neo.

In the years following the disclosure, the Tuskegee study became a byword for the long and complicated history of medical research of African Americans without their consent. In 1997, President Bill Clinton apologized to eight of the survivors. “You did nothing wrong, but you were grievously wronged,” he said. “I apologize and I am sorry that this apology has been so long in coming.” As Clinton noted, African-American participation in medical research and organ donation remained low decades after the 1972 news broke, a fact that has often been attributed to post-Tuskegee wariness.

In 2016, a National Bureau of Economic Research paper argued that after the disclosure of the 1972 study, “life expectancy at age 45 for black men fell by up to 1.5 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men and 25% of the gap between black men and women.” However, many experts argue that the discrepancy has more to do with racial bias in the medical profession.

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Write to Olivia B. Waxman at [email protected]