Kaiser Daily HIV/AIDS Report Rounds Up Commentary on the 20th Anniversary of AIDS
Commemorating the 20th anniversary of the first published reports of AIDS, a number of publications have run recent op-eds and columns on the epidemic. Several of those pieces are summarized below.
- CDC HIV/STD/TB Prevention News Update: Writing in the CDC's daily prevention information newsletter, Helene Gayle, director of the National Center for HIV, STD and TB Prevention, says, "Perhaps the best way to honor those lost, as well as those who have fought to save them, is to accelerate our efforts to stop HIV transmission." She notes that while past prevention efforts led to a "dramati[c]" decrease in infection rates by the early 1990s, "new strategies" are now needed to "maintain and accelerate progress." The HIV epidemic's primary impact, she writes, has shifted from gay white men to communities of color. Concurrently, as new drug therapies have extended the "length and quality of life" for many HIV patients, the "urgency of HIV prevention seems to have vanished." Gayle says, "We stand at a critical threshold. Prevention efforts must be sustained among white gay communities ... expanded to reach gay and bisexual men of color ... tailored to equip Latino and African-American women with the skills and knowledge to protect themselves from infection, and begun anew with every generation of young people." In conclusion, Gayle outlines the CDC's recently announced plan to half new AIDS infections within five years, saying, "On this 20th anniversary of the first cases of AIDS in this nation, let us remember those lost by recommitting to all those who can be saved" (Gayle, CDC HIV/STD/TB Prevention News Update, 5/31).
- New York Times: Columnist Bob Herbert writes, "Twenty years after the first scientific paper on the disease we now call AIDS, the world is still not ready to properly fight the epidemic that has already killed more than 23 million people and will soon surpass the lethal toll of the bubonic plague of the Middle Ages." Herbert notes that many countries hardest hit by the disease do not have the money, medical resources or "sociopolitical infrastructure necessary to fight the disease." Meanwhile, there is still no "real plan among the wealthier nations to fight AIDS globally." A "dangerous sense of complacency" has "settled in" across the United States, where the advent of AIDS drugs has reduced AIDS deaths "dramatically." Herbert concludes, "Twenty years later the epidemic is still with us. There is no cure. There is no vaccine. And in a world as interconnected as ours has become, there is no cause for complacency. ... [I]n some places much, much worse is yet to come" (Herbert, New York Times, 5/31).
- U.S. News & World Report: U.S. News reflects on lessons to be learned from "20 years of missteps on AIDS," noting, "Many who have fought against AIDS heap blame on political leaders all around the world for not taking the disease more seriously early on." The article recalls that in 1984, when HIV was first identified, "everyone expected a vaccine to do away with the scourge quickly ... a costly scientific miscalculation." The article notes that "the peril of underestimating the virus itself" provided another "painful lesson." Scientists have now learned that "the virus always rebounds once drugs are withdrawn, and no one even utters the word cure anymore. Drug resistance is increasing, and some studies suggest that the genetic variants of HIV sweeping through Africa and Asia will be particularly hard to combat" (Boyce, U.S. News & World Report, 6/4).
- San Francisco Chronicle: David Perlman, who in 1981 wrote the Chronicle's first report on a "mysterious outbreak of a sometimes fatal pneumonia among gay men," recalls, "At that time, the disease was certainly not an epidemic -- merely a curiosity -- and news of it was hardly worth putting my byline on." But Perlman writes that "[h]orror and panic and misunderstanding" soon followed that report, as "the first young men began to die ... [w]ithin weeks." Perlman describes how San Francisco physicians soon became "overwhelmed" with AIDS patients and how the health department's epidemiologist, Dr. Selma Dritz, became "deeply worried." Randy Shilts, whose reporting on the epidemic became the basis for the book and HBO film, "And the Band Played On," joined the Chronicle staff later that year and "pursued the issue ferociously," Perlman recalls. He adds that "more than any other journalist ... [Shilts] exposed the Reagan administration's denial and its parsimony with research funds." Perlman also recounts the "flawed prediction" of Reagan administration HHS Secretary Margaret Heckler, who predicted in 1984 that an AIDS vaccine would be ready for human trials "within two years" (Perlman, San Francisco Chronicle, 5/30).
- San Francisco Chronicle: Staff writer Dave Ford provides an image to describe the "height" of the AIDS epidemic in San Francisco in the 1980s: "Invite 30 close friends over for a party. Get happy for a few hours. Then, in the span of 20 minutes, each of your guests should leave -- some without a goodbye, others with a long, sad parting -- until you are all alone. Turn out the light and sit in the dark and imagine you will never, ever see them again." Ford describes the "eight long and dreary" Reagan years, noting that the former president "failed to publicly mention the word 'AIDS' until seven years into the epidemic." He adds that "[t]hings sank further" when "Reagan morphed into Bush ... and the disease raged on and friends kept dying." But, Ford writes, when Clinton was elected president, "The zeitgeist changed. Gay characters started peeking out from behind television closet doors. Medicines that showed real promise in stalling the effects of HIV became available" (Ford, San Francisco Chronicle, 5/29).
- San Francisco Chronicle: Eric Rofes, an assistant professor of education at Humboldt State University in Arcata, Calif., who teaches what he calls a "queer studies" course, writes, "No one can deny that the nation's attitudes have been transformed during the past two decades: What was once seen as a marginal radical movement of gender heretics and sexual deviants has now become broadly accepted as a liberal civil rights cause." However, Rofes notes, "[A]ttributing this transformation primarily to AIDS misses the mark for two reasons." While AIDS "provided lesbian and gay leaders with public visibility," the epidemic also "reintroduced a destructive link between homosexuality and disease" and claimed the lives of a "huge number of gay male leaders." Rofes also points out that while "dozens of solid, well-funded" AIDS organizations exist, "Most surviving lesbian and gay groups limp along, inadequately funded, underdeveloped and without broad constituencies." Rofes concludes, "We'll never know what the path would have looked like absent AIDS. But to attribute all the progress to AIDS rather than to gay community organizing seems deeply misguided" (Rofes, San Francisco Chronicle, 5/31).
- Boston Globe: Columnist James Carroll writes, "It would be nice to observe this 20th anniversary in a different climate, and certainly by now the heroic responses of local communities, medical practitioners, researchers, advocates, survivors of those who have died and persons living with HIV/AIDS have transformed the disease." However, Carroll notes, "[T]he government has effectively continued to embody the Reagan response -- even until now." Carroll cites Shilts, "who predicted Reagan "would be remembered in history books for one thing beyond all else. He was the man who had let AIDS rage through America, the leader of the government that, when challenged to action, had placed politics above the health of the American people." Carroll adds that the federal government is "still neglecting its own infirm mothers and disabled brothers," contributing "next to nothing" to the global AIDS fund and "mark[ing] [AIDS'] 20th anniversary by adopting the largest tax cut in that same exact 20 years." But Carroll praises the grassroots movement against the epidemic, calling it "exemplary" (Carroll, Boston Globe, 5/29).
- Knight Ridder/Tribune/Charlotte Observer: San Francisco-based freelance writer Bruce Mirken also comments on the "lessons from AIDS" that "have not been learned." Mirkin writes, "[W]hen politics trumps science, people die," citing the example of the needle-exchange debate. "[D]espite such overwhelming proof" that needle exchange is "[o]ne of the most effective ways to prevent the spread of HIV among injection drug users ... federal AIDS-prevention dollars still can't be used to support these life-saving efforts," Mirken writes. Mirken also criticizes abstinence-only sex education campaigns, saying that they are less effective than comprehensive programs. Finally, Mirkin criticizes the pharmaceutical industry, which has "until recently hoarded its medicine by pricing it out of the range of most patients." Mirken concludes, "We can celebrate the progress made in fighting AIDS, but if we don't pay attention to the lessons of the last two decades, the next 20 years could bring millions of more needless deaths" (Mirken, Knight Ridder/Tribune/Charlotte Observer, 5/30).