hiv history, timelapse

7/24/2019 Hiv History, timelapse

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These are some of the most important events that occurred in the history of

AIDSup to 1986.

Dr. Conant and Dr. Volerdin! discussin! "aposi#s Sarcoma

$e do not %no& ho& many people developed AIDS in the 19'(s) or indeed in

the years efore.

"The dominant feature of this rst period was silence, for the human

immunodeciency virus (HIV) was unknown and transmission was not

accompanied by sins or symptoms salient enouh to be noticed! hile rare,

sporadic case reports of #I$% and sero&archaeoloical studies have

documented human infections with HIV prior to '*, available data suest

that the current pandemic started in the mid& to late '*s! +y '*, HIV had

spread to at least ve continents (-orth #merica, %outh #merica, .urope,

#frica and #ustralia)! $urin this period of silence, spread was unchecked byawareness or any preventive action and appro/imately '**,***&0**,***

persons may have been infected!" & 1onathan 2ann '

$e also do not %no& for certain &here the AIDSvirus *IVori!inated) ut it is

no& !enerally accepted that the ori!in of AIDScan e traced ac% to Africa.

1981 *istory

"aposi#s Sarcoma +"S, &as a rare form of relatively eni!n cancer that tended

to occur in older people. -ut y arch 1981 at least ei!ht cases of a more

a!!ressive form of "S had occurred amon!st youn! !ay men in /e& 0or%.

At aout the same time there &as an increase) in oth California and /e& 0or%)

in the numer of cases of a rare lun! infection 2neumocystis carinii pneumonia

+2C2,. 3In April this increase in 2C2 &as noticed at the Centers for Disease

Control +CDC, in Atlanta. A dru! technician) Sandra 4ord) oserved a hi!h

numer of re5uests for the dru! pentamine) used in the treatment of 2C2

"# doctor was treatin a ay man in his 3*s who had pneumonia! Two weeks

later, he called to ask for a rell of a rare dru that I handled! This was unusual

& nobody ever asked for a rell! 4atients usually were cured in one '*&day

treatment or they died" & %andra 5ord for -ewsweek 6

In 7une) the CDC pulished a report aout the occurrence) &ithout identiale

cause) of 2C2 in ve men in os An!eles. :This report is sometimes referred to

as the ;e!innin!; of AIDS) ut it mi!ht e more accurate to descrie it as the

e!innin! of the !eneral a&areness of AIDS in the


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A fe& days later) follo&in! these reports of 2C2 and other rare life=threatenin!

opportunistic infections) the CDC formed a Tas% 4orce on "aposi#s Sarcoma and

>pportunistic Infections +"S>I,. 6

Around this time a numer of theories emer!ed aout the possile cause of

these opportunistic infections and cancers. ?arly theories included infection

&ith cytome!alovirus) the use of amyl nitrite or utyl nitrate #poppers#) and

#immune overload#. '89

-ecause there &as so little %no&n aout the transmission of &hat seemed to

e a ne& disease) there &as concern aout conta!ion) and &hether the disease

could y passed on y people &ho had no apparent si!ns or

symptoms. 1("no&led!e aout the disease &as chan!in! so 5uic%ly that

certain assumptions made at this time &ere sho&n to e unfounded @ust a fe&

months later. 4or eample) in 7uly 1981 Dr Curran of the CDC &as reported as

follo&s

"$r! 7urran said there was no apparent daner to non homose/uals from

contaion! 8The best evidence aainst contaion8, he said, 8is that no cases

have been reported to date outside the homose/ual community or in women"

& The -ew 9ork Times ''

7ust ve months later) in Decemer 1981) it &as clear that the disease aBected

other population !roups) &hen the rst cases of 2C2 &ere reported in in@ectin!

dru! users. 1At the same time the rst case of AIDS &as documented in the

I) the name already !iven to the

CDC tas% force. 11:

In contrast some still lin%ed the disease to its initial occurrence in !ay men)

&ith a letter in The ancet callin! it ;!ay compromise syndrome;. 16>thers

called it EID +!ay=related immune deciency,) AID +ac5uired

immunodeciency disease,) ;!ay cancer; or ;community=ac5uired immune

dysfunction;. 1'18

In 7une a report of a !roup of cases amon!st !aymen in Southern California

su!!ested that the disease mi!ht e caused y an infectious a!ent that &as

seually transmitted. 19

-y the e!innin! of 7uly a total of : cases) from 3 states) had een reported

to the CDC. (
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ater that month the rst reports appeared that the disease &as occurrin! in

*aitians) as &ell as haemophiliacs. 1This ne&s soon led to speculation

that the epidemic mi!ht have ori!inated in *aiti) and caused some parents to

&ithdra& their children from haemophiliac camps. 3

The occurrence of the disease in non=homoseuals meant that names such as

EID &ere redundant. The acronym AIDS &as su!!ested at a meetin! in

$ashin!ton) D.C.) in 7uly. -y Au!ust this name &as ein! used in

ne&spapers and scientic @ournals. :6'AIDS +Ac5uired Immune Deciency

Syndrome, &as rst properly dened y the CDC in Septemer !8

+y the beinnin of 1uly a total of 6:3 cases, from 30 states, had been reported

to the 7$7!

An ana!ram of AIDS) SIDA) &as created for use in 4rench and

Spanish. 9Doctors thou!ht AIDS &as an appropriate name ecause people

ac5uired the condition rather than inherited itF ecause it resulted in a

deciency &ithin the immune systemF and ecause it &as a syndrome) &ith a

numer of manifestations) rather than a sin!le disease. 3(

Still very little &as %no&n aout transmission and pulic aniety continued to

!ro&.

"It is frihtenin because no one knows what8s causin it, said a 3&year old

law student who went to the %t! 2ark8s 7linic in ;reenwich Villae last week

complainin of swollen lands, thouht to be one early symptom of the

disease! .very week a new theory comes out about how you8re oin to spread

it!" & The -ew 9ork Times 0'

-y 198 a numer of AIDS specic voluntary or!anisations had een set up in

the


4/88

"hen it bean turnin up in children and transfusion recipients, that was a

turnin point in terms of public perception!

receive blood productsA now appears small, but is unknown!" 6*

The ris% for haemophiliacs &as so !reat ecause the lood concentrate that

some haemophiliacs used eposed them to the lood of up to :)((( individual

lood donors.

In arch) the CDC stated that)"persons who may be considered at increased

risk of #I$% include those with symptoms and sins suestive of #I$%B se/ual

partners of #I$% patientsB se/ually active homose/ual or bise/ual men with

multiple partnersB Haitian entrants to the


5/88

ris% of AIDS homoseuals) haemophiliacs) heroin addicts and

*aitians. :Some people sustituted #hoo%ers# for haemophiliacs. 6

In 2ay '0, doctors at the Institute 4asteur in 5rance reported that they had

isolated a new virus, which they suested miht be the cause of #I$%!

In the


6/88

or, less commonly, by percutaneous inoculation of infectious blood or blood

products! -o evidence suests transmission of #I$% by airborne spread! The

failure to identify cases amon friends relatives, and co&workers of #I$%

patients provides further evidence that casual contact o>ers little or no risk

@!!!A the occurrence in youn infants suests transmission from an a>ected

mother to a susceptible infant before, durin, or shortly after birth!" :

Eeports from ?urope su!!ested that t&o rather separate AIDS epidemics &ere

occurrin!. In the ctoer) the rst ?uropean $orld *ealth >r!anisation +$*>, meetin! &as

held in Denmar%. At the meetin! it &as reported that there had een )8(3

AIDS cases in the andit &as reported that AIDS &as present in the


7/88

198 *istory

At the CDC researchers had een continuin! to investi!ate the cause of AIDS

throu!h a study of the seual contacts of homoseual men in os An!eles and

/e& 0or%. They identied a man as the lin% et&een a numer of diBerent

cases and they named him ;patient (;. The research appeared to conrm that

AIDS &as a transmittale disease) and the co=operation of ;patient (;

contriuted to the study. 6'

>ne of the researchers) Darro&) &as to later chan!e his ori!inal statement)

sayin! that he did not name the man as patient Hero ut rather he named him

Jpatient >K) for J>ut of CaliforniaK 68

"I called this uy 4atient F!!! +ut my colleaues read it as 4atient Gero!"

& $arrow for -ewsweek ?

$hatever Darro& did) or didnLt say) in 198 the JmythK of 2atient ero had

e!un. '(See the *istory of 198' pa!efor more aout 2atient ero.

ar!aret *ec%ler

>n April nd) Dr ason of the CDC &as reported as sayin!

"I believe we have the cause of #I$%!"

*e &as referrin! to the 4rench virus) AV) and he &as asin! his opinion on the

ndin!s made in the precedin! &ee%s y the researchers at the 2asteur

Institute &ho had discovered the virus the previous year. '1

7ust one day later) on April 3rd) the


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scientic papers re!ardin! allo#s discovery of *TV=III &ere pulished on th

ay. ':-y 1'th ay) private companies &ere already applyin! to the

Department of *ealth M *uman Services for licences to develop a commercial

test) &hich &ould detect evidence of the virus in lood) a test &hich it had

already een said &ould e used to screen the entire supply of donated lood

in the


9/88

ensure the safety of the lood supply. And even more aspects needed to e

considered efore the test could e more &idely used. Concern particularly

centred on issues of condentiality and the meanin! of a positive test

result. 8'88

"ichard $unne, director of the ;ay 2en8s Health 7risis, said that the roup

would not obect to the wider availability of the procedure provided that certain

safeuards were assuredJ informed consent, ood counsellin and

condentiality, 8which means anonymity,8 he said! He stressed that the city

must prevent insurance companies, employers, schools and others from

ainin access to test results!" & The -ew 9ork Times

The rst small=scale needle and syrin!e echan!epro@ect had een started in

198 in Amsterdam) the /etherlands) ut more pro@ects &ere started in 198:

as a result of !ro&in! concerns aout *TV=IIINAV. 9(

In April more than ((( people attended the rst international Conference on

AIDS held in Atlanta. Three ma@or topics of discussion &ere the ne& *TV=IIINAV

test) the situation &ith re!ards to AIDS internationally) and the etent of

heteroseual transmission. 91

"%ome e/perts are sceptical that #I$% will spread as rapidly amon

heterose/uals as it has amon homose/uals! 9et other e/perts, takin their

cues from data emerin from preliminary studies from #frica showin eCual

se/ distribution amon males and females, are less sure!" & The -ew 9ork

Times 3

Immediately after the conference) the $orld *ealth >r!aniHation +$*>,

or!aniHed an international meetin! to consider the AIDS epidemic and to

initiate concerted &orld&ide action. 93

ean&hile in many countries there &as a separate ;epidemic of fear; and

pre@udice. 9

In the


10/88

In the n Septemer 1'th) 2resident Eea!an pulicly mentioned AIDS for the rst

time) &hen he &as as%ed aout AIDS fundin!at a press conference. At the

same press conference he &as also as%ed a 5uestion &hether he &ould send

his children if they &ere youn!er to school &ith a child &ho has AIDS.

"It is true that some medical sources had said that this cannot be

communicated in any way other than the ones we already know and which

would not involve a child bein in the school! #nd yet medicine has not come

forth uneCuivocally and said, 8This we know for a fact, that it is safe!8 #nd until

they do, I think we ust have to do the best we can with this problem! I can

understand both sides of it!" & onald ! eaan '*0

Dru!s such as riavirin) thou!ht to e active a!ainst *TV=IIINAV) &ere ein!

smu!!led from eico into the ctoer 3rd 198:. *e &as the rstma@or pulic !ure %no&n to have died of AIDS. 1(:

All


11/88

concluded ;Althou!h slim disease resemles AIDS in many &ays) it seems to

e a ne& entity.; 1(8*o&ever) others thou!ht diBerently

"@.videnceA suests that slim disease cannot be distinuished from #I$% and

#7 @#I$% related comple/A by e/treme weiht loss and diarrhea! Thus slim

disease may not be a new syndrome but simply identical with #I$% as seen in

#frica!" '*

In Decemer 198:) the 2asteur Institute led a la&suit a!ainst the /ational

Cancer Institute to claim a share of the royalties from the /CI#s patented AIDS

test. 11(

Durin! the year) %no&led!e of transmission routes &as to chan!e a!ain) &hen

it &as reported that the virus had een transmitted from mother to child

throu!h reast feedin!. 111The rst case of AIDS &as also reported in China)

and as a result) AIDS had een reported in every re!ion in the &orld. 11

-y the end of 198:) ()3(3 cases of AIDS had een reported to the $orld*ealth >r!anisation. 113In the


12/88

In Au!ust) the

Crypotococcal menin!itis in "inshasa) aire +late 19'(s to early 198(s,.

In conclusion
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"These studies suested that while isolated cases of #I$% may have occurred

in #frica earlier, it was probably rare until the late '*8s and early '*8s, a

pattern similar to that in the r!anisation had een notied of 3)88( cases of AIDS in 91

countries. '
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The rst *IV case &as oGcially recorded in the Soviet


15/88

?*&second commercial featurin the rim reaper, a macabre and dramatic

rotten corpse with scythe in one hand and bowlin ball in the other, is

spearheadin e>orts by the -ational #dvisory 7ommittee on #I$% to educate

#ustralians about the incurable disease!" '

>n 31st arch) at a ceremony at the $hite *ouse attended y 2resident

Eea!an) it &as announced that an a!reement had een reached re!ardin!

o&nership of the *IV antiody test patent. The 2asteur Institute a!reed that it

&ould end its le!al challen!e) and &ould share the prots from the test &ith

the


16/88

administration#s policies &ere arrested outside the $hite *ouse y police

&earin! lon! yello& ruer !loves. '

"Fn the nihtly news broadcasts, the world saw pictures of demonstrators

bein arrested by police wearin briht yellow, arm&lenth loves! #lthouh

research had by now proved that the #I$% virus could not be passed throuh

casual contact, the siht of the loves served to reinforce the public8s eneral

overestimation of the risk of HIV transmission!" 3

ran 4ury *IV poster

In 7une the


17/88

Shilts &as the rst to identify a 4rench=Canadian Pi!ht attendant called aetan

Du!as as #2atient ero#. +See the *istory of AIDS up to 1986for an introduction

to #2atient ero#,. Shilts claimed that aetan Du!as played a %ey role in the

early spread of AIDS in America) and the story of #2atient ero# &as &idely

pulicised y the media. 38-ut the claim has since een &idely disputed

"There8s no 4atient Gero! It8s lots and lots of people movin around from -ew

9ork to %an 5rancisco, and the rest of the world! If there ever was an oriinal

4atient Gero, it would have been back in the mid&%eventies! +ut there isn8t an

oriinal 4atient Gero!" & #ndrew 2oss 0

In Africa) 2resident "aunda of amia announced that his son had died of AIDS)

and appealed to the international community to treat AIDS as a &orld&ide

prolem. (In

*IVNAIDS came to!ether to found the community or!anisation TAS>. 1

In >ctoer) AIDS ecame the rst disease ever deated on the Poor of the

+1)1(,. :

The $*> also reported that an estimated : to 1( million people &ere infected

&ith *IV &orld&ide) &ith 1:()((( cases of AIDS epected to develop in the

follo&in! 1 months and up to 3 million &ithin the net : years. 6

1988 *istory

As the !loal moilisation a!ainst AIDS continued) a &orld summit of ministers

of health &as held in ondon to discuss a common AIDS strate!y. The summit

focused on pro!rammes for AIDS prevention. Dele!ates from 18 countries

attended.
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18/88

>ne outcome of the meetin! &as the ondon Declaration on AIDS 2revention)

&hich emphasised education) the free echan!e of information and eperience)

and the need to protect human ri!hts and di!nity. 'The Director=eneral of

the $orld *ealth >r!aniHation chose this occasion to announce that the $*>

intended to promote an annual $orld AIDS Day) and the rst such day &ould

e on 1st Decemer 1988. 8

ran 4ury #All people &ith AIDS are innocent# poster

The meetin! &as opened y the ctoer 11th more than 1)(((

ACT=


19/88

?i!ht days after the ACT=r!anisation +$*>,. The $*> re!arded this as under=reportin!) and

estimated the actual numer of people &ith AIDS around the &orld to e over

(()(((. It &as predicted that this !ure &ould rise to 1.1 million y 1991. It

&as also estimated that :=1( million people &ere already infected &ith *IV. 63

>n April nd) *ans Verhoef) a Dutch man &ith AIDS) &as @ailed in innesota

under the federal la& annin! travellers &ith *IV from enterin! the n Au!ust 1'th a press conference &as held) at

&hich the *ealth Secretary) ouis Sullivan said

"Today we are witnessin a turnin point in the battle to chane #I$% from a

fatal disease to a treatable one!" ??

The result had enormous nancial implications for the ma%ers of the dru!)

-urrou!hs $ellcome. The day after the press conference) the value of the

company#s stoc% rose y 3 per cent. 6'The hi!h price of AT an!ered many
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peopleF &ith a year#s supply for one person costin! aout ')((() -urrou!hs

$elcome &ere accused of ;price !ou!in! and proteerin!;. 6869

In Septemer) the cost of the dru! &as cut y ( percent. '(

In >ctoer the second dru! for the treatment of AIDS) dideoyinosine +ddI,) &as

made availale to people &ith AIDS) even thou!h only preliminary tests hadeen completed.

"It become clear that ddl was not ust another dru in terms of needJ it was a

life&and&death matter, said ichard M! ;elb, chairman of +ristol 2yers!" '

199( *istory

At the e!innin! of the year) it &as reported that a lar!e numer of children in

Eomanian hospitals and orphana!es had ecome infected &ith *IV as a result

of multiple lood transfusions and the reuse of needles. 7onathan ann) the

head of the $*>#s loal pro!ramme on AIDS) noted that #?astern ?urope isthe ne& frontier for the AIDS epidemic#. '

In China) 16 people in 0unnan 2rovince near the -urmese order &ere found

to e infected &ith *IV due to sharin! needles. This shoc%ed pulic health

oGcials in China. It &as not %no&n &hether this &as the rst si!n of an

epidemic or an isolated outrea%. '3

In /e& 0or% city the needle echan!e scheme &as closed do&n. '

7onathan ann resi!ned as the head of the $*> AIDS pro!ramme) in protest of

the failure of the director=!eneral

Dr. *iroshi /a%a@ima. ':Durin! 7onathan ann#s leadership) the AIDS

pro!ramme ecame the

Eyan $hite +19'1=199(, &ith his mother

lar!est sin!le pro!ramme in the or!anisation#s history. '6-ut more

importantly

"1onathan8s persistence and passion helped wake up the world!"

and)

"Had it not been for 1onathan8s uniCue contributions, the world8s approach to

#I$% miht very well have one towards mandatory testin and

Cuarantine!"
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>n April 8th Eyan $hite died in the


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other ris% factors or ehaviours that could have put the patient at ris% of *IV

infection. 9(A couple of months later the patient &as named as =year old

"imerly -er!alis and the dentist &as named as David Acer. 91

"hen she was dianosed with #I$% we were in disbelief! #ll we could wonder

was whether somethin went wron at the dentists! Health oDcials said no

way, it ust can8t happen! +ut Pimberly stuck by her uns and kept tellin them

to look at the dentist! .ventually the 7$7 supported her conclusion!" & ;eore

+eralis 3

In the


23/88

In the autumn) in a dramatic move) "imerly -er!alis testied to the


24/88

The red rion ecame an international symol of AIDS a&areness durin!

1991. The or!anisation) Visual AIDS in /e& 0or%) to!ether &ith -road&ay Cares

and ?5uity 4i!hts AIDS) estalished the &earin! of a red rion as a &ay of

si!nifyin! support for people livin! &ith *IVNAIDS. 11

As the end of 1991) aout :()((( AIDS cases had een reported to the loal

2ro!ramme on AIDS +2A, N $orld *ealth >r!anisation +$*>,. It &as estimated

that :=' million men and 3=: million &omen had een infected &ith *IV. >f

these 9=11 million *IV=infected adults) nearly 1.: million &ere estimated to

have pro!ressed to AIDS. 113

199 *istory

The $*> set as a priority tar!et for prevention that) y the year ((() the

&hole population at ris% from *IV and AIDS in Africa and Asia should live in

communities &here condoms &ere oth readily availale and aBordale. 11

In the


25/88

Tennis star Arthur Ashe announced he had ecome infected &ith *IV as a result

of a lood transfusion in 1983. 13

4earful that it &as discoura!in! tourists) a ne& !overnment in Thailand

threatened to scale do&n the country#s etensive AIDS a&areness campai!n)

&hich had e!un in 1991 and &on international acclaim. *o&ever) the

!overnment lost po&er &ithin &ee%s and the campai!n &as restored. 1

The 4DA approved the use of ddC in comination &ith AT for adult patients

&ith advanced *IV infection &ho &ere continuin! to sho& si!ns of clinical or

immunolo!ical deterioration. This &as the rst successful use of comination

dru! therapy for the treatment of AIDS. 1:

"This new dru is not a cure, said 1ames 2ason, 2!$!, assistant secretary for

health and head of the 4ublic Health service, but it constitutes an important

addition to the e/pandin roup of antiviral drus currently available, includin

#GT and $$I, for treatin people with #I$%!"

The CDC) under pressure from patients and doctors) decided to revise its

denition of AIDS. The previous list of illnesses that dened AIDS had een

criticised for some time ecause it did not include many of the conditions most

often seen in *IV positive &omen and in@ectin! dru! users. The ne& denition

&ould ta%e eBect from the start of 1993. 161'

The VIII International Conference &as successfully held in Amsterdam rather

than in its ori!inally planned venue in -oston. 18

In 4rance four health care oGcials &ere rou!ht to trial accused of allo&in! the

distriution) et&een 198( and 198:) of lood products %no&n to econtaminated &ith *IV. 1913(The former director of the transfusion service)

ichel arretta) &as sentenced to four years in prison) as &as 7ean=2ierre

Allain) the former head of research at the transfusion centre. The third doctor)

7ac5ues Eou) &as !iven a four=year suspended sentence) &hilst the fourth

doctor &as ac5uitted. 131

In response to risin! *IV prevalence) the Indian !overnment decided to allocate

1(( million to the /ational AIDS Control pro@ect over the net ve years)

&hich amounted to more than 1: percent of the national health ud!et. ost

of this money &ould come from a $orld -an% loan. 13?perts predicted that

&ithin ve years there mi!ht e more people aBected y AIDS in India than in

any other country. 133

= See more at httpNN&&&.avert.or!Nhistory=aids=198'=

199.htmQsthash.DOs%er.dpuf

*istory of AIDS 1993=199'
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#?urope a!ainst AIDS# Pyin! condom poster

These are some of the most important events that have occurred in thehistory

of AIDSover the period 1993=199'.

1993 *istory

In 7anuary it &as reported that some people &ith AIDS already had resistance

to the dru! idovudine +AT, even thou!h they themselves had never ta%en

the dru!.

"%ome of the patients may have otten the virus from other patients who have

been takin #GT and who are now transmittin the resistant virus!"

Eesearchers said there &as an ur!ent need to develop ne& dru!s to comat

the epidemic. 1

>n 7anuary 6th the Eussian allet star Eudolf /ureyev died. *is doctor said that

;he died from a cardiac complication follo&in! a cruel illness;) ut it &as &idely

reported that he had died from AIDS. 3*e &as uried in his evenin! clothes

&ith his medals and his favourite eret.

Durin! 7anuary) 116 ne& cases of AIDS &ere reported in the


27/88

2rincess Diana continued her *IVNAIDS advocacy &or% and spo%e at the

openin! address of the nd International Conference on *IV in Children and

others in ?dinur!h.

"+y the year two thousand, only seven years from now & even the most

conservative estimates predict there will be more than thirty million people

worldwide with HIV & eCuivalent to more than half the population of the


28/88

The $orld -an% revie&ed its *IV and AIDS activities Africa) and decided that

AIDS should not dominate its a!enda on population) health and nutrition issues.

The $orld -an% elieved that AIDS &ould have little demo!raphic eBect ut

reco!nised that it &as a serious threat to health and economic development.

$ith reference to lood screenin!) it &as ar!ued that this &as costly and

;mi!ht not e cost=eBective under all circumstances;.

The ninth International AIDS meetin! &as held in -erlin) ermany. The !eneral

feelin! of the meetin! &as one of disappointment. The messa!e conveyed y

the people &ho attended &as once a!ain to put more money and eBort into

eBective prevention of *IV and AIDS.

Q$r! 1ames ! 7urran, who heads the #I$% 4roramme at the 7enters for

$isease 7ontrol and 4revention in #tlanta, said he left the meetin 8dispirited

by the relentless assault of the virus8!R30

At the e!innin! of the year the CDC had epanded the #s Ee!ional >Gce for ?urope accepted the inclusion of the additional

indicator diseases ut not the CD cell count criteria.

In mid=1993 si ) e!an to

see% a!reement on formin! a @oint and cosponsored ctoer

1993. In >ctoer) the failure of a small erman lood supply company called

Gce y chance)

as a result of routine eamination of positive *IV test results. 9The 4ederal
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overnment also admitted that oGcials had covered up 3'3 cases of *IV=

contaminated lood in the 198(s. 3(

>n $orld AIDS Day) 1st Decemer) -enetton in collaoration &ith ACT


30/88

+a !overnment funded ody,) &ho later in the year &ere anned y the

Department of *ealth from distriutin! the oo%) ;0our 2oc%et uide to

Se;. 3:

In 4eruary the lm ma%er Dere% 7arman died of AIDS. *e had &ritten in the

preface of his autoio!raphy

"Fn 33nd of $ecember '?, ndin I was body positive, I set myself a taretJ

I would disclose my secret and survive 2araret Thatcher! I did! -ow I have my

sihts on the millennium and a world where we are eCual before the law!" 0?

Eandy Shilts) author of the oo% #And the and played on# also died in

4eruary. 3'

In arch) the actor Tom *an%s &on an >scar for playin! a !ay man &ith AIDS in

the lm 2hiladelphia. 38

>Gcial statistics for -raHil) &ith a population of aout 1: million) indicatedthat some 6)((( cases of AIDS had een recorded) ut estimates put the

actual numer at any&here et&een :()((( and 3 million cases. T&o thirds of

the %no&n cases &ere in Sao 2aulo state &here AIDS &as the leadin! cause of

death of &omen a!ed (=3:. 39

In 4rance) on 'th April all the television net&or%s) pulic and private) roadcast

#Tous contre le Sida# +#All a!ainst AIDS#,) a special =hour AIDS pro!ramme. The

aim &as to hei!hten a&areness aout *IVNAIDS and to raise money. (The

estimated audience for the pro!ram &as 33 million. Some 3)((( cases of AIDS

had een recorded in 4rance) &ith 1: deaths each day) and an estimated

1:()((( people &ere thou!ht to e infected. 1

Durin! the summer) the AIDS 2revention A!ency in -russels) in collaoration

&ith the ?uropean


31/88

-y 7uly 199 the numer of AIDS cases reported to the $*> &as 98:)119. The

$*> estimated that the total numer of AIDS cases !loally had risen y 6(

percent in the past year from an estimated .: million in 7uly 1993 to million

in 7uly 199. :It &as estimated that &orld&ide there &ere three men infected

for every t&o &omen) ut that y the year ((( the numer of ne& infections

amon! &omen &ould e e5ual to that amon! men. 6

At the end of 7uly) it &as announced that the $*>#s loal pro!ramme on AIDS

&ould e replaced. The ctoer to adopt a la& ma%in! *IV tests compulsory

for all forei!n residents) tourists) usinessmen and even memers of oGcial

dele!ations. :3

India y this time had around 1.6 million people livin! &ith *IV) up y 6(

percent since 1993. ocal and state !overnments &ere accused of underusin!

and misusin! *IV prevention funds. :
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2edro amora) an *IV=positive reality TV sho& star

>n 11th /ovemer AIDS %illed the =year old 2edro amora. *e had ecome

famous &hen he appeared on TV#s #Eeal $orld# documentary aout the real

lives of a !roup of youn! room mates. ::

In Decemer) 2resident Clinton as%ed 7oycelyn ?lders to resi!n from the post ofr!anisation loal 2ro!ramme on AIDS. ?i!hteenmillion adults and 1.: million children &ere estimated to have een infected

&ith *IV since the e!innin! of the epidemic. :'

ater in the month the CDC announced that in the e of the 7$7

& :

T&o research reports provided important ne& information aout ho& *IV

replicates in the ody and ho& it aBects the immune system. :96(

ean&hile in the


33/88

The South African inistry of *ealth announced that some 8:()((( people = .1

percent of the ( million population = &ere elieved to e *IV positive. Amon!

pre!nant &omen the !ure had reached 8 percent and &as risin!. 6:

2eter 2iot = former spo%e out aout the #inade5uate

international response#

"The impact of the HIVS#I$% epidemic on women O is not yet receivin

suDcient political awareness, commitment or enouh action of prorammes

respondin to the specic needs of women!"?

Also in Au!ust) researchers announced the results of a study in TanHania) &hich

found that treatin! people for seually transmitted diseases such as !onorrhea

sustantially reduced their ris% of ecomin! infected &ith *IV. '(

In Septemer t&o clinical trials) the Delta trial and the ACT1': trial) sho&ed

that cominations of AT &ith ddI or ddC &ere more eBective than AT alone in

delayin! disease pro!ression and prolon!in! life. '1

>n 1st Decemer) $orld AIDS Day) /elson andela called on all South Africans

to

"speak out aainst the stima, blame, shame and denial that has thus far beenassociated with this epidemic!" 3

The 4DA approved the rst of a potent ne& family of anti=AIDS medications.

The dru! sa5uinavir elon!ed to a class of dru!s called protease inhiitors. Its

approval in record time &as said to e

"some of the most hopeful news in years for people livin with #I$%!" 0
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-y Decemer 1:th) the $orld *ealth >r!anisation had received reports of

1)91)81( cumulative cases of AIDS in adults and children from 193 countries

or areas. The $*> estimated that the actual numer of cases that had

occurred &as around 6 million. ?i!ht countries in Africa had reported more than

()((( cases. '

>ther or!anisations estimated that y the end of 199:) 9. million people

&orld&ide had died from AIDS. ':

$orld&ide durin! 199:) it &as estimated that .' million ne& *IV infections

occurred. >f these) .: million occurred in Southeast Asia and 1.9 million in

su=Saharan Africa. Approimately :(()((( children &ere orn &ith *IV. '6

The $*>#s loal pro!ramme on AIDS closed as planned on 31st Decemer

199:. ''They estimated that y the end of the century) 3( to ( million

people &ould have een aBected y *IV. '8

1996 *istory

The ne& 7oint


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health professionals. ne doctor su!!ested that !ivin! comination therapy to patients in the rstfe& &ee%s of infection mi!ht mean that the virus could e completely

eliminated in t&o or three years. 9

*o&ever) /%osaHana uma) the health minister of South Africa) reminded the

conference dele!ates that
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"most people infected with HIV live in #frica, where therapies involvin

combinations of e/pensive antiviral drus are out of the Cuestion!" 0

It &as also reported that there &ere limitations on the use of the dru!s) such as

severe side eBects and the diGculty of ta%in! lar!e numers of pills each

day. 9

"If you think the cure is here, think aain! The cure is not here! e are a lon

way from a cure, even for the rich who can a>ord the treatments!" & .ric

%awyer :

The !overnment of -raHil pled!ed to e!in providin! free comination

antiretroviral treatment y the end of the year. It said it &ould spend up to :

million on protease inhiitors over the follo&in! t&elve months. 96

In >ctoer) in $ashin!ton D.C.) the AIDS emorial Ouilt &as displayed in its

entirety for the last time) ut it &as also the rst time that a display of the 5uilt

had een visited y an American president. 9'98

"hat it has done always in the past, and will continue to do, is to put a face

on this epidemic! It makes this epidemic human!" & #nthony Turney

In Decemer) the $hite *ouse announced its rst ever AIDS strate!y. This

called) amon!st other thin!s) for sustained research to nd a cure and a

vaccineF a reduction in ne& infectionsF !uaranteed access to hi!h 5uality care

for AIDS patientsF and !htin! AIDS=related discrimination.

"-one of us can a>ord to sit by and watch this epidemic continue to take our

neihbors, friends and loved ones from us" & 4resident 7linton in a letteraccompanyin the #I$% plan '**

AIDS advocates said that much &ould depend on ho& the state!y &as

implemented.

"It doesn8t reCuire rocket science to ure out what to do, what it reCuires is

the political will to back it up!" & 4aul $onato '*'

/e& outrea%s of *IV infection &ere eruptin! in ?astern ?urope) the former

Soviet


37/88

estimated 6. million people = : million adults and 1. million children = had

already died.

199' *istory

Children at a school in Illin!e) South Africa

?arly in 199' it &as reported that) for the rst time since the AIDS epidemic

ecame visile in 1981) the numer of deaths from AIDS had dropped

sustantially across the


38/88

"ith the strides of recent years, it is no loner a Cuestion of whether we can

develop an #I$% vaccine & it is simply a Cuestion of when! #nd it cannot come a

day too soon!" & 4resident 7linton''0

In 7uly the CDC reported that it &as li%ely that there had een a case of

transmission of *IV as a result of ;deep %issin!;) althou!h other routes of

transmission in this case could not denitely e ecluded. The *IV positive man

had sores in his mouth and !ums that re!ularly led) and his female partner

also had !um disease &ith inPamed and sore areas in her mouth. 11

In Au!ust) at a


39/88

"It is a crisis of staerin proportion, that is oin to a>ect not only the future

of these countries, it is oin to a>ect the entire lobal network of trade,

diplomacy and development! hat we are talkin about here is somethin that

has never been seen before, which is countries with one&si/th to one&Cuarter of

all children without one or both parents!" '3*

*istory of AIDS 1998=((

u!u Dlamini#s red rion memorial

These are some of the most important events that occurred in thehistory of

AIDSover the period 1998=((.

1998 *istory

In Canada there &as an outrea% of *IV infection amon!st in@ectin! dru!

usersin Vancouver. 1

lao $ellcome cut the price of AT y ':W after a trial in Thailand sho&ed it

&as safe and eBective at preventin! mother=to=child transmission of *IV in

developin! countries. *o&ever) even &ith this price cut it &as epected that

the dru! &ould still e far too epensive for use in many developin!

countries. 3

The 7linton #dministration refused to lift a ten&year ban on usin federal funds

for needle e/chane prorammes

In some countries *IV positive people &ere returnin! to &or%) havin! recoveredtheir health as a result of comination antiretroviral dru! treatment. *o&ever)

some people e!an to e aBected y 5uite severe side eBects of the dru!s.

The emer!ence of ne!ative reactions = &hich included a %ind of fat

redistriution called lipodystrophy = cast dout on the lon! term safety of

comination therapy. The reasons &hy lipodystrophy appeared in some people

ta%in! anti=*IV dru!s &ere un%no&n. Some reports lin%ed the syndrome to dru!

re!imens that countained protease inhiitors.

"hile fat disappears from some areas, for unknown reasons it redistributes to

build up in others! The back of the neck resembles a bu>alo hump! +reasts

enlare! # woman may have to buy a bra that is two siLes larer that the last

one! The abdomen swells producin a sometimes painful pot belly that is

dubbed 8a protease paunch8! # woman may look prenant when she is not!

./ercise may not work it o>!" :

In April) the Clinton Administration refused to lift a ten=year an on usin!

federal funds for needle echan!epro!rammes) despite concludin! for the rst
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time that such echan!es prevent the spread of *IV and do not encoura!e dru!

use. eaders in the !ht a!ainst AIDS condemned the unepected decision)

&hich &as announced y *ealth and *uman Services Secretary Donna Shalala.

Durin! her speech Shalala 5uoted /I* director Varmus as sayin!

"#n e/haustive review of the science indicates that needle e/chane

prorammes can be an e>ective component of the lobal e>ort to end the

#I$% epidemic! ecent ndins have strenthened the scientic evidence that

needle e/chane prorammes do not encourae the use of illeal drus!"

-ut) &ithout eplanation) Shalala said the administration had ;decided that the

est course at this time is to have local communities use their o&n dollars to

fund needle echan!e pro!rammes;. 6

In the


41/88

"# series of reports about new problems with anti&HIV drus and setbacks in

vaccine trials left many participants thinkin that their best hope aainst the

epidemic was the stratey they had since it beanJ prevention!" ''

A 4rench court ordered the former 4rench prime minister aurent 4aius to

stand trial on char!es of involuntary homicide for allo&in! *IV=tainted lood to

e used in transfusions. 1

The rst case of a patient ein! infected &ith a strain of *IV resistant to the

most po&erful ne& antiretroviral dru!s &as reported in San 4rancisco in 7uly.

The mutated strain of *IV) seemin!ly impervious to protease inhiitors and

older dru!s) &as found in a ne&ly infected patient at San 4rancisco eneral

*ospital.

"e may be seein an emerin and danerous ede to the epidemic!" & $r!

5rederick Hecht of the


42/88

concentrated in the youn!er a!e !roups. The campai!n also had a special

representative) -raHilian footaller Eonaldo. 19

/ ?stimated ne& *IV infections 1998/orth America )(((Cariean :)(((atin America 16()((($estern ?urope 3()(((/orth AfricaNiddle ?ast 19)(((Su=Saharan Africa million?astern ?uropeNCentral Asia 8()(((?ast AsiaN2acic (()(((South AsiaNSouth=?ast Asia 1. millionAustralia M /e& ealand 6((

loal total :.8 millionSu=Saharan Africa &as home to '(W of people &ho ecame infected &ith *IV

durin! the year. South Africa) &hich trailed ehind some of its nei!hourin!

countries in *IV infection levels at the start of the 199(s &as catchin! up fast.

It &as estimated that one in seven ne& *IV infections in Africa &ere elieved to

e occurrin! in South Africa. In -ots&ana) /amiia) S&aHiland and ima&e)

the estimates sho&ed that et&een (W and 6W of people &ere livin! &ith

*IV or AIDS. 1

1999 *istory

In the


43/88

The

pro!ramme usin! rapid tests in an eBort to reduce the spread of *IV. This eBort

&as intended to ma%e *IV screenin! services accessile to more people)

especially in rural areas &here there &ere neither modern laoratories nor

electricity to run standard *IV tests. '8Since 1986 the

had implemented a numer of successful initiatives) and &hereas in 199 it&as estimated that 3(W of adults in "ampala &ere livin! &ith *IV) y 1999 the

!ure had fallen to 1W. 9*o&ever) *IVNAIDS &as still a considerale health

prolem in

livin! &ith *IVNAIDS as at the end of 1999. 3(

In the orts to brin an end to

#I$%, not only in the


44/88

concern and disappointment amon! pulic health authorities ecause) instead

of declinin!) the rate of ne& *IV infections had remained at aout :(( per

year. 3'

In@ectin! dru! use +IDort must be made to brin the

problem under control!" & 4resident 2oi 6:

*o&ever the president also said that his !overnment and "enya#s churches

&ould not advocate the use of condoms as a method of prevention ecause

this &ould encoura!e youn! people to have se.

A research study pulished in /ovemer ar!ued that male circumcisioncould

help to reduce *IV infection rates in Africa and Asia. 6

At the re5uest of countries around the &orld ea!er to reach the a!e !roup at

hi!hest ris%) the 1999 $orld AIDS Day campai!n) ;isten) earn and iveX;)

continued to focus on people under :. '

-y the end of 1999)


45/88

disease in 1999) more than in any other year since the epidemic e!an. 8It

&as also reported that for the rst time more &omen than men &ere infected

&ith *IV in Africa. 9

"In '3, a team headed by the late $r! 1onathan 2ann at the Harvard %chool

of 4ublic Health, published estimates of HIV infections in sub&%aharan #frica

ranin from 3*! million to 00!? million by 3***! The orld Health

Franisation criticiLed $r! 2ann8s estimates as e/cessive! -ow academic

scientists are criticiLin the ures of $r! 4iot8s Team! 8hen we look at the

ures today, they are worse than the scenarios 1onathan had published,8 $r!

4iot" :*

The $orld -an% &arned that the eBect of AIDS in Asiacould e to erase the

re!ion#s economic !ains over the last t&o decades unless !overnments

maintained fundin! for social pro!rams. The


46/88

A more denitive study &as pulished aout the ris% of transmittin! *IV

throu!h oral se. Althou!h earlier studies had identied oral se as a means of

transmittin! *IV) the ne& study &as desi!ned to nd out the etent of *IV

transmission throu!h oral se amon! men &ho have se &ith men. The

research su!!ested that oral se accounted for aout 'W of cases. :8

"I think it reinforces what we8ve said already & which is that condoms should be

used for whatever type of se/ you have!" & $r! obert 1anssen, $irector of the

$ivision of HIVS#I$% prevention at the 7$7 :

?arly in the year the South African !overnment made a decision to invite a

panel of eperts to pursue deate on 5uestions relatin! to *IVNAIDS. 6(In

arch it &as reported that South African 2resident Thao e%i had consulted

t&o American #dissident# researchers to discuss their claim that *IV &as not the

cause of AIDS. 61

Israel lost one of its most successful sin!ers) >fra *aHa) from &hat &as

elieved to e an AIDS=related complication. 4ollo&in! her death there &as a

considerale increase in demand for helplines and anonymous *IV testin!.

"-evertheless, her death has brouht the whole issue of #I$% out into the open

in Israel! This can only be a ood thin for a country which has seven openly

HIV positive people & includin myself & out of an estimated '*,***!" & #viram

;ermanovitch, $irector of the Israeli #I$% Task 5orce ?3?0

In April) 2resident e%i sent a letter to &orld leaders eplainin! his vie&s on

*IVNAIDS. In this letter e%i ar!ued) amon!st other thin!s) that since *IV is

spread mostly throu!h heteroseual contact in Africa) the continent#s prolems

are uni5ue.

"#ccordinly, as #fricans, we have to deal with this uniCuely #frican

catastrophe!!! It is obvious that whatever lessons we have to and may draw

from the est about the rave issue of HIVI$%, a simple superimposition of

estern e/perience on #frican reality would be absurd and illoical!" ?6?:

In -ots&ana) as many as one in four adults and four of every ten pre!nant

&omen &ere estimated to e infected &ith *IV. 66The president of -ots&ana)

4estus o!ae) announced that ne& contriutions from donors includin! :(

million donated y the -ill and elinda ates 4oundation &ould allo& his

country to provide antiretroviral therapy to all *IV=infected pre!nant &omen

and children orn &ith the virus. 6'

The Clinton Administration formally declared *IVNAIDS to e a threat to


47/88

mar%et democracies aroad. It &as the rst time the /ational Security Council

&as involved in !htin! an infectious disease. 6869

"e shouldn8t pretend that we can ive inections and work our way out of this!

e have to chane behaviour, attitudes, and it has to be done in an oraniLed,

disciplined, systematic way!" & +ill 7linton *

ater in the year) the


48/88

e%i used his openin! address at the conference to stress the role of poverty

in eplainin! the prolems faced y Africa and compared the campai!n a!ainst

AIDS &ith the stru!!le a!ainst apartheid. 83

"#s I listened and heard the whole story told about our own country, it seemed

to me you could not blame everythin on a sinle virus!" 6

An *IV=positive &oman marchin! at the Duran AIDS Conference) South Africa

To counter the comments made y president e%i) over :)((( scientists

around the &orld si!ned the #Duran Declaration# aGrmin! that *IV is the

cause of AIDS. 8:86

/elson andela) South Africa#s former president) closed the AIDS conference

&ith a call for action to comine eBorts and save people. 8'

"History will ude us harshly if we fail to do so now, and riht now!"

At the conference) preliminary ndin!s &ere reported from nonoynol=9 studies

in Africa and Thailand. Scientists had hoped that nonynol=9 &ould prove to e

the rst eBective #microicide# that could reduce the ris% of *IV transmission

durin! se) ut the ndin!s &ere 5uite the opposite. $omen at hi!h ris% of *IV

infection &ere &arned not to use the spermicide nonoynol=9 ecause the

studies su!!ested it mi!ht increase the ris% of transmission. 88

"If you use nono/ynol&, you are either wastin your money or possibly wastin

your life!" & $r! 1oseph 4erriens

4or some people these &ere not surprisin! ndin!s) since the toic eBects of

nonoynol=9 had een reported since 1989. 9(

There &ere fe& other note&orthy scientic ndin!s reported at the conference.

In Septemer) the rst phase of a ne& vaccine trial &as launched in >ford.

The trials &ere sponsored y the International AIDS Vaccine Initiative. 91The

research into an AIDS vaccine &as criticised y the $orld -an% for focusin! on

a vaccine that could e mar%eted in &estern countries) despite the fact that

more than 9(W of *IV infections &ere in the developin! &orld. 9

It &as reported that the numer of people livin! &ith *IV in -raHil&as less than

half that once predicted y health eperts) and the numer of AIDS deaths had

plummeted y as much as fty per cent since the introduction of comination

antiretroviral therapy in 1996. The country#s *IV prevention and treatment

pro!rammes &ere seen as a model for other resource=poor countries to

emulate.
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"It makes a lot of sense to look at what +raLil is doin!!! %omethin they8re

doin is workin!" & 2bulelo akwena, %outh #frica8s ambassador to +raLil & 0

Treatment provision remained non=eistent in South Africa) and 2resident e%i

stated in an intervie& &ith the Time a!aHine that he did not thin% that *IV

alone caused AIDS.

"7learly there is such a thin as acCuired immune deciency! The Cuestion you

have to ask is what produces this deciency! # whole variety of thins can

cause the immune system to collapseO +ut the notion that immune deciency

is only acCuired from a sinle virus cannot be sustained! Fnce you say immune

deciency is acCuired from that virus your response will be antiviral drus! +ut

if you accept that there can be a variety of reasons, includin poverty and the

many diseases that aEict #fricans, then you can have a more comprehensive

treatment response!" 6

In >ctoer) 2resident e%i announced his &ithdra&al from the scientic and

pulic deate on the causes of AIDS after admittin! that he had created

confusion in South Africa. 9:

There has een a lot of confusion aout &hat e%i said and did not say durin!

the year. 96It is clear that over a period of some months) particularly in April

and in Septemer) e%i led many people to thin% that either 1, he does not

elieve that *IV causes AIDS or , he does not elieve that *IV causes AIDS on

its o&n.

It &ould seem that e%i may have elieved that immune deciency is caused

y a collection of factors such as poverty) nutrition and contaminated &ater as

&ell as *IV) rather than @ust *IV on its o&n

"9ou cannot attribute immune deciency solely and e/clusively to a virus!"

It is true that poverty related factors such as malnutrition &ill hasten the onset

of AIDS in people &ho are *IV=positive. Therefore) it is also true that provision

of food &ill slo& do&n the pro!ression of *IV. *o&ever improved nutrition is not

enou!h in itself to permanently %eep people healthy. *istory provides evidence

of this. 98

((1 *istory

After years of denial) China nally admitted that *IVNAIDS threatened its pulic

health and economic security. China#s most senior AIDS researcher stated that

China could soon have one of the &orld#s lar!est populations of people livin!

&ith *IV. Infections &ere predicted to !ro& from aout 6(()((( to 6 million y

((:. 99It &as elieved that nearly ':W of people livin! &ith *IV in China had

ac5uired the virus throu!h in@ectin! dru! useor transfusion &ith contaminated

lood. 1((
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The Indian dru! company Cipla oBered to ma%e AIDS dru!s availale at

reduced prices to the international aid or!anisation edecins Sans 4rontieres

+S4,. Cipla#s oBer to produce dru!s at a price less than 1 per day put further

pressure on multinational dru! companies. 1(1

The


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In April) at the African Summit in /i!eria) ort, there is no us and them, no developed and developin countries,

no rich and poor & only a common enemy that knows no frontiers and threatens

all people!" & Po #nnan at the ; summit in ;enoa '':

There &ere some concerns aout ho& this ne& initiative &as !oin! to e

!overned and implemented) and the


52/88

There &as a sudden eplosion in *IV cases amon! in@ectin! dru! users in

Dulin) Ireland. It &as reported that dia!noses @umped vefold et&een 7anuary

1999 and 7une (((. Dia!noses fell to a lo& of 1 in 1998) ut in the net 18

months 96 people tested positive. Doctors lamed this on a sudden ti!htenin!

of re!ulations around the supply of the heroin sustitute methadone) &hich

caused more people to start in@ectin! street heroin. 13

Stephen "elly &as found !uilty at las!o& *i!h Court of #culpale and rec%less

conduct# for havin! unprotected se despite %no&in! that he had *IV. *e

infected his !irlfriend in 199. "elly &as the rst person to e tried under

Scottish la& for this type of oBence. It &as feared that the threat of le!al action

&ould ma%e people more reluctant to e tested for *IV. 1

2resident eor!e -ush appointed an openly !ay man) Scott ?vertH) as Director

of the >Gce of /ational AIDS 2olicy) ut did not nd any etra money in his

(( ud!et for AIDS prevention or treatment. 1:

The


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AIDS and other diseases &ithout havin! to !et permission from patent holders.

It &as hoped that the ne& rules &ould help improve access to

antiretrovirals. 131

It &as reported that some Asian countries had reduced the transmission of *IV

throu!h &idespread condom use. In Thailand) the rate of ne& infections had

plummeted from 13)((( in 1991 to ()((( in (((. 13ean&hile *IV &as

spreadin! fastest in ?astern ?urope and Eussia. 133

A senior Iranian health oGcial &arned that the numer of AIDS cases in the

country had risen dramatically. In the past) Iranian oGcials estimated the

numer of *IV=positive people to e around )((() ut the Deputy *ealth

inister said that the real !ure &as more than 1:)(((. 13

(( *istory


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The Chinese overnment announced a 1'W @ump in AIDS cases. The

!overnment estimated that the numer of people &ith full=lo&n AIDS &as as

hi!h as (()((() of &hom more than half &ere presumed already dead. It also

estimated that up to 8:()((( people &ere infected &ith *IV y the end of

((1. These !ures &ere still far elo& the estimates y eperts at the ) &ho said that as many as 1.: million people could have eeninfected in China. 11

The /ational Statistics Institute in ison announced that there &ere 1(. *IV

cases per one million 2ortu!uese residents in ((() compared &ith 88.3 cases

in 1999. This &as the hi!hest rate of *IV infection in the ?uropean pulished !uidelines for providin! antiretroviral dru!s for treatin! *IV

infection in resource poor countries. They also released a list of 1 essential

AIDS dru!s. These t&o moves &ere seen as ;vital steps in the battle aainst

the #I$% pandemic @thatA should encourae both industrialised and developin

country overnments to make HIV treatment more widely available!; 1:

In April) the South African !overnment promised to start providin! nevirapine to*IV=positive pre!nant &omen and their aies to reduce the ris% of *IV

transmission. It &as also !oin! to e possile to oBer AT as post=eposure

prophylais +2?2, to &omen &ho had een raped. 16

A $orld -an% report said that *IV &as spreadin! so rapidly in parts of Africa

that it &as %illin! teachers faster than the nations could train them. The report

noted that for eample in parts of

teachers &ere *IV=positive. 1'

"ith more than ''0 million children not in school in the poorest countries

already presents a maor challene! However, HIVS#I$% makes this muchreater in those countries where the education system is already strulin to

row, teachers are dyin, or are too sick to teach! #nd every year more

children are losin their parents and the support that allows them to o to

school! #chievin education for all in a world of #I$% presents an

unprecedented challene to the world education community!" & orld +ank

4resident 1ames $! olfensohn '6
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A report &arned that 2apua /e& uinea &as on the rin% of an *IVNAIDS

epidemic and the country could face losin! 13=38W of its &or%in! population y

((. It &as estimated that 2apua /e& uinea had et&een 1()((( to 1:)(((

people infected &ith *IV. In comparison) Australia &ith a population almost :

times that of 2apua /e& uinea had less than 1)((( *IV positive people. It

&as feared that *IVNAIDS could spread rapidly since 9(W of infections &eretransmitted throu!h heteroseual se. 19

A ma@or Spanish study found that over 19)((( instances of unprotected oral

se did not lead to a sin!le case of *IV transmission amon! 13: *IV=ne!ative

heteroseuals in a seual relationship &ith a person &ith *IV. 1:(

The $*> &arned that *IV could spread rapidly throu!hout Af!hanistan due to

hi!h levels of in@ectin! dru! use and unsafe lood transfusions. It also said that

refu!ees &ere especially vulnerale to *IV infection ecause of seual ause)

violence and lac% of information and education. To learn more aout this

prolem) the $*> &as fundin! the rst survey of *IVNAIDS in Af!hanistan. 1:1

Treatment activists at the International AIDS Conference (() Spain

In 7uly) the 1th $orld AIDS Conference &as held in -arcelona) Spain. Issues

around providin! *IV treatment for resource=poor countries dominated the

mood and a!endas of the conference.

"If we can et cold 7oca 7ola and beer to every remote corner of #frica, it

should not be impossible to do the same with drus!" & 1oep Mane, the

4resident of the International #I$% %ociety speakin at the closinceremony ':3

At the -arcelona conference) there &ere encoura!in! results from trials of T=()

an in@ectale dru! from a ne& class of treatments called fusion inhiitors. The

results provided !ood ne&s for people &ho had ecome resistant to eistin!

dru!sF the fusion inhiitors &ere called #the most ecitin! advance since

protease inhiitors &ere introduced#. 1:3

The numer of children orphaned y *IVNAIDS had risen three=fold in si years

to reach an all time hi!h of 13. million. It &as estimated that India had the

lar!est numer of AIDS orphans of any country in the &orld) &ith an estimatedat 1. million in ((1F this &as predicted to rise to million in ve years and

.' million in ten years. 1:

"7hildren are takin the role of adults in many places a>ected by HIV because

a eneration has disappeared! They can8t o throuh normal development!

They have to work 6* hours a week! The very fabric of society is disappearin,

with family structures crumblin!" & 4eter 4iot
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Indonesia) the &orld#s fourth most populous country) demonstrated ho&

suddenly *IVNAIDS epidemics could emer!e. After more than a decade of lo&

*IV prevalence) the country &as seein! rates increasin! rapidly amon!

in@ectin! dru! users and se &or%ers) &ith as many as (W of people in dru!

treatment centres in 7a%arta testin! positive. 1::

S&iss researchers reported the rst fully documented case of *IV=positive man

&ho &as additionally infected &ith a second strain of *IV throu!h unprotected

se more than t&o years after he &as rst infected. 1:6

"ami) a PuBy) mustard=coloured) *IV=positive character @oined the cast of the

South African version of Sesame Street. "ami#s name &as derived from the

Ts&ana &ord for #acceptance#. 1:'

In the

to *IV prevention. 163
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The erin from #I$%, and for children orphaned by

#I$%!" 4resident +ush :
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7ust t&o days later)

hiv history, timelapse

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