30 years of AIDS

Not that long ago, we celebrated the 30^th anniversary of the first report of an AIDS-related illness. In June 1981, a short article in the Center for Disease Control’s weekly publication described five cases of Kaposi’s sarcoma, a rare cancer associated with immune deficiency and hitherto only seen with any consistency in some populations of Ashkenazi Jews. The cases described certainly didn’t fit the bill: these were young men, and no one could think of a good reason for them to develop Kaposi’s sarcoma.

There was a time before AIDS and HIV. It’s hard to imagine now, with almost weekly reminders of the dramatic pandemic which has unfolded over the last three decades. The numbers are staggering: according to the WHO, there are over 30 million people living with HIV, 2.5 million were infected in 2009 alone and, in the same year, 1.8 million died of the disease.

The other numbers which boggle the mind are those related to funding. There has been a rise from some $300 million spent on HIV/AIDS research in 1996 to nearly $16 billion in 2008. The scientific community has taken us from an utterly helpless situation, as it was in the early 1980s, to one where clinicians can choose from dozens of antiviral drugs, while vaccines and other preventative methods are continuously being investigated. It is hard to think of another situation in which so much progress has been made so quickly.

AIDS is now so much more than a scientific issue. It is a key part of many political, economical and developmental debates and is likely to remain so for decades to come.

However, it is worth remembering that the progress is not universal despite the efforts of the past thirty years. In Tanzania, witch-doctors advocate the rape of albino girls and the harvesting of their body parts for potions as a means of curing AIDS. Clearly, fear and hopelessness will push people to unbelievable extremes. So will ignorance: in the last few years we heard Thabo Mbeki, then President of South Africa, deny the link between HIV and AIDS, his successor, Jacob Zuma, claim he had showered after sex with an HIV-infected woman to protect himself from infection, and his health minister, Manto Tshabalala-Msimang, advocate beetroot, garlic and lemon concoctions to treat the disease.

We need no reminding that we remain a long way away from the end of the AIDS pandemic. The drugs we have are far from perfect, and the majority of HIV-infected people do not have access to them. The stigma associated with AIDS remains strong, both in developing countries and in the West. And all the while, HIV continues to evolve, keeping one step ahead of us and ruthlessly challenging scientists, clinicians and patients.

Hyde Park

The 7th July attacks had just taken place – a week ago, a second ago. Londoners filled the streets, not endeavouring to take either the bus or the tube to reach their destinations. Although the calendar said it was the middle of summer, London skies remained true to themselves, mostly grey and threatening with rain. My father was in town to cover the bombings - it was also the first time he came to visit me in my new city. So we walked together across London, eyes and ears nervously looking for signs of another attack. The sound of ambulances hysterically swerving in the middle of the street, ignoring traffic lights, kept us on our toes, wondering whether any other disaster had occurred. We were edgy, London was edgy.

Hyde Park seemed like the perfect place to get some respite. The sight of nature, as tamed as it may have been, reminded us that there are forces stronger than Man’s petty fights. We had been walking aimlessly for an hour or so when we reached the Speakers’ Corner – the symbolic stage of tolerance and freedom of speech, I had been taught. As it was usual on a Saturday afternoon, this little corner of the Earth was filled with people listening to three or four very vocal citizens, standing on upside-down plastic buckets as if on a podium.

Our attention was quickly caught by a roar: “One day, the Islamic flag will fly over the Houses of Parliament!” The speaker was an Islamic fundamentalist – three body guards stood around him and, a few meters behind, a crowd of mostly men and a handful of women in burkas clamoured in support. His sentences were strong and hurtful in the face of our recent memories: “London got what it deserved”; “ we respect those who had the courage to die for our cause”; “this is a country with no more values that needs to be taught a lesson”; “the war will not end here”... Other listeners were clearly upset and answered back – but the responses remained calm, respecting the ethos of that symbolic setting: everyone is free to speak their mind. And so the speech went for about fifteen minutes, until the speaker concluded and stepped off his stand.

A thirty-year old French man, wearing loose jeans, an old t-shirt and an unkempt beard, excitedly made a move for the stand. He had been listening to his predecessors’ speech with great attention and even admiration. His occasional outbursts showed that he agreed with some of the points previously made: this capitalist system is filled with injustice and simply can’t go on; British and American imperialism must come to a halt! However, his plans to voice his revolutionary thoughts were brusquely curtailed. The body guards that had surrounded the Islamic speaker hid the stand and pushed the French speaker away: “You are a kuffar, a non-believer, you cannot stand where He stood, you cannot speak after His intervention”.

Everyone was taken aback; no one knew how to react to this bomb. The French man recoiled in fear; he walked towards another stand and waited a while longer for his chance to speak his mind

ACF