TW: discussion of HIV/AIDS related death
Looking back
June 5th, 1981 the U.S. Centre for Disease Control (CDC) published an article describing cases of a rare lung infection in five young, and otherwise healthy men- all of which died by the time the report was released- or soon after [1]. This would mark the first official reporting of what is later identified as the AIDS epidemic.
In 1983 the cause of AIDS was identified by Dr Francoise Barre - Sinoussi and her colleagues at the Pasteur institute when they isolated the virus [2]. By 1985 the UN stated the presence of HIV in each region of the world [3]. In 1987 The World Health Organisation (WHO) launched The Special Programme on AIDS, later named the Global Programme on AIDS. The aims of which included to provide awareness, produce evidence based policies and champion the rights of those living with HIV [4].
Where are we now?
When world AIDS day was established in 1998 things were very different compared to where we are to today.
Now, 40 years on there is a lot to celebrate with the advancements in science and response programmes globally. We have life saving treatments, quick and accessible testing and preventative options. New infections are decreasing in adults and children, AIDS- related deaths have reduced by 60% since the peak in 2004 and as the end of June 2020, there were 26 million people accessing antiretroviral treatment [5].
The scale up of this treatment has saved millions of lives and prevented millions of new infections. However, in 2020 a new UNAIDS report stated that 12.6 million of the 38 million living with HIV did not access this life saving treatment [5]. The inequitable distribution of treatment and access to healthcare is a far too present issue, with UNAIDs warning of ‘unequal progress’ made. The July 2020 report discussed the remarkable progress made but that unequal achievements between countries meant the global HIV targets of 2020 would not be reached [6].
With COVID-19 causing disruption to the HIV response, particularly in more resource limited settings, its important focus remains on HIV and reaching the sustainable development goals - including ending the global AIDS epidemic by 2030.
“The Aids epidemic remains a global crisis fuelled by inequalities. We've been successful to reduce new infections and reduce deaths, but now with Covid disrupting the whole world, we must double down building these successes and act with greater urgency to reach the millions that are still left behind,” the UNAids head said.
Public understanding of the disease is also a concern, a survey carried out in 2014 (UK) reported only 45% of the public can correctly identify all correct routes of transmission [7]. Furthermore, there is evidence that misconceptions are increasing amongst the public, with an increased percent of those surveyed believing incorrect myths about how the disease is transmitted, compared to a similar survey carried out in 2010 [7]. The acceptance of incorrect ideas about HIV can lead to stigma and discrimination. Increased accessibility to education, advice and services provide opportunities to correct misconceptions and normalise the subject.
HIV/ AIDS has a complex and turbulent history within science and society, a past involving misinformation, stigma and pain. A past that also includes community organisers, activists and heroes that were essential to the progress made and in raising awareness. It is a history that should not be forgotten, particularly the lessons learnt. However, the story is not over, it is now up to us to write how it ends.
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References
1 Gottlieb, M.S., Schanker, H.M., Fan, P.T., Saxon, A., Weisman, J.D. and Pozalski, I., 1981. Pneumocystis pneumonia—Los Angeles. Mmwr, 30(21), pp.250-2. [online] Available at https://www.thebodypro.com/article/pneumocystis-pneumonia-los-angeles
2 Avert HIV and AIDS Organisation, Origin of HIV & AIDS 2021 [online] Available at: https://www.avert.org/professionals/history-hiv-aids/origin#:~:text=It%20was%20only%20in%201983,the%20Pasteur%20Institute%20in%20France.
3 HIV.gov A Timeline of HIV and AIDS [online] Available at: https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timelin
4 Mann, J.M., 1987. The World Health Organization's global strategy for the prevention and control of AIDS. Western Journal of Medicine, 147(6), p.732.[online] Available at:
5 The Joint United Nations Programme on HIV/AIDS Global HIV & AIDS statistics — 2020 fact sheet, 2021[online] Available at https://www.unaids.org/en/resources/fact-sheet
6 The Joint United Nations Programme on HIV/AIDS, Press release: report on the global AIDS epidemic shows that 2020 targets will not be met because of deeply unequal success; COVID-19 risks blowing HIV progress way off course [online] Available at:
7 National Aids Trust, HIV Public Knowledge and Attitude, 2014, [online] Available at: https://www.nat.org.uk/sites/default/files/publications/Mori_2014_report_FINAL_0.pdf