AIDS at 30 Years — Positive Developments at Last

Timothy Ray Brown, the First Person to Be Cured of AIDS

A cure for AIDS has been discovered, if only for one person. After receiving a bone marrow transplant from an individual with a genetic immunity to the disease — about one percent of Caucasians carry such an immunity — Timothy Ray Brown, also known as The Berlin Patient, stopped taking his AIDS medication, and he hasn’t had to take them since. “I’m cured of HIV,” he says. “I had HIV, and I don’t any more.” This is an absolute first, and welcome news indeed. Even notoriously skeptical medical professionals admit cautious optimism in Mr. Brown’s case, a sentiment in fact somewhat fitting with the modest but steady stream of good news regarding the worldwide fight against AIDS: 30 years after the first recorded outbreaks, worldwide cases of new HIV infection appear to be leveling off, treatments are becoming more affective, and the global death toll is, mercifully, beginning to fall.

In 1981, the Centres for Disease Control reported an outbreak of an unusual form of pneumonia afflicting five men in Los Angeles. The San Francisco Chronicle covered the story the next day, and suddenly doctors from around the country were flooding the CDC with reports of similar cases of patients falling prey to strange illnesses they should have held natural defenses to. Doctors soon concluded that the problem was an immune system deficiency: in 1983, AIDS (Acquired Immune Deficiency Syndrome) was given its name. It was some time yet before HIV (Human Immunodeficiency Virus) was identified as the cause.

The early years of AIDS are marred by misinformation, misunderstanding, fear, and prejudice. As many of those infected were gay men, it was at first assumed that these were the only peoples at serious risk of the disease; instances of homophobic discrimination rose, and coupled with a general panic over the long-mysterious means of transmission, AIDS patients in general were highly stigmatized. The New York Times reported that landlords in San Francisco and New York were evicting AIDS patient tenants. In 1985, a 13-year old child named Ryan White, who had contracted AIDS through a blood transfusion, became a poster boy for anti-AIDS patient discrimination when he was banned from school classes. Compulsory testing became a hot button issue. Meanwhile the numbers of infected grew exponentially throughout the world. In 1990 the WHO estimated that 8-10 million people were living with HIV. In 2000, 25-28 million.

However, thanks to an aggressive push to increase access to retroviral drugs, and educate at-risk peoples on safe sex practices, these numbers now appear, finally, to be leveling off. In 2008 an estimated 33 million people worldwide were suffering from HIV, a number which has held steady in the years since, and even dropped slightly as fewer cases have developed. According to the 2011 UNAIDS report, 22 of the most affected countries in sub-Saharan Africa have managed to reduce their instances of AIDS by 25%. Less people are dying from AIDS. Thanks to a healthy increase in the funding of anti-AIDS programs such as the UN’s Global Fund, George W. Bush’s PEPFAR, and The Gates Foundation, accurate sex education and pharmaceutical treatment has become increasingly available in developing countries such as South Africa and Kenya, where it is most needed. What had once been a death sentence everywhere is now, in many places, a livable condition.

Unfortunately, given the financial crises shaking the worlds’ major economies, maintaining the same level of funding in the coming years may prove difficult, and in the fight against AIDS, money talks. Should funding evaporate, these hard fought gains could prove temporary. Misinformation and stigmatization remain widespread. Here in the U.S., where there were approximately 35,000 new cases of HIV in 2009, slightly less than the 38,000 in 2000, there are an estimated 1.3 million people living with HIV… and one in five of them doesn’t even know that they have it.

While the gains that have been made are valuable, in fact the fight is just beginning. For the first time since the start of the AIDS epidemic, we have the resources and the tools to go on the offensive. But there is still a long way to go. Yes, the Berlin Patient offers an elusive hope for the development of a vaccine based on a genetic immunity, but it appears that he himself only survived thanks to a rare and highly difficult bone marrow transplant. De-stigmatization and consistent education remain of utmost importance, as is frank and honest dialogue. And at no point, no matter how far from the headlines AIDS coverage recedes, should we allow ourselves to become complacent.