Hay guys, how did aids happen?

magic johnson won't tell me.

[Ihaman]

People like you.

[pine trees]

i hear it has something to do with the gay.

[DeadSwan]

licking subway poles.

[sppunk]

hese are some of the most important events that have occurred in the history of AIDS up to 1986.

This is one of a group of HIV/AIDS history pages. Other HIV/AIDS history pages can be found in our HIV and AIDS history and pictures section here.
Mid-1970's-1980 history

We do not know how many people developed AIDS in the 1970s, or indeed in the years before. Neither do we know, and we probably never will know, where the AIDS virus HIV originated. But what we do know is:

"The dominant feature of this first period was silence, for the human immunodeficiency virus (HIV) was unknown and transmission was not accompanied by signs or symptoms salient enough to be noticed. While rare, sporadic case reports of AIDS and sero-archaeological studies have documented human infections with HIV prior to 1970, available data suggest that the current pandemic started in the mid-to late 1970s. By 1980, HIV had spread to at least five continents (North America, South America, Europe, Africa and Australia). During this period of silence, spread was unchecked by awareness or any preventive action and approximately 100,000- 300,000 persons may have been infected."

- Jonathan Mann - 1

1981 History

Kaposi's Sarcoma (KS) was a rare form of relatively benign cancer that tended to occur in older people. But by March 1981 at least eight cases of a more aggressive form of KS had occurred amongst young gay men in New York.2

At about the same time there was an increase, in both California and New York, in the number of cases of a rare lung infection Pneumocystis carinii pneumonia (PCP)3. In April this increase in PCP was noticed at the Centers for Disease Control (CDC) in Atlanta. A drug technician, Sandra Ford, noticed a high number of requests for the drug pentamine, used in the treatment of PCP.

"A doctor was treating a gay man in his 20s who had pneumonia. Two weeks later, he called to ask for a refill of a rare drug that I handled. This was unusual-nobody ever asked for a refill. Patients usually were cured in one 10-day treatment or they died"

- Sandra Ford for Newsweek -4

In June, the CDC published a report about the occurrence, without identifiable cause, of PCP in five men in Los Angeles5. This report is sometimes referred to as the "beginning" of AIDS, but it might be more accurate to describe it as the beginning of the general awareness of AIDS in the USA.

A few days later, following these reports of PCP and other rare life-threatening opportunistic infections, the CDC formed a Task Force on Kaposi's Sarcoma and Opportunistic Infections (KSOI). 6

Around this time a number of theories were developed about the possible cause of these opportunistic infections and cancers. Early theories *******d, infection with cytomegalovirus, the use of amyl nitrite or butyl nitrate "poppers" and "immune overload".7 8 9

Because there was so little known about the transmission of what seemed to be a new disease, there was concern about contagion, and whether the disease could by passed on by people who had no apparent signs or symptoms.10 Knowledge about the disease was changing so quickly that certain assumptions made at this time were shown to be unfounded just a few months later. For example, in July 1981 Dr Curran of the CDC was reported as follows:

"Dr. Curran said there was no apparent danger to non homosexuals from contagion. 'The best evidence against contagion', he said, 'is that no cases have been reported to date outside the homosexual community or in women'"

- The New York Times-11

Just five months later, in December 1981, it was clear that the disease affected other population groups, when the first cases of PCP were reported in injecting drug users.12 At the same time the first case of AIDS was documented in the UK. 13
1982 History

The disease still did not have a name, with different groups referring to it in different ways. The CDC generally referred to it by reference to the diseases that were occurring, for example lymphadenopathy (swollen glands), although on some occasions they referred to it as KSOI, the name already given to the CDC task force.14 15

In contrast some still linked the disease to it's initial occurrence in gay men, with the Lancet calling it the 'gay compromise syndrome', whilst at least one newspaper referred to it as GRID (gay-related immune deficiency).16 17 and another newspaper described it as 'gay cancer'.18 The disease was also called 'community-acquired immune dysfunction'.19

In June a report of a group of cases amongst gay men in Southern California, suggested that the disease might be caused by an infectious agent that was sexually transmitted.20

By the beginning of July a total of 452 cases, from 23 states, had been reported to the CDC.21

Later in July the first reports appeared that the disease was occurring in Haitians, as well as haemophiliacs.22 23

By August the disease was being referred to by it's new name of AIDS24. The word AIDS was an abbreviation of Acquired Immune Deficiency Syndrome25. An anagram of AIDS, SIDA was created for use in French and Spanish26. The doctors thought 'AIDS' suitable because people acquired the condition rather than inherited it, because it resulted in a deficiency within the immune system, and because it was a syndrome, with a number of manifestations, rather than a single disease.27

Very little was still known about transmission and public anxiety continued to grow.

"It is frightening because no one knows what's causing it, said a 28-year old law student who went to the St. Mark's Clinic in Greenwich Village last week complaining of swollen glands, thought to be one early symptom of the disease. Every week a new theory comes out about how you' re going to spread it."

- The New York Times - 28

By 1982 a number of AIDS specific voluntary organisations had been set up in the USA. They *******d the San Francisco AIDS Foundation (SFAF), AIDS Project Los Angeles (APLA), and Gay Men's health Crisis (GMHC).29 In November 1982 the first AIDS organisation, the 'Terry Higgins Trust', was formally established in the UK, and by this time a number of AIDS organisations were already producing safer sex advice for gay men.30 31

In December a 20-month old child who had received multiple transfusions of blood and blood products died from infections related to AIDS32. This case provided clearer evidence that AIDS was caused by an infectious agent, and it also caused additional concerns about the safety of the blood supply. Also in December, the CDC reported the first cases of possible mother to child transmission of AIDS.33

By the end of 1982 many more people were taking notice of this new disease, as it was clearer that a much wider group of people was going to be affected.

" When it began turning up in children and transfusion recipients, that was a turning point in terms of public perception. Up until then it was entirely a gay epidemic, and it was easy for the average person to say 'So what?' Now everyone could relate."

- Harold Jaffe of the CDC for newsweek -34

It was also becoming clear that AIDS was not a disease that just occurred in the USA. Throughout 1982 there were separate reports of the disease occurring in a number of different countries.35 A report also appeared that a disease previously known as "slim", was actually an African form of AIDS. 36
1983 History

The number of people who could become infected was to widen again at the beginning of 1983, when it was reported that the disease could be passed on heterosexually from men to women.37

At about the same time the CDC convened a meeting to consider how the transmission of AIDS could be prevented, and in particular to consider the newly emerged evidence that AIDS might be spread through blood clotting factor and through blood transfusions. As James Curran, the head of the CDC task force said:

"The sense of urgency is greatest for haemophiliacs. The risk for others [who receive blood products] now appears small, but is unknown."38

The risk for haemophiliacs was so great because the blood concentrate that some haemophiliacs used, exposed them to the blood of up to 5000 individual blood donors.

In the UK there were public concerns about the blood supply with references in newspapers to "killer blood."39 The media more generally started to take notice of AIDS, with the screening of a TV Horizon programme, "the killer in the village", and a number of newspaper articles on the subject of the "gay plague."40 41

In May 1983, doctors at the Institute Pasteur in France reported that they had isolated a new virus, which they believed was the cause of AIDS.42 Little notice was taken of this announcement at the time, but a sample of the virus was sent to the CDC.43 A few months later the virus was named lymphadenopathy-associated virus or LAV, patents were applied for, and a sample of LAV was sent to the National Cancer Institute.44

But whilst progress was being made by scientists there was at the same time increasing concern about transmission, and not just in relation to the blood supply. A report of AIDS occurring in children suggested quite incorrectly the possibility of casual household transmission.45

AIDS transmission became a major issue in San Francisco, where the Police Department equipped patrol officers with special masks and gloves for use when dealing with what the police called 'a suspected AIDS patient.'

"The officers were concerned that they could bring the bug home and their whole family could get AIDS."

- The New York Times - 46

and in New York:

"landlords have evicted individuals with AIDS" and "the Social Security Administration is interviewing patients by phone rather than face to face."

- Dr David Spencer, Commisioner of Health, New York City -47

There was considerable fear about AIDS in many other countries as well.

"In many parts of the world there is anxiety, bafflement, a sense that something has to be done - although no one knows what."

- The New York Times - 48

As anxiety continued, the CDC tried to provide reassurance that the children had probably become infected from their mother and that casual transmission did not occur. 49

Meanwhile in Europe two rather separate AIDS epidemics were occurring, one linked to Africa, the other linked to gay men who had visited the USA. In France and in Belgium AIDS was occurring mainly in people from Central Africa or those with links to the area, whilst in the UK, West Germany and Denmark the majority of people with AIDS were homosexual.50

In the UK, in September, people who might be particularly susceptible to AIDS were asked not to donate blood.51

In October the first European World Health Organisation (WHO) meeting was held in Denmark. At this meeting it was reported that there had been 2,803 AIDS cases in the USA. 52

This meeting was followed in November by the first meeting to assess the global AIDS situation. This was the start of global surveillance by WHO and it was reported that AIDS was present in the U.S.A., Canada, fifteen European countries, Haiti, and Zaire as well as in seven Latin American countries. There were also cases reported from Australia and two suspected cases in Japan.53

During the course of 1983 a number of investigations took place to determine more about the occurrence of AIDS in Central Africa. These investigations resulted in 26 patients with AIDS being identified in Kigali, Rwanda, and 38 patients identified in Kinshasa, Zaire where there was said to be a "strong indication of heterosexual transmission."54 55 Shortly afterwards, the Zairian Department of Health created a national AIDS research programme.56

By the end of the year the number of AIDS cases in the USA had risen to 3,064 and of these 1292 had died. 57
1984 History

At the CDC researchers had been continuing to investigate the cause of AIDS through a study of the sexual contacts of homosexual men in Los Angeles and New York. They identified a man as the link between a number of different cases and they named him 'patient O' for 'Out of California'.58 The research appeared to show that AIDS was a transmittable disease, and the co-operation of 'patient O' contributed to the study.59

However a problem arose when other people read the scientific paper.

"I called this guy Patient O ….. But my colleagues read it as Patient Zero."

- Darrow for Newsweek - 60

And so in March 1984 the myth of Patient Zero began.61 See 1987 for more information about Patient Zero.

Just one month later, on April 22nd, Dr Mason of the CDC was reported as saying:

"I believe we have the cause of AIDS."

He was referring to the French virus, LAV, and he was basing his opinion on the findings made in the preceding weeks by the researchers at the Pasteur Institute who had discovered the virus the previous year.62

Just one day later, on April 23th, the United States Health and Human Services Secretary Margaret Heckler announced that Dr. Robert Gallo of the National Cancer Institute had isolated the virus which caused AIDS, that it was named HTLV-III, and that there would soon be a commercially available test for the virus61. It was a dramatic and optimistic announcement that also *******d:

"We hope to have a vaccine [against AIDS] ready for testing in about two years."

and it concluded with:

"yet another terrible disease is about to yield to patience, persistence and outright genius".64

The same day patent applications were filed covering Gallo's work, but it was clearly a possibility that LAV and HTLV-III were the same virus.65 66 The scientific papers regarding Gallo's discovery of HTLV-III were published on 4th May.67 By 17th May, private companies were already applying to the Department of Health & Human Services for licences to develop a commercial test, which would detect evidence of the virus in blood, a test which it had already been said would be used to screen the entire supply of donated blood in the USA.68 69

Meanwhile there continued to be concern about the public health aspects of AIDS. This was particularly the case in San Francisco where all the gay bath houses and private sex clubs were closed. Some gay men regarded the closures as an attack on their civil rights. But Mervyn Silverman, Director of the San Francisco Department of Public Health stated the public health view as follows:

" There are certain places where things are allowed and certain places where they are not. You can't have sex at the McDonald's. You generally cannot have sex in the pews of a church or in a synagogue. People don't feel their civil liberties are being in any way abrogated because of that".70

By the end of 1984, there had been 7699 AIDS cases and 3665 AIDS deaths in the USA, and 762 cases had been reported in Europe.71 72 In the UK there had been 108 cases and 46 deaths.73
1985 History

In January 1985 a number of more detailed reports were published concerning LAV and HTLV-III, and by March it was clear that the viruses were the same.74 The same month the U.S Food and Drug Administration (FDA) licensed, for commercial production, the first blood test for AIDS. The test would reveal the presence of antibodies to LAV/HTLV-III, and it was announced that anyone who had antibodies in their blood would not in future be allowed to donate blood.75

There were a number of social and ethical issues, as well as certain medical matters, that had to be considered before the new test could be used even to ensure the safety of the blood supply. And even more aspects needed to be considered before the test could be more widely used. Concern particularly centred on issues of confidentiality and the meaning of a positive test result.76 77

"Richard Dunne, director of the Gay Men's Health Crisis, said that the group would not object to the wider availability of the procedure provided that certain safeguards were assured: informed consent, good counselling and confidentiality, "which means anonymity," he said. He stressed that the city must prevent insurance companies, employers, schools and others from gaining access to test results."

- The New York Times -78

The first small -scale needle and syringe exchange project was started in 1984 in Amsterdam, the Netherlands but more projects were started in 1985 as a result of growing concerns about HIV. 79

In April more than 2000 people attended the first international Conference on AIDS held in Atlanta. Three major topics of discussion were the new HTLV-III/LAV test, the situation with regard to AIDS internationally, and the extent of heterosexual transmission.80

"Some experts are sceptical that AIDS will spread as rapidly among heterosexuals as it has among homosexuals'. Yet other experts, taking their cues from data emerging from preliminary studies from Africa showing equal sex distribution among males and females, are less sure."

- The New York Times - 81

Immediately after the conference, the World Health Organization (WHO) organized an international meeting to consider the AIDS pandemic and to initiate concerted worldwide action.82

Meanwhile in many countries there was a separate "epidemic of fear" and prejudice.83

In the UK tabloid press, AIDS gained many headlines and caused alarm among the public. In some newspapers, the prejudice was obvious. The haemophiliacs were seen as the "innocent victims" of AIDS whereas gays and drug-users were seen as having brought the disease upon themselves.84 The fear of AIDS caused firemen to ban the kiss of life, and caused holidaymakers to cut their holiday short for fear of contracting AIDS from an HIV-positive passenger on the Queen Elisabeth 2.85 86. A 9-year old HTLV-III positive haemophiliac was allowed to attend the local school, but some of the pupils where kept home by anxious parents.87

In the US, it was feared that drinking communion wine from a common cup could transmit AIDS, and Ryan White, a 13-year old haemophiliac with AIDS was barred from school.88 89

"In 1985, at 13, Ryan White became a symbol of the intolerance that is inflicted on AIDS victims. Once it became known that White, a haemophiliac, had contracted the disease from a tainted blood transfusion, school officials banned him from classes."

- Time Magazine - 90

On September 17th, President Reagan publicly mentioned AIDS for the first time, when he was asked about AIDS funding at a press conference. At the same press conference he was also asked a question whether he would send his children if they were younger to school with a child who 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 being in the school. And yet medicine has not come forth unequivocally and said, 'This we know for a fact, that it is safe.'' And until they do, I think we just have to do the best we can with this problem. I can understand both sides of it."

- Ronald W. Reagan - 91

Drugs such as ribavirin, though to be active against HIV, were being smuggled from Mexico into the USA. 92

The actor Rock Hudson died of AIDS on October 3rd 1985. He was the first major public figure known to have died of AIDS.93

All UK blood transfusion centres began routine HIV testing of all blood donations in October. 94

For the Global Surveillance of AIDS, the WHO had initially used the definition of AIDS as developed in the USA in 1982. But this definition was difficult to use in developing countries where there was a lack of sophisticated laboratory tests. So in order to help with the surveillance of AIDS, particularly in Africa, a new WHO definition was adopted in October. This definition of AIDS became known as the Bangui definition.95

In December 1985, the Pasteur Institute filed a lawsuit against the National Cancer Institute to claim a share of the royalties from the NCI's patented AIDS test.96

During the year, knowledge of transmission routes was to change again, when the first report appeared of the transmission of the virus from mother to child through breast feeding.97 The first case of AIDS was also reported in China, and AIDS had as a result been reported in every region in the world.98

By the end of 1985, 20,303 cases of AIDS had been reported to the World Health Organisation99. In the USA 15,948 cases of AIDS had been reported, and in the UK 275 cases.100 101
1986 History

The first UK needle exchange scheme started in Dundee in February.102

In the UK, the government launched, in March, the first public information campaign on AIDS, with the slogan "Don't Aid AIDS". There were a series of advertisements in national newspapers.103

There was still at this time disagreement about the name of the virus.

" The name of the virus had itself become a political football as the French insisted on LAV (lymphadenopathy-associated virus), while Gallo's group used HTLV-3 (human T-cell lymphotropic virus, type 3)."

- Time Magazine - 104

In May 1986, the International Committee on the Taxonomy of Viruses ruled that both names should be dropped and the dispute solved by a new name, HIV, (Human Immunodeficiency Virus).105

At the opening speech of the International Conference in Paris, held from June 23-25 1986, Dr H Mahler, the Director of WHO, announced that as many as 10 million people world wide could already be infected with HIV.106

In August, the USA Federal Government accused an employer of illegal discrimination against a person with AIDS for the first time. A hospital had dismissed a nurse and refused to offer him an alternative job. This was seen as a violation of his civil rights.107

In September there was dramatic progress in the provision of medical treatment for AIDS, when early results of clinical tests showed that a drug called azidothymidine (AZT) slowed down the attack of the AIDS virus. AZT was first synthesised in 1964 as a possible anticancer drug but it proved ineffective.

The AZT clinical trial divided patients into two groups: one received AZT and the other placebo, or dummy drugs. At the end of six months, only one patient in the AZT group was dead, whilst there were 19 deaths among the placebo group. The clinical trial was stopped early, because it was thought to be unethical to deny the patients of the placebo groups a better chance of survival.108

"The announcement set off a flurry of excitement and controversy. AIDS hotlines and doctors' offices were flooded with calls, community leaders warned about undue optimism, and doctors debated the ethical and medical issues raised by the early cancellation of the AZT study."

- Time Magazine - 109

In the United States, the Surgeon General's Report on AIDS was published. The report was the Government's first major statement on what the nation should do to prevent the spread of AIDS. The 'unusually explicit' report urged parents and schools to start 'frank, open discussions' about AIDS.110

Finally, by the end of the year, 85 countries had reported 38,401 cases of AIDS to the World Health Organisation. By region these were, Africa 2323, Americas 31741, Asia 84, Europe 3858, Oceania 395.

[sppunk]

1987 History

At the beginning of January the UK Secretary of State for Social Services, Norman Fowler, visited San Francisco, and in a widely publicised visit shook hands with an AIDS patient. It was suggested that Princess Diana should follow his example, which she did later in the year. 1 2

1987 Ice berg advert1987, Don't die of ignorance leaflerA leaflet about AIDS was delivered to every household in the UK, and the British Government also launched a major advertising campaign with the slogan "AIDS: Don't Die of Ignorance", and with the secondary advice: 3 4

"Anyone can get it, gay or straight, male or female. Already 30,000 people are infected." 5

In February there was a general media "AIDS week", when there were numerous TV and radio programs on AIDS in the UK. 6 Many other countries also had education campaigns.

By this time, the World Health Organisation had been notified of 43,880 cases of AIDS in 91 countries. 7

The first HIV case was officially recorded in the Soviet Union. Also, a massive HIV testing programme was conducted. 8

Meanwhile, in San Francisco gay rights activist Cleve Jones made the first panel for the AIDS Memorial Quilt in memory of his friend Marvin Feldman. 9

"The Names project is a campaign to provide memorials to those lives by creating a huge quilt made up of individual panels, each 3 by 6 feet, that have been made by families friends and co-workers of those who died. Each of the nearly 3000 panels, which have come from all over the country, bears the name of a victim of acquired immune deficiency."10

In March the U.S Food and Drug Administration (FDA) approved AZT as the first antiretroviral drug to be used as a treatment for AIDS. 11

Silence = Death, gay protestAround the same time the organisation ACT UP (the AIDS Coalition to Unleash Power) was founded. ACT UP was committed to direct action to end the AIDS crisis, and their demands *******d better access to drugs as well as cheaper prices, public education about AIDS and the prohibition of AIDS-related discrimination. On March 24th their first mass demonstration was held on Wall Street. 12

Many of the placards used in ACT-UP's demonstrations carried the graphic emblem "SILENCE=DEATH". Created earlier in 1987 by a group of gay men calling themselves the Silence=Death project, the emblem was lent to ACT-UP and to many people in the USA it became the symbol of AIDS activism. 13

Kissing doesn't kill advertOne ACT-UP committee used the emblem in a window display called "Let the Record Show" at the New Museum of Contemporary Art in New York, and afterwards they regrouped as Gran Fury: 14

"a band of individuals united in anger and dedicated to exploiting the power of art to end the AIDS crisis". 15

Over the next few years Gran Fury produced many high profile public projects which *******d the art-banner announcing "Kissing doesn't kill: Greed and indifference do" and the poster "AIDS: 1 in 61" about babies born HIV positive in New York City. 16

The other side of the world, in Australia, the Grim Reaper education campaign was launched, with television images of death mowing down a range of victims in a bowling alley. Although widely criticised at the time, the advertisements did succeed in ensuring widespread discussion of AIDS. 17

"A Bowling alley of death, haunted by decomposing grim reaper bowling over men, pregnant women, babies and crying children was featured on national television last night as the part of a $3 million AIDS education campaign, The 60-second commercial featuring the grim reaper, a macabre and dramatic rotten corpse with scythe in one hand and bowling ball in the other,Australian Grim Reaper advert is spearheading efforts by the National Advisory Committee on AIDS to Educate Australians about the incurable disease." 18

On 31st March, at a ceremony at the White House attended by President Reagan, it was announced that an agreement had been reached between the Pasteur Institute and the U.S Department of Health and Human Services. The agreement was that the Pasteur Institute would end its court case regarding the patent for the HIV antibody test, and would share the profits from the test with the U.S department of Health and Human Services.19 Although the agreement officially resolved the question of who had invented the HIV antibody test, it did not address the question of who had discovered HIV and identified it as the cause of AIDS. It was generally agreed that:

"historians can decide who found the AIDS virus first." 20

but to many people it appears clear that HIV was isolated in Paris a year before it was isolated in the USA. 21

The following day President Reagan made his first major speech on AIDS, when he addressed the Philadelphia College of Physicians. Reagan advocated a modest federal role in AIDS education, having told reporters the previous day that he favoured AIDS education:

"as long as they teach that one of the answers to it is abstinence - if you say it's not how you do it, but that you don't do it." 22

In England the first specialist AIDS hospital ward was opened by Princess Diana. The fact that she did not wear gloves when shaking hands with people with AIDS, was widely reported in the press.

"she shook my hand without her gloves on. That proves you can't get AIDS from normal social contact." 23

Meanwhile, the WHO Global Programme on AIDS had developed a Global AIDS Strategy, which was approved by the World Health Assembly in May. The Global AIDS Strategy established the objectives and principles of local, national and international action to prevent and control HIV/AIDS, and it *******d the need for every country to have a "supportive and non-discriminatory social environment. 24

But on 31st May President Reagan gave a speech about AIDS at a dinner of the American Foundation for AIDS Research and particularly focused on increasing routine and compulsory AIDS testing. 25

The following day Vice President George Bush opened the 3rd International Conference on AIDS in Washington and was booed by the audience when he defended President Reagan's HIV testing proposals. At a demonstration outside the White House, to protest about the Administration's policies, demonstrators were arrested by police wearing long yellow rubber gloves. 26

"On the nightly news broadcasts, the world saw pictures of demonstrators being arrested by police wearing bright yellow, arm-length gloves. Although research had by now proved that the AIDS virus could not be passed through casual contact, the sight of the gloves served to reinforce the public's general overestimation of the risk of HIV transmission." 27

In June the U. S. Public Health Service added AIDS to its list of diseases for which people on public health grounds could be excluded from the USA. 28 Subsequently in July the "Helms amendment" by Senator Jesse Helms, added HIV infection to the exclusion list.29 Few would foresee the implications of the addition and so it went virtually unnoticed.30

1 in 61 advertIn July WHO reviewed the evidence and confirmed that HIV could be passed from mother to child through breastfeeding. But they also recommended that in developing countries, HIV positive mothers should still be encouraged to breastfeed, as in many circumstances safe and effective use of alternatives was not possible.31 The CDC revised their definition of AIDS to place a greater emphasis on HIV infection status.32

Meanwhile the prejudice against people with AIDS continued. The Ray family lived in Arcadia, Florida, and they had three sons, each of whom was a haemophiliac and who was HIV positive. During 1986 the family was told their sons could not attend school. In 1987 the family moved to Alabama, and once again they were refused entry to school. Threats against the family grew louder and more frequent, and on August 28th the Rays' small single-storey house was doused with gasoline and torched.33

In England, the UK Government expanded the syringe exchange schemes, to prevent transmission of HIV through drug use, and there was an advertising campaign 'Don't inject AIDS'. 34

In the autumn, 'And the Band Played On' was published, a book about the AIDS epidemic by Randy Shilts.35 Shilts' book made an important contribution to documenting the history of AIDS. But his view of "the facts about AIDS" as well as his opinions, differ greatly from others on a number of occasions. 36

Shilts identified publicly for the first time, as a French-Canadian flight attendant Gaetan Dugas, the person who had been referred to in 1984, in early AIDS studies, as 'Patient Zero'. Shilts claimed that Gaetan Dugas played a key role in the early spread of AIDS in North America, and the story of 'Patient Zero' was widely publicised by the media.37 But there never was a Patient Zero.

"There's no Patient Zero. It's lots and lots people moving around from New York to San Francisco, and the rest of the world. If there ever was an original Patient Zero, it would have been back in the mid-seventies. But there isn't an original Patient Zero."

- Andrew Moss -38

In Africa, President Kauanda of Zambia announced that his son had died of AIDS, and appealed to the international community to treat AIDS as a worldwide problem.39 In Uganda, 16 volunteers who had been personally affected by HIV/AIDS, came together to found the community organisation TASO. 40

In October, AIDS became the first disease ever debated on the floor of the United Nations (UN) General Assembly. The General Assembly resolved to mobilize the entire UN system in the worldwide struggle against AIDS, under the leadership of WHO.41

Dr. Peter Duesberg published a scientific paper in a cancer journal, which criticised the then dominant theory that viruses were involved in cancer causation.42 In November, Channel 4 broadcast the documentary 'AIDS: the Unheard Voices' to its British Audience. In the documentary Duesberg and others argued that HIV could not be the cause of AIDS.43

By December, 71,751 cases of AIDS had been reported to the World Health Organisation with the greatest number of cases reported from the USA (47,022). Countries reporting over 2000 cases *******d France (2,523), Uganda (2,369) and Brazil (2,102). Five other countries reported over 1000 cases: Tanzania (1,608), Germany (1,486), Canada (1,334), UK (1,170) and Italy (1,104).

WHO also reported that an estimated 5 to 10 million people were infected with HIV worldwide, with 150,000 cases of AIDS expected to develop in the following 12 months and up to 3 million within the next 5 years.44
1988 History

1988 World AIDS day logoAs the global mobilisation against AIDS continued, a world summit of ministers of health was held in London to discuss a common AIDS strategy. The summit focused on programmes for AIDS prevention, and there were delegates from 148 countries.

One outcome of the meeting was the London Declaration on AIDS Prevention, which emphasised education, the free exchange of information and experience, and the need to protect human rights and dignity.45 It was also announced by the Director-General of the World Health Organization, that WHO intended to promote an annual World AIDS Day, and the first such day would be on 1st December 1988. 46

The meeting was opened by the UK's Princess Royal, who upset many people involved in AIDS education, as well as many people with AIDS, when she stated that:

All people with AIDS are innocent"the real tragedy concerns the innocent victims, people who have been infected unknowingly, perhaps as a result of a blood transfusion, … but possibly, worst of all, those babies who are infected in the womb and are born with the virus."47

If there are "innocent victims", then by implication there are also "guilty victims". This was an unfortunate suggestion to be making at a world meeting on AIDS prevention.

A message from the 1998 US surgeon generalIn May the United States finally launched a co-ordinated HIV/AIDS education campaign.48 The distribution took place of 107 million copies of "Understanding AIDS", a booklet by Surgeon General C. Everett Koop. 49 'Understanding AIDS' was the single most widely read publication in the United States in June 1988, with 86.9 million readers. 50

The following month the American Medical association urged doctors to break confidentiality in order to warn the sexual partners of people being treated for AIDS. 51

" We are saying for the first time that, because of the danger to the public health and danger to unknowing partners who may be contaminated with this lethal disease, the physician may be required to violate patient confidentiality. The physician has a responsibility to inform the spouse or known partners. This is more than an option. This is an professional responsibility."

AIDS activitists with the slogan 'everyhalf an hour someone dies from AIDS' in Washington DC, 1988In the USA frustration continued to grow over the speed of access to drugs. When the Presidential Commission on the HIV Epidemic issued it's final report in June 1988, it also declared that the FDA arrangements were "not meeting the needs of people with AIDS". On October 11th more than 1000 ACT-UP demonstrators virtually shut down operations at the FDA headquarters. 52

Eight days after the ACT-UP demonstration the FDA announced new regulations to speed drug approval.53

The first official syringe exchange was started in the US to prevent transmission of HIV through drug use.54 A limited experiment started in November in New York City, and at about the same time, the Prevention Point opened in San Francisco.55 56 But Congress prohibited the use of federal funds to support needle exchange programs.57

On December 1st, the first World AIDS Day took place, with WHO asking everyone to "Join the Worldwide Effort." 58
1989 History

On February 7th, the FDA announced that it was going to approve in aerosol form, the drug Pentamidine, for the treatment of pneumonia in people with AIDS.59 Much of the data given to the FDA was collected by CCC, the County Community Consortium of San Francisco, with further data collected by CRI, the Community Research Initiative of New York, these were two community research organisations. 60

By March 1st, 145 countries had reported 142,000 cases of AIDS to the World Health Organisation (WHO). WHO regarded this as under reporting, and estimated the actual number of people with AIDS, around the world, to be over 400,000. It was predicted that this figure would rise to 1.1 million by 1991. It was also estimated that 5-10 million people were already infected with HIV. 61

On April 2nd, Hans Verhoef, a Dutch man with AIDS, was jailed in Minnesota under the federal law banning travellers with HIV from entering the USA.62 In June a protest about the law took place at the opening ceremony of the Fifth International Conference on AIDS in Montreal, when 250 protestors with placards stormed the stage.63

AZT bottlesIn August, there were more developments with respect to treatment, when the results were announced of a major drug trial known as ACTG019. ACTG019 was a trial of the drug AZT, and it showed that AZT could slow progression to AIDS in HIV positive individuals with no symptoms at all. The findings were considered extremely exciting, and on August 17th a press conference was held, at which the Health Secretary, Louis Sullivan said:

"Today we are witnessing a turning point in the battle to change AIDS from a fatal disease to a treatable one."

The result had enormous financial implications for the makers of the drug Burroughs Wellcome, and the day after the press conference, the value of Burroughs Welcome stock rose 32 per cent. 64 The cost of AZT angered many people, and with a year's supply for one person costing about $7,000, Burroughs Welcome were accused of "price gouging and profiteering": 65 66

In September, the cost of the drug was cut by 20%. 67

In October the second drug for the treatment of AIDS, dideoxyinosine (ddI), started to be made available to people with AIDS, even though only preliminary tests had been completed.

"It become clear that ddl was not just another drugs in terms of need: it was a life-and-death matter, said Richard L. Gelb, chairman of Bristol Myers." 68
1990 History

At the beginning of the year, it was reported that a large number of children in Romanian hospitals and orphanages had become infected with HIV as a result of multiple blood transfusions and the reuse of needles. Jonathan Mann, the head of WHO's Global programme on AIDS, noted that 'Eastern Europe is the new frontier for the AIDS epidemic'. 69

In China, 146 people in Yunnan Province near the Burmese border were found to have HIV infection due to sharing needles. This shocked public health officials in China, and it was not known whether this was the first sign of an epidemic or an isolated outbreak. 70

'AIDS and drug addiction are still seen as consequences of contact with the West, AIDS being known as aizibing, the "loving capitalism disease." 71

In New York city the needle exchange scheme was closed down. 72

Jonathan MannAnd then Jonathan Mann resigned as the head of the WHO AIDS programme, to protest against the failure of the UN and governments worldwide to respond adequately to the exploding pandemic, and to protest against the actions of the then WHO director-general Dr. Hiroshi Nakajima.73 During Jonathan Mann's leadership, the AIDS programme became the largest single programme in the organisations history.74 But more importantly:

"Jonathan's persistence and passion helped wake up the world." 75

and

"Had it not been for Jonathan's unique contributions, the world's approach to AIDS might very well have gone towards mandatory testing and quarantine."76

Ryan WhiteOn April 8th Ryan White died in the United States. He was a haemophiliac infected with HIV through the use of infected blood products. He had become well known a few years earlier as a result of his fight to be allowed to attend public school.77 Just a few months later the Ryan White CARE Act was passed by Congress. The aim of the act was to provide grants to improve the quality and availability of care for individuals and families with HIV disease.78

In the UK and the US, there started to be more discussion about whether there would ever be a heterosexual epidemic because of the difficulty of female-to-male transmission of HIV.79 80 81

In June, another TV programme 'The AIDS Catch' was screened in the UK that further questioned HIV as the cause of AIDS and whether AIDS is infectious or not. The programme provoked a hostile response among the AIDS community and organisations.82 Some people felt that the programme was sensational tone in and that it contained factual inaccuracies. It was also felt that the programme caused significant distress among people with HIV and undermined the efforts carried out in the field of HIV/AIDS prevention.83

Protests about the US ban on HIV positive people entering the country had continued. There had been minor changes to the law, but at the time of the 6th International Conference on AIDS in San Francisco in June, the law was still considered by many people to be "discriminatory and medically unsupportable".84 As a result of the US travel law there was a widespread boycott of the conference, and many people who did speak at the conference took the opportunity to voice their views. Such a person was June Osborn, the Chair of the National Commission on AIDS who said:

"How sorry I am, and how embarrassed as an American, that our country whose tradition serves as a proud beacon for emerging democracies, should persist in such misguided and irrational current policy." 85

ACTUP protestors at the AIDS conferenceMany demonstrations took place during the conference week, the most significant being the "United Call to Action", when activists, scientists, and many others marched together to emphasise the importance of unified action to end AIDS. 86

The International AIDS Society (IAS) announced that no further IAS sponsored conference would be held in a country that restricted the entry of HIV infected travellers.87 As a result of the US travel policy no major international AIDS conference has been held in the USA since 1990. Today, the policy still remains in force.

In July the CDC reported the possible transmission of HIV to a patient during a dental procedure. The dentist had been diagnosed with AIDS three months before performing the procedure. The CDC investigation did not identify any other risk factors or behaviours that could have put the patient at risk of HIV infection in any other way.88 A couple of months later the patient was named as 22-year old Kimberly Bergalis and the dentist was named as David Acer.89

"When she was diagnosed with AIDS we were in disbelief. All we could wonder was whether something went wrong at the dentists. Health officials said no way, it just can't happen. But Kimberly stuck by her guns and kept telling them to look at the dentist. Eventually the CDC supported her conclusion."

- George Bergalis -90

In the UK, John Major, the Prime Minister announced that the Government would pay £42 million compensation to haemophiliacs infected with HIV and their dependants.91

By the end of the year, over 307,000 AIDS cases had been officially reported to the WHO, but the actual number was estimated to be closer to a million. The estimate of the number of people with HIV worldwide was 8-10 million. Of the 8 million, it was estimated that about 5 million were men, and that 3 million were women. 92

Area Estimated HIV Reported AIDS Estimated AIDS
Africa >5,500,000 77,043 >650,000
N America 1,000,000 156,658 200,000
S America 1,000,000 28,937 90,000
Asia 500,000 843 2,000
Europe 500,000 41,564 50,000
Oceania 30,000 2,334 2,700
Total <9,000,000 307,379 <1,000,000

The estimated 3 million HIV positive women are also estimated to have between them given birth to about 3 million infants, of whom over 700,000 were estimated to have become infected with HIV.
1991 History

At the beginning of 1991 the CDC published a report confirming that, in addition to Kimberly Bergalis, two other patients had probably been infected by the same dentist.93 Such was the public concern about this that America's leading medical and dental associations announced that HIV positive doctors and dentists should warn their patients about their infection status or give up surgery.94 During the summer, with continuing public hysteria, the CDC also recommended that infected health care workers should be barred from certain procedures.95 96

The largest peak in requests for HIV testing in the UK was observed in January 1991 when the character Mark Fowler, in the BBC television series EastEnders, was diagnosed HIV-positive.97

In the autumn, in a dramatic move, Kimberly testified to the US Congress. In what she called her "dying wish", she asked members of congress to enact legislation for mandatory HIV testing of health care workers, to ensure that: 98

"others don't have to go through the hell that I have."

But overwhelmed by opposition from the medical profession, the CDC changed its plans, and just a few days later Kimberly Bergalis died.99 100

During the summer, the third antiretroviral drug dideoxycytidine (ddC) had been authorised by the FDA for use by patients intolerant to AZT.101

Also during the summer, a study was published which showed that HIV was transmitted much more easily through breast milk than had previously been thought102. But although it said the news was discouraging, WHO also said that women in developing countries should continue to breastfeed, as the risks of infant death from contaminated water, was even greater than the risk of infant death from AIDS.103

The decision was taken to hold the 1992 international AIDS conference in Amsterdam, rather than its planned location in Boston, following the American administration's decision not to lift entry restrictions on HIV-infected travellers.104

In the USA Earvin (Magic) Johnson announced that he had tested HIV positive and that he was retiring from professional basketball as a result, on the advice of his doctors. He said that he planned to use his celebrity status to help educate young people about the disease. He also said:

" I think sometimes we think, well, only gay people can get it - it is not going to happen to me. And here I am saying that it happen to anyone, even me Magic Johnson." 105

AIDS RibbonA couple of weeks later, in the UK, Freddie Mercury the lead singer with the rock group Queen, confirmed that he had AIDS, and just the day after it was announced that he had died. 106

In France, haemophiliacs who became infected through infected blood products, sued leading medical and government officials. They accused the blood transfusion centres of allowing the use of HIV-contaminated blood, even though tests to screen blood for HIV and techniques to destroy the virus in blood products were available.107 108

The red ribbon became an international symbol of AIDS awareness during 1991. The organisation Visual AIDS in New York, together with Broadway Cares, and Equity Fights AIDS, established the wearing of a Red Ribbon as something that signified support for people living with HIV/AIDS.109

As the end of 1991, about 450,000 AIDS cases had been reported to Global Programme on AIDS (GPA)/ World's Health Organisation (WHO). The estimated global distribution of HIV and AIDS varied from 5 to 7 million men and from 3 to 5 million women that had been infected with HIV. Of these 9-11 million HIV-infected adults, nearly 1.5 million were estimated to have progressed to AIDS. 110
1992 History

WHO set as a priority target for prevention, that the whole population at risk of HIV and AIDS in Africa and Asia, should by the year 2000, live in communities where condoms were both readily available and affordable.111

In the UK, the Department of Health made it offence to sell, advertise or supply the home HIV antibody testing kits.112

During 1992, the a major UK newspaper ran a series of articles challenging the orthodox view that HIV alone causes AIDS.113

"But suppose the researchers are looking in the wrong place. Suppose HIV doesn't equal AIDS. Then we will have witnessed the biggest medical and scientific blunder this century."

- The Sunday Times Journalist Neville Hodgkinson -114

Many other British newspapers also joined the heated debate with journalists, researchers, activists and organisations expressing their opinions about the cause of AIDS.115

"'But what if HIV does cause AIDS? What effect will such articles have on attempts to inform the public on safe sex, or on the people who are suffering from AIDS and taking anti-HIV drugs?"116

The tennis star Arthur Ashe announced that he had been infected with HIV as a result of a blood transfusion in 1983.117

The FDA approved the use of ddC in combination with AZT for adult patients with advanced HIV infection who were continuing to show signs of clinical or immunological deterioration. This was the first successful use of combination drug therapy for the treatment of AIDS.118

"This new drug is not a cure, said James Mason, M.D., assistant secretary for health and head of the Public Health service, but it constitutes an important addition to the expanding group of antiviral drugs currently available, including AZT and DDI, for treating people with AIDS."

During the summer, the CDC under pressure from patients and doctors, revised its definition of AIDS. The previous list of illnesses that defined AIDS had been criticised for some time, because it did not ******* many conditions most often seen in HIV positive women and injecting drug users.119 120

The VIII International Conference was successfully held in Amsterdam rather than in its originally planned venue in Boston due to the U.S. travel policies on HIV positive people.121

In France four health care officials were brought to trial accused of allowing the distribution, between 1980 and 1985, of blood products known to be contaminated with HIV.122 123 The former Director of the Transfusion service, Michel Garretta, was sentenced to four years in prison, as was Jean-Pierre Allain the former head of research at the transfusion centre. The third doctor, Jacques Roux, was given a four-year suspended sentence whilst the fourth doctor was acquitted.124

[Karl Connor]

we talked about this a few months ago. i suggested somebody fucked an ape and somebody got mad for whatever reason.

[sppunk]

1993 History

In January it was reported that some people with AIDS already had resistance to the drug Zidovudine (AZT) even though they themselves had never taken the drug.

"Some of the patients may have gotten the virus from other patients who have been taking AZT and who are now transmitting the resistant virus."

Researchers say there is an urgent need to develop new drugs to combat the epidemic1.

On January 6th the Russian ballet star Rudolf Nureyev died. His doctor said that "he died from a cardiac complication following a cruel illness", but it was widely reported that he had died from AIDS.2 3 He was buried in his evening clothes with his medals and his favourite beret.4

During January, 116 new cases of AIDS were reported in the UK, bringing the cumulative total to 7045. One in 6 of these new cases were acquired through heterosexual intercourse.5

HIV positive Romanian kidsIn Romania, despite the progress made since the overthrow of the Causescu regime, the number of children infected with HIV had increased, and there was estimated to be 98,000 infected orphans.6

China had reported one thousand cases of HIV infection, mostly in injecting drug users, but it was believed that this greatly underestimated the actual situation with regard to the HIV epidemic in China.7 8 The Ministry of Health in China announced that soon only approved government blood donation centres would be able to collect and sell blood.9

In February the tennis player Arthur Ashe died, less than a year after announcing that he had been infected with the virus.10

In March, the House of Representatives in the USA voted overwhelmingly to retain the ban on the entry into the country of HIV positive people.11

In South Africa, the National Health Department reported that the number of recorded HIV infections had increased 60% in the previous two years and the number was expected to double in 1993. A survey of women attending health clinics indicated that nationally some 322,000 people were infected.12

In the UK in March, there were a large number of rather hysterical stories in the British press about the fact that a number of doctors in England had continued to practise medicine, whilst knowing they were infected with HIV.13 The UK government responded by issuing new guidelines which meant that health care workers who believed that they had been exposed to HIV had to seek medical advice and testing.14

Meanwhile scientists had found that HIV 'hides out' in lymph nodes and similar tissue early in the course of infection. 15

"The virus lies concealed for a decade or, so quietly seeding the destruction of the immune system, the researchers found. The finding resoundingly solves a mystery of AIDS: where does the virus secrete itself during the decade or so after an initial infection when patients feel well and little virus can be detected in their blood?"16

In early April the ministers of health and finance from 39 countries, met in Riga Latvia, and launched an initiative to contain the spread of HIV in Central and Eastern European countries.17 Many countries of central and eastern Europe, the newly independent states, and the Russian Federation had introduced during the eighties, large-scale screening for HIV infection, with in excess of 20 million tests being carried out in the Russian Federation during 1993. One aspect of the Riga initiative was for a refocusing of testing policies away from this mass screening and towards voluntary testing.18

The preliminary results were published of the large Anglo-French clinical trial of AZT known as Concorde.19 The results were interpreted as meaning that AZT was not after all a useful therapy for HIV positive people who had not developed symptoms.20

In the UK the radio DJ and comedian Kenny Everett announced that he was HIV positive, and so also did Holly Johnson, former lead singer with the group Frankie goes to Hollywood.21 22

The World Bank reviewed it activities against AIDS in Africa, and decided that AIDS should not dominate its agenda on population , health and nutrition issues. The World Bank believed that AIDS would have little demographic effect but recognised that it was a serious threat to health and economic development. With reference to blood screening, it was argued that this was costly and "might not be cost-effective under all circumstances".23

The ninth International AIDS meeting was held in Berlin Germany. The general feeling of the meeting was one of disappointment. The message that was shared by the people who attended was once again to put more money and efforts to effective prevention of HIV and AIDS.

"Dr. James W. Curran, who heads the AIDS Programme at the Centers for Disease Control and Prevention in Atlanta, said he left the meeting 'dispirited by the relentless assault of the virus."24

At the beginning of the year the CDC had expanded the definition of AIDS to ******* additional opportunistic infections, as well as HIV infected adults with a CD4 count of less than 200. The expert epidemiology group of the European Centre for the Epidemiological Monitoring of AIDS together with the WHO's Regional Office for Europe accepted the inclusion of the additional indicator diseases but not the CD4 cell count criteria. Data collection on this basis began on July 1st 1993.25

In mid-1993 six United Nations organizations, including WHO, began to seek agreement on forming a novel joint and cosponsored UN programme on HIV/AIDS.26

By this time it had been realised that HIV was also spreading rapidly in the Asia and Pacific regions, home to more than half the world's population, and where more than 700,000 people were already believed to be HIV positive.27

The drug 3TC was authorised by the FDA in the USA and the Federal Health Protection Branch in Canada, to be used in "compassionate" therapy in people who had not responded to other AIDS treatment or who are not eligible for clinical trials.28

Despite the years of litigation and number of newspaper accounts of the infection of haemophiliacs and transfusion recipients, no formal investigation of what had happened in Germany was undertaken until the 'scandal' of October 1993. In October, a small German Blood-supply company called UB plasma failure to screen blood and plasma for HIV was made public. The company's misconduct was discovered by the Federal Health Office only because of routine examination of positive HIV test results. It was simply by chance that the illegal activities of UB Plasma were discovered.29 The Federal Government also admitted that officials had covered up 373 cases of HIV-contaminated blood in the 1980's.30

On World AIDS Day, the 1st of December 1993, Benetton in collaboration with ACT UP Paris, placed a giant condom (22 metres high and 3.5 wide) on the obelisk in Place de la Concorde in Central Paris in order to waken the world to the reality of the disease. A symbolic monument to prevention from HIV infection, it appeared on the cover of newspapers worldwide.31

At the end of 1993 the estimated number of AIDS cases worldwide was 2.5 million32

Region Estimated Adult HIV infection Estimated adult AIDS cases
Australasia >25000 5000
North America >1 million 400000
Western Europe 500000 125000
Latin America & Caribbean 1.7 million 300000
Sub-Saharan Africa >9 million 1.7 million
South and South-East Asia 2 million >75000
East Asia and Pacific >35000 >1000
Eastern Europe and Central Asia >50000 4500
North Africa & The Middle East 75000 12000
Total >14 million >2.5 million

1994 History

In the US the CDC launched a series of 13 bold and frank AIDS advertisements breaking away from their previous low-key approaches. The advertisements focused on the use of condoms, which were rarely seen or even mentioned on American television.

"One of the television ads, entitled Automatic, features a condom making its way from the top drawer of a dresser across the room and into bed with a couple about to make love. The voice-over says, 'it would be nice if latex condoms were automatics. But since they're not using them should be. Simply because a latex condom, used consistently and correctly, will prevent the spread of HIV." 33

Your pocket guide to sexIn the UK, the Department of Health vetoed an AIDS campaign promoting safer sex and condoms, developed at a cost of £2 million, on the grounds that it was too explicit.34 The campaign was developed by the Health Education Authority (a government funded body), who later in the year were banned by the Department of Health from distributing the book, "Your Pocket Guide to Sex". 35

In February the filmmaker Derek Jarman died of AIDS. He wrote in the preface of his autobiography:

"On 22nd of December 1986, finding I was body positive, I set myself a target: I would disclose my secret and survive Margaret Thatcher. I did. Now I have my sights on the millennium and a world where we are equal before the law." 36

Randy ShiltsRandy Shilts, author of the book 'And the band played on' also died in February.37

In March, the actor Tom Hanks won an Oscar for playing a gay man with AIDS in the film Philadelphia.38

Official statistics for Brazil, with a population of about 154 million, indicated that some 46,000 cases of AIDS had been recorded but estimates put the actual number at anywhere between 450,000 and 3 million cases. Two thirds of the known cases are in Sao Paulo state where AIDS was the leading cause of death of women aged 20-35.39

In France, on 7th April all the television networks, public and private, broadcast "All against AIDS', a special 4-hour AIDS programme. The aim of Tous contre le Sida was to heighten awareness about HIV/AIDS and to raise money.40 The estimated audience for the program was 33 million. Some 32,000 cases of AIDS had been recorded in France, with 15 deaths each day, and an estimated 150,000 people thought to be infected.41

European safe sex campaignDuring the summer, the AIDS Prevention Agency in Brussels, in collaboration with the European Union, launched a campaign whose central image was 'the flying condom'. This was intended to serve as a visual minder to young travellers of the risks of HIV infection. The logo was displayed -in airports, railway stations, popular holiday destinations and other places young people visited during the summer.42

A large European study on mother to child transmission, showed that the mother having a Caesarean section halved the rate of HIV transmission.43

By July 1994 the number of AIDS cases reported to WHO was 985,119. Also, WHO estimated that the total number of AIDS cases globally had risen by 60% in the past year from an estimated 2.5 million in July 1993 to 4 million in July 1994.44 It was also estimated that worldwide there were three men infected for every two women, and that by the year 2000 the number of new infections among women would be equal to that among men.45

At the end of July, the UN Economic and Social Council approved the establishment of a new "joint and cosponsored UN programme on HIV/AIDS" to replace the WHO's Global Programme on AIDS. The separate AIDS programmes of the UNDP, World bank, UN Population Fund, UNICEF and UNESCO, would be headquartered with the WHO in Geneva, starting in 1996.46 Later in the year it was announced that Dr. Peter Piot, the head of the research and intervention programme within the Global Programme on AIDS, would be the head of the new UN program.47

A study, ACTG 076, showed that AZT reduced by two-thirds the risk of transmission of HIV from infected mothers to their babies.48 Some people believed that ACTG076 was:

"the most stunning and important result in clinical acquired immunodeficiency syndrome research to date. " 49

And according to Dr Harold Jaffe of the CDC:

"It is the first indication that mother-to-child transmission of HIV can be at least decreased, if not prevented. And it will provide a real impetus for identifying more HIV-infected women during pregnancies so that they could consider the benefit of AZT treatment for themselves and their children."

- The New York Times - 50

In early August 1994, the Tenth International Conference on AIDS was held in Yokohama, Japan. It was the first of the International Conferences to be held in Asia. No major breakthroughs emerged, and it was announced that in future the international conference would be held every two years.51

Pedro ZamoraMeanwhile in the Russian Federation, deputies in the Russian Parliament, the Duma, voted at the end of October to adopt a law making HIV tests compulsory for all foreign residents, tourists, businessmen and even members of official delegates.52

On November 11th the death occurred from AIDS of 22-year old Pedro Zamora. He became famous when he appeared on MTV's 'Real World' documentary about the real lives of a group of young roommates.53

In December, President Clinton asked Joycelyn Elders for her resignation from the post of US Surgeon General, following her suggestion during a World AIDS Day conference that school children should, amongst other things, be taught about masturbation. Gay activist defended the Surgeon General and criticised the president's record on AIDS. Fears were expressed that the president's action will discourage other government leaders from speaking frankly about AIDS.54
1995 History

By 1st January 1995, a cumulative total of a million cases of AIDS had been reported to the World Health Organisation Global Programme on AIDS. Eighteen million adults and 1.5 million children were estimated to have been infected with HIV since the beginning of the epidemic.55

Later in the month the CDC announced that in the US, AIDS had become the leading cause of death amongst all Americans aged 25 to 44.

"The dramatic rise is due to the accumulating toll from AIDS and is almost certain to continue because of AIDS deaths reflect infections from HIV, the AIDS virus that were acquired several years earlier."

- Dr. Harold W. Jaffe from the CDC-56

Two research reports provided important new information about how HIV reproduces in the body and how it affects the immune system.57 58

Meanwhile in the USA, two reports by government scientists, recommended that the Clinton administration lift the ban on federal funding for needle exchange programs, because the programs are effective in reducing the spread of disease.59 60

In March the VII International Conference for People Living with HIV and AIDS was held in Cape Town, South Africa, the first time that the annual conference was held in Africa.61 The conference was opened by the deputy President, Thabo Mbeki, who spoke about how:

"the impact has begun to cut deep. Those affected are from the young and able-bodied work-force as well as young intellectuals." 62

The South African Ministry of Health announced that some 850,000 people, 2.1 per cent of the 40 million population were believed to be HIV positive, but in some groups such as pregnant women the figure had reached 8 per cent and is rising.63

Peter PiotThe conference was also addressed by Dr Piot, the Director of the new Joint United nations Programme on AIDS (UNAIDS). Dr Piot confirmed his commitment to involve people living with HIV/AIDS in the planning, shaping and guiding of the global response to the epidemic.64

In July, the US Senate voted to extend the Ryan White Care Act.65 As a result of the first five years of the Act:

"in the place of activists there were now thousands of AIDS organisations throughout the country - the AIDS "industry" made possible by the Ryan White Care Act".66

By the autumn of 1995 7-8 million women of childbearing age were believed to have been infected with HIV. And WHO spoke out about the 'inadequate international response':

"The impact of the HIV/AIDS epidemic on women … is not yet receiving sufficient political awareness, commitment or enough action of programmes responding to the specific needs of women." 67

It was also in August reported from Tanzania, that treating people for sexually transmitted diseases such as gonorrhea, substantially reduced people's risk of becoming infected with HIV.68

In September 1995 two clinical trials, the Delta trial and the ACTG175 trial, showed that combinations of AZT with ddI or ddC, were more effective than AZT alone in delaying disease progression and prolonging life.69

On 1st December, World AIDS Day, Nelson Mandela called on all South Africans to

"speak out against the stigma, blame, shame and denial that has thus far been associated with this epidemic."70

Protease InhibitorsThe FDA approved the first of a potent new family of anti-AIDS drugs. The drug saquinavir, belongs to a class of drugs called protease inhibitors. the drug was approved in record time, and was said to be:

"some of the most hopeful news in years for people living with AIDS." 71

By December 15th 1995, the World Health Organisation had received reports of 1,291,810 cumulative cases of AIDS in adults and children from 193 countries or areas. In contrast WHO estimated that the actual number of cases that had occurred was around 6 million. Eight countries in Africa had reported more than 20,000 cases.72

Other organisations estimated that by the end of 1995, 9.2 million people worldwide had died from AIDS.73

Worldwide during 1995, it was estimated that 4.7 million new HIV infections occurred. Of these, 2.5 million occurred in Southeast Asia and 1.9 million infections were in sub-Saharan Africa. Approximately 500,000 children were born with HIV infection.74

The WHO's Global programme on AIDS closed as planned on 31st December 1995.75 They estimated that by the end of the century, 30 to 40 million people would have been affected by HIV.76
1996 History

United Nations LogoThe new Joint United Nations (UN) Programme on AIDS (UNAIDS), bringing together six agencies belonging to or affiliated with the UN system - WHO, UNDP, UNICEF, UNFPA, UNESCO and the World Bank, became operational on January 1st 1996.77

In February the heavyweight boxer Tommy Morrison was identified as HIV positive after being tested prior to a fight.78

"I thought AIDS was something that happened to gays and drug addicts. A macho guy like me who loves ladies and is superfit-he doesn't get AIDS.' These words were spoken not in 1986 but in 1996 by Tommy Morrison." 79

In March, a government appointed panel issued its report, which sharply criticised the government's response to AIDS in the US.

"The Government's $1.4 billion AIDS research program is uncoordinated, lacks focus and needs a major overhaul to attract new scientific talent and spur novel and imaginative ideas." 80

Meanwhile the effect of AIDS was continuing to be felt at a community level. In the USA there had been a cumulative total of 81,500 AIDS cases in New York, and:

"despite two world wars, the Depression and epidemics, nothing in this century has affected the life expectancy for New Yorkers as greatly as AIDS." 81

In May the Food and Drug Administration (FDA) approved the first HIV test kit that involved the collection of blood samples in a person's home. Until then the FDA had insisted that all tests for HIV (whether blood or saliva) had to be done under the supervision of health professionals.

"Too many American do not know their HIV status. Knowledge is power, and power leads to prevention", said HHS Secretary Donna E. Shalala. "The availability of a home test should empower more people to learn their HIV status and protect themselves and their loved ones." 82

Meanwhile in China it was estimated that the actual number of AIDS cases could be as high as 100,000. Two thirds of the reported AIDS cases had occurred in the southern province of Yunnan, where the use of heroin and the sharing of dirty needles had helped the spread of HIV.83

NevirapineIn June the FDA approved the drug Viramune (nevirapine), the first in a new class of drugs known as the non-nucleoside reverse transcriptase inhibitors.84 Another treatment development that took place was the viral load test, which provided information about the risk of disease progression.85

Throughout 1996 there was excitement and optimism about the treatment of HIV infected people.86 The health of many HIV positive people improved enormously when they started taking combination therapy. For some people, particularly those previously ill in hospital who were then able to go home, the improvement in their health was so dramatic that it was referred to as the "Lazarus Syndrome".87

At the start of the 11th International Conference on AIDS in Vancouver in July:

"the air was electric with excitement and anticipation about the findings on combination therapies to be reported during the meeting."88

some scientists even declared that:

"aggressive treatment with multiple drugs can convert deadly AIDS into a chronic, manageable disorder like diabetes."89

One doctor suggested that giving combination therapy to patients in the first few weeks of infection, might mean that the virus could be completely eliminated in two or three years.90

However, Nkosazana Zuma, the health minister of South Africa, reminded the conference delegates, that:

"most people infected with HIV live in Africa, where therapies involving combinations of expensive antiviral drugs are out of the question." 91

It was also reported that there were limitations on the use of the drugs, such as severe side effects and the difficulty of taking large numbers of pills each day.92

"If you think the cure is here, think again. The cure is not here. We are a long way from a cure, even for the rich who can afford the treatments."

- Eric Sawyer - 93

In October, in Washington D.C., the AIDS Memorial quilt was displayed in its entirety for the last time, but it was also the first time that a display of the quilt had been visited by an American president.94 95

"What 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."

- Anthony Turney - 96

In December, the White House announced its first-ever AIDS strategy. The strategy called amongst other things, for sustained research to find a cure and a vaccine, a reduction in new infections, guaranteed access to high quality care for AIDS patients, and fighting AIDS-related discrimination.

"None of us can afford to sit by and watch this epidemic continue to take our neighbors, friends and loved ones from us","-Clinton wrote in a letter accompanying the AIDS plan." 97

AIDS advocates said that much will depend on how the stategy is implemented.

Drug use russia"It doesn't require rocket science to figure out what to do, what it requires is the political will to back it up."

- Paul Donato - 98

New outbreaks of HIV infection were erupting in Eastern Europe, the former Soviet Union, India, Vietnam, Cambodia, China and elsewhere.

"The epidemic is starting to skyrocket in Russia and the Ukraine where transmission is from everything - injecting drugs, poor hygiene, and heterosexual and homosexual intercourse."

- Dr Piot - 99

At the end of the year UNAIDS estimated that during 1996 some three million people, mostly under the age of 25, had become newly infected with HIV, bringing to nearly 23 million the total number of infected people. In addition an estimated 6.4 million people; 5 million adults and 1.4 million children, had already died.
1997 History

Early in 1997 it was reported that for the first time since the AIDS epidemic began in 1981, the number of deaths from the disease had dropped substantially across the USA.100 This was excellent news but:

"The decline in deaths leaves more people living with AIDS and HIV infection. We do not want to be a wet blanket here, but we still need programs that assure good access to treatment and care for infected people."

- Dr John Ward - 101

In New York city the decline was even more dramatic with the number of people dying from AIDS falling by about 50 per cent compared to the previous year.102 The number of babies being born HIV positive had also declined dramatically. 103

By the spring it was clear that although excellent for many people, the antiretroviral drugs did have unpleasant and in some cases serious side effects. Resistance could also occur, even when three drugs were being taken, and adherence was an important issue with many pills needing to be taken each day.104

A number of treatment guidelines were published, and some doctors, particularly in the UK, disagreed with the more aggressive approach taken by the US guidelines.105 106 Some doctors were particularly concerned about the recommendations concerning the beginning of treatment when patients did not have symptoms. The US approach was sometimes referred to as the

"hit early, hit hard".108

approach to treatment.

Later in the year a number of studies were published which showed that HIV could not after all be eradicated by two or three years of treatment, even if three drugs were taken and the treatment was strictly followed.109

In July 1997 the CDC reported that it was likely that there had been a case of transmission of HIV as a result of "deep kissing", although other routes of transmission could not definitely be excluded. The HIV positive man had sores in his mouth and gums which regularly bled, and his female partner also had gum disease with inflamed and sore areas in her mouth.110

In August, at a UNAIDS organised meeting in Nepal, an appeal was made for urgent joint action by South Asian regional governments to check the spread of the pandemic. Estimates of HIV/AIDS cases in India, Myanmar (Burma), Bangladesh and Nepal were put at 3 million, 350,000, 20,000, and 15,000 respectively.111

At the end of the year, UNAIDS reported that word-wide the HIV epidemic was far worse than had previously been thought. More accurate estimates suggested that 30 million people were infected with HIV. The previous year's estimate had been 22 million infected people.112

"The older estimates were based on data that came from a small number of countries. It was assumed that one could extrapolate similar rates of transmission for all countries in a particular regional factors would be pretty much the same. It turns out that the assumption was wrong."

-The New York Times- 113

South African KidsIt was also estimated that 2.3 million people died of AIDS in 1997 - a 50% increase over 1996. Nearly half of those deaths were in women, and 460,000 were in children under 15. UNAIDS reported that they considered that in terms of AIDS mortality the full impact of the epidemic was only just beginning.113

World-wide, 1 in 100 adults of the 15-49 age group were thought to be infected with HIV; and only 1 in 10 infected people were aware of their infection. It was estimated that by the year 2000 the number of people living with HIV/AIDS would have grown to 40 million.

In Latin America and the Caribbean the disease was already having a major impact.114 Earlier in the year a doctor in San Pedro Sula, Honduras has said:

"We will go from a city that is predominantly young to a city of old people and children. We are in over our heads with AIDS cases. It is devastating us. And all we can do here is watch people die, nothing more."115

The United States Agency for International Development (USAID) reported that it believed that 40 million children in developing nations would lose one or both parents to AIDS by the year 2010.

"It is a crisis of staggering proportion, that is going to affect not only the future of these countries, it is going to affect the entire global network of trade, diplomacy and development. What we are talking about here is something that has never been seen before, which is countries with one-sixth to one-quarter of all children without one or both parents." 116

[sppunk]

1998 History

In Canada there was an outbreak of HIV infection amongst injecting drug users in Vancouver.1

Glaxo Wellcome cut the price of AZT by 75% after a trial in Thailand showed it's effectiveness and safety in preventing mother-to-child transmission in developing countries.2 However, even with this price cut it was expected that the drug would still be far too expensive for use in many developing countries.3

In some countries HIV positive people were able to return to work as a result of the improvement in their health due to combination therapy drug treatment. However, some people began to be affected by quite severe side effects of the drugs. These side effects known as lipodystrophy began to cast doubt on the long term safety of combination therapy. The reasons why lipodystrophy appeared in some people taking anti- HIV drugs were unknown. Some reports linked the syndrome to the drug regimens that contained protease inhibitor drugs.4

"While fat disappears from some areas, for unknown reasons it redistributes to build up in others. The back of the neck resembles a buffalo hump. Breast enlarge. A woman may have to buy a bra than is two sizes larger that the last one. The abdomen swells producing a sometimes painful pot belly that is dubbed 'a protease paunch'. A woman may look pregnant when she is not. Exercise may not work it off."5

In April, the Clinton Administration refused to lift a 10-year ban on using federal funds for needle exchange programs, despite concluding findings for the first time that such exchanges prevent the spread of HIV. Leaders in the fight against AIDS condemned the unexpected decision, which was announced by Health and Human Services Secretary Donna Shalala. She also quoted NIH director Varmus as saying:

"An exhaustive review of the science indicates that needle exchange programmes can be an effective component of the global report to end the AIDS epidemic. Recent findings have strengthened the scientific evidence that needle exchange programmes do not encourage the use of illegal drugs'. But without explanation, she said the administration has 'decided that the best course at this time is to have local communities use their own dollars to fund needle exchange programmes."

- San Francisco Chronicle - 6

In the UK the London Lighthouse charity closed its residential unit.7

In June, the company AIDSvax started the first human trial of an AIDS vaccine using 5,000 volunteers from across the USA.

"It opened a new era in AIDS research, and led us toward the human trials. It was like being in a room that was partially lit and getting darker and darker, and suddenly the lights went on and you could see the pathway out."8

San Francisco started a pioneering Post Exposure Prophylaxis (PEP) program giving HIV drugs to people that might have been exposed to HIV through sexual contact or through needle sharing by injecting drug use. The HIV drugs were given to people at the earliest possible time after the risk exposure.

"'The treatment really is to try, in case they've been exposed to HIV, to stop the replication before it infects the cells and like a brush fire gets out of control. "9

A study found that choosing to have a caesarean delivery combined with taking AZT reduced the risk of HIV transmission to the baby to less than 1%. The study also found that women who took AZT but delivered their babies by natural childbirth had a higher risk (6.6%) of transmitting HIV to their babies.10

In July, the 12th International AIDS conference was held in Geneva. The challenge of this conference was not only to discuss the advantages available for the treatment of HIV virus, but to conquer the overwhelming pessimism as well. The mood of the meeting was a sharp contrast to the euphoria at the previous AIDS meeting, in Vancouver two years before.

"A series of reports about new problems with anti-HIV drugs and setbacks in vaccine trials left many participants thinking that their best hope against the epidemic was the strategy they had since it began: prevention."11

A French court ordered the former French prime minister ******t Fabius to stand trial on charges of involuntary homicide for allowing HIV-tainted blood to be used in transfusions.12

The first case of a patient being infected with a strain of HIV resistant to the most powerful new anti-viral drugs was reported in San Francisco in July. The mutated strain of HIV, seemingly impervious to protease inhibitors and older anti-virals now in use, was found in a newly infected patient at San Francisco General Hospital.

"We may be seeing an emerging and dangerous edge to the epidemic."

- Dr. Frederick Hecht of the University of California at San Francisco-13

The United Nations issued recommendations intended to discourage women infected with HIV from breast-feeding after decades of promoting 'breast is best' for infant nutrition.14

Jonathan Mann, the first director of the Global Program on AIDS, died in the crash of Swissair flight 111, along with his wife the AIDS researcher Mary-Lou Clements-Mann.

"It was always safe for scientists and institutions to think of AIDS as a virus, a transmissible infection… but Dr. Mann structured it 'as a human rights issue, and a global rights issue. He really was a spiritual leader as well as scientific leader."

- Dr. James Curran - 15

The FDA gave approval for various new drugs including Sustiva (efavirenz), another drug in the NNRTI group.16

Red ribbon in South Africa dedicated to Gugu DlaminiIn South Africa, Gugu Dlamini, an AIDS activist, was beaten to death by her neighbours after revealing her HIV positive status on Zulu television. This happened just a month after Deputy President Thabo Mbeki had called for people to "break the silence about AIDS" in order to defeat the epidemic.17

"It is a terrible story. We have to treat people who have HIV with care and support, and not as if they have an illness that is evil."

- Thabo Mbeki -18

The 1998 World AIDS Campaign 'Young People: Force for Change' was prompted in part by the epidemic's threat to those under 25 years old, for as HIV rates rose in the general population, new infections were increasingly concentrated in the younger age groups. The campaign also had a special representative, Brazilian football player Ronaldo.19

UNAIDS estimated that during the year a further 5.8 million people became infected with HIV, half of them being under 25.20
Country Estimated new HIV infections 1998
North America 44,000
Caribbean 45,000
Latin America 160,000
Western Europe 30,000
North America/Middle East 19,000
Sub-Saharan Africa 4 million
Eastern Europe/Central Asia 80,000
East Asia/Pacific 200,000
South Asia/South-East Asia 1.2 million
Australia & New Zealand 600
Global total 5.8 million

Sub-Saharan Africa was home to 70% of people who became infected with HIV during the year. South Africa, which trailed behind some of its neighbouring countries in HIV infection levels at the start of the 1990s was catching up fast. It was estimated that one in seven new HIV infections in Africa were believed to be occurring in South Africa. In Botswana, Namibia, Swaziland and Zimbabwe, the estimates showed that between 20% and 26% of people were living with HIV or AIDS.21
1999 History

In the United States a doctor who injected his former lover with HIV infected blood, was sentenced to 50 years in prison.22

A group of researchers at the University of Alabama claimed to have discovered that a particular type of chimpanzee, once common in West Central Africa, was the source of HIV. The researchers believe that HIV-1 was introduced into the human population when hunters became exposed to infected blood.23

Reports started to emerge from South Africa about rape cases involving young girls. It was suggested that a popular myth that sex with a virgin is the cure for AIDS was believed to be the root cause for this increase in child rapes.24 Later on in the year, the South African President Thabo Mbeki claimed that HIV drug AZT was toxic and could be a danger to health.25

According to the annual World Health Report, AIDS had become the fourth biggest killer worldwide, only twenty years after the epidemic began.26

The Ugandan ministry of Health started a voluntary door-to-door HIV screening programme by using rapid tests in an effort to reduce the spread of HIV. This effort was also intended to make HIV screening services more accessible to more people, especially in rural areas where there are neither modern laboratories nor electricity to run standard HIV tests.27 Since 1986 the Ugandan government had implemented a number of successful initiatives, and whereas in 1992 it was estimated that 30% of people in Kampala were HIV positive, by 1999 the figure had been reduced to 12%.28 However, HIV/AIDS was remaining a considerable health problem in Uganda. It was estimated that 820,000 adults and children were living with HIV/AIDS as at the end of 1999.29

In the UK a judge ordered that a five-month-old baby girl should be tested for HIV against her parents' wishes. The baby's parents refused to have their daughter tested, contending she is perfectly healthy and that they should be able to decide what is best for her.

"This case is not about the rights of the parents, and if, as the father has suggested, he regards the rights of a tiny baby to be subsumed within the rights of the parents, he is wrong, the judge said."30

South Africa won the first round in its battle with the United States and multinational pharmaceutical companies to force a cut in drugs prices. The dispute concentrated on South African legislation, which enabled local companies to manufacture HIV/AIDS drugs, which then could be sold at a fraction of the price of similar imported drugs. The US argued that the South African laws undermined drug manufacture's patent rights.31

Initial findings from a joint Uganda-US study identified a new drug regimen; a single oral dose of the antiretroviral drug nevirapine, as being both more affordable and effective in reducing mother to baby transmission of HIV. This research provided real hope that mother to child transmission of HIV could be effectively reduced in developing countries.32

"This extraordinary finding is the most recent in our efforts to bring an end to AIDS, not only in the United States but in countries around the world."

- Donna E. Karala, the Health and Human Services Secretary-

The UK Government announced that all pregnant women in Britain would be offered HIV test in an attempt to reduce the children infected with HIV. The Labour Government set a target of reducing the number of children with HIV by 80% by 2002.33

Health officials rejected the attempts to reopen the bath houses in San Francisco, which were closed 15 years previously at the height of the epidemic in 1984.34 A survey published in August found that growing numbers of gay men in San Francisco were having unprotected sex.35 The Public Health Authorities expressed concern and disappointment with the survey results, because instead of the number of new infection decreasing in the city, infections had remained at about 500 per year.36

Needle sharing among injecting drug users set off an explosive increase in HIV infections in Russia. In Moscow, three times as many cases were reported in the first nine months of 1999 as in all previous years combined.37

Injecting drug use in Russia"Russia is broke, and AIDS prevention programs are taking a back seat to problems that appear more pressing, such as mass poverty, crime and Russia's huge foreign debts."38

In November, China broadcast its first television advertisement ever for condoms in an effort to stop the spread of sexually transmitted diseases and HIV/AIDS.39 Shortly after the advertisement was seen by hundreds of millions of people, it was banned by the State Administration of Industry and Commerce.40

'The River', a book by Edward Hooper was published. There was a lot of debate about the role of polio vaccine and the cause of AIDS.41

T-20, a new class of drug called a fusion inhibitor went into clinical trials.42

The Kenyan President Daniel arap Moi declared AIDS as national disaster and ordered a National AIDS Control Council to be set up immediately.

"AIDS is not just a serious threat to our social and economic development, it is a real threat to our very existence, and every effort must be made to bring the problem under control."

- President Moi-43

But disappointingly the president also said that his government and Kenya's churches would not advocate the use of condoms as a method of prevention because this would encourage young people to have sex.

A research study published in November argued that male circumcision could help to reduce HIV infection rates in Africa and Asia.44

At the request of countries around the world eager to reach the age group at highest risk, the 1999 World AIDS day campaign, Listen, Learn and Live!, continued to focus on people under 25.45

By the end of 1999, UNAIDS estimated that 33 million people around the world were living with HIV/AIDS and that 2.6 million people worldwide had died of the disease in 1999, the most of any year since the epidemic began.46 It was also reported that for the first time more women than men were infected with HIV in Africa.47

"In 1992, a team headed by the late Dr. Jonathan Mann at the Harvard School of Public Health, published estimates of HIV infections in sub-Saharan Africa ranging from 20.8 million to 33.6 million by 2000. The World Health Organisation criticized Dr. Mann's estimates as excessive. Now academic scientists are criticizing the figures of Dr. Piot's Team. When we look at the figures today, they are worse than the scenarios Jonathan had published, Dr. Piot said."48

The World Bank warned that the AIDS epidemic in Asia could erase the region's economic gains over the last two decades unless governments maintained funding for social programs. The United Nations estimated that 7 million people in Asia were infected with HIV/AIDS.49
2000 History

Jesse Jackson publicly taking an oral HIV testIn January, the CDC reported that for the first time, AIDS was diagnosed in more black and Hispanic gay men than in white gay men in the US. Statistics from the Centers for Disease Control and Prevention showed that African Americans compose of 57 % of all new HIV infections, even though they make up just 13% of the U.S. population. In order to publicise the importance of HIV testing to African-Americans, reverend Jesse Jackson publicly took an oral HIV test.51

At the beginning of 2000, it was reported for the first time in 1999 the number of newly diagnosed heterosexually acquired HIV infections was higher than the number of newly diagnosed homosexually acquired HIV infections in the UK.52

Preliminary studies presented at the 7th Conference on Retroviruses and Opportunistic Infections showed that in some cases temporary stopping of HIV-drug therapy could still keep HIV under control and that the virus might not develop resistance to drug therapy.53 This became later known as the structured treatment interruption or drug holiday.

In February, the trial of the Bulgarian health workers started, they were charged in Libya with deliberately infecting children with HIV. The Bulgarian medics, five nurses and anaesthetist, were detained in 1998 after almost 400 children were given infected blood at a hospital in Benghazi, Libya's second largest city. Eight Libyans and a Palestinian were also charged.54

A more definitive study was published about the risk of transmitting HIV through oral sex. Earlier studies had identified oral sex as means of transmitting HIV but the purpose of this new study was to find out the extent of HIV transmitted by oral sex among men who have sex with men. The research suggested that in about 7% of cases, the virus was likely to have been transmitted during oral sex.55

"I think it reinforces what we've said already - which is that condoms should be used for whatever type of sex you have."

- Dr. Robert Janssen, Director of the Division of HIV/AIDS prevention at the CDC-56

Thabo MbekiAlso, early in the year the South African government made a decision to invite a panel of experts to pursue debate on questions relating to HIV/AIDS.57 In March, it was reported that South African President Thabo Mbeki had consulted two American 'dissident' researchers to discuss their views that HIV is not the cause of AIDS.58

Israel lost one of its most successful singers, Ofra Haza, from what was believed to be an AIDS-related complication. Since her death the number of people coming forward for anonymous HIV testing and contacting helplines increased considerably.

"Nevertheless, her death has brought the whole issue of AIDS out into the open in Israel. This can be only a good thing for a country which has seven openly HIV positive people- including myself- out of an estimated 10."

- Aviram Germanovitch, Director of the Israeli AIDS Task Force - 59

In April, President Mbeki sent a letter to world leaders explaining his views on HIV/AIDS. In this letter, Mbeki argued, amongst other things, that since HIV is spread mostly through heterosexual contact in Africa, the continent's problems are unique.

"Accordingly, as Africans, we have to deal with this uniquely African catastrophe' and that ' it is obvious that whatever lessons we have to and may draw from the West about the grave issue of HIV-AIDS, a simple superimposition of Western experience on African reality would be absurd and illogical."60

In Botswana, as many as one in four adults and four of every ten pregnant women were estimated to be infected with HIV.61 Also the president of Botswana, Festus Mogae announced that new contributions from donors including $ 50 million donated by the Bill and Melinda Gates Foundation would allow his country to provide antiretroviral therapy to all HIV-infected pregnant women and children born with the virus.62

The Clinton Administration formally declared HIV/AIDS as a threat to U.S national security. The United States believed that the global spread of AIDS was reaching catastrophic dimensions that could topple foreign governments, spark ethnic wars and undo decades of work building free-market democracies abroad. It was the first time the National Security Council was involved in fighting an infectious disease.63

"We shouldn't pretend that we can give injections and work our way out of this. We have to change behaviour, attitudes, an it has to be done in an organized, disciplined, systematic way."

- Bill Clinton -64

Later on in the year, the US Institute of Medicine released a report that sharply criticised the Clinton Administration for a failure to develop a comprehensive and effective plan to combat the disease in the United States.65

In May, at the opening of the first meeting of the presidential advisory panel on AIDS in South Africa, President Mbeki offered his first detailed explanation of why he had consulted the two American researchers. He also explained why the 33-member presidential AIDS advisory panel consisted of people who believe that HIV causes AIDS and as well as those who not.

"We were looking for answers because all the information that has been communicated points to the reality that we are faced with a catastrophe, and you can't respond to a catastrophe merely by saying I will do what is routine."66

He also said that he and his ministers knew that HIV causes AIDS.67

"What we knew was that there is a virus, HIV. The virus causes AIDS. AIDS causes death and there's no vaccine against AIDS."68

Five pharmaceutical companies offered to negotiate steep cuts in the price of AIDS drugs for Africa and other poor regions.69 A couple of months later the United States offered sub-Saharan African nations loans to finance the purchase of AIDS drugs and medical services.70 The offer was not seen as a solution to a HIV/AIDS crisis and it was rejected by many African nations71.

"Making drugs affordable is the solution rather than offering loans that have interest."72

According to the UNAIDS report, there were 34.3 million people infected with HIV worldwide, of whom 1.3 million were children under the age of 15. They also reported that AIDS would cause early death in as many as half of the teenagers living in the hardest hit countries of southern Africa, causing population imbalances. In particular, it was predicted that two thirds of the 15 years -olds in Botswana would die of AIDS before reaching age 50.73

Almost four million people were estimated to be living with HIV in India. This meant that the country had the second largest HIV population in the world: only South Africa had more people living with HIV.74

HIV positive woman marching during the AIDS conferenceIn July, the 13th International AIDS Conference was held in Durban, South Africa. This was the first time that such a conference was held in a developing country or in Africa.75 Nkosi Johnson, 11-years old HIV-positive boy gave a speech in the opening ceremony of the conference and called for the government to give AZT to pregnant HIV-positive mothers.76

Mbeki used his opening address at the conference to stress the role of poverty in explaining the problems faced by Africa and compared the campaign against AIDS with the struggle against apartheid.77

"As I listened and heard the whole story told about our own country, it seemed to me you could not blame everything on a single virus."78

To counter the comments made by president Mbeki over 5,000 scientists around the world signed 'the Durban Declaration' affirming that HIV is the cause of AIDS.79

Nelson Mandela, South Africa's former president, closed the AIDS conference with a call for action to combine efforts and save people.80

"History will judge us harshly if we fail to do so now, and right now."

At the conference, preliminary findings were reported from nonoxynol- 9 studies in Africa and Thailand. These studies had hoped to prove nonxynol-9 as the first effective microbicide for women to work against HIV during sex but the findings were quite the opposite. It was warned that women who are at high risk of contracting HIV should not use spermicide nonoxynol-9 because it may increase the transmission of HIV.81

"If you use nonoxynol-9, you are either wasting your money or possibly wasting your life."

- Dr. Joseph Perriens - 82

For some people, these were not surprising findings, since the toxic effects of nonoxynol-9 had been reported since 1989.83

There were few other noteworthy scientific findings reported at the conference.

In September, the first phase of a new vaccine trial was launched in Oxford. The trials were sponsored by the International AIDS Vaccine Initiative.84 The research into an AIDS vaccine was criticised by the World Bank for focusing on vaccine that could be marketed in western countries, despite the fact that more than 90% of HIV infections occur in the developing world.85

President Mbeki stated in an interview with the Time Magazine that he did not think that HIV alone causes AIDS.

"Clearly there is such a thing as acquired immune deficiency. The question you have to ask is what produces this deficiency. A whole variety of things can cause the immune system to collapse… But the notion that immune deficiency is only acquired from a single virus cannot be sustained. Once you say immune deficiency is acquired from that virus your response will be antiviral drugs. But if you accept that there can be a variety of reasons, including poverty and the many diseases that afflict Africans, then you can have a more comprehensive treatment response." 86

In October, President Mbeki announced his withdrawal from the scientific and public debate on the causes of AIDS after admitting that he has created confusion in South Africa.87

There had also been a lot of confusion about what Mbeki said and did not say during the year.88 It is clear that over period of some months more, particularly in April and in September, Mbeki led many people to think that either 1) he does not believe that HIV causes AIDS or 2) he does not believe that HIV causes AIDS on its own.

It would seem that Mbeki may have believed (and may still believe in 2004) that immune deficiency is caused by collection of factors such as poverty, nutrition and contaminated water and HIV, rather than just HIV on its own.

"You cannot attribute immune deficiency solely and exclusively to a virus."89

It is true that poverty related factors such as malnutrition will hasten the onset of AIDS in people who are HIV-positive. Therefore, it is also true that provision of food will slow down the progression of HIV but improved nutrition is not enough in itself to permanently keep people healthy. History provides evidence of this.90 If many people believe that improved nutrition is not only necessary but sufficient to prevent the onset of AIDS, this would have serious implications for the treatment and care of HIV-positive people in South Africa and globally.
2001 history

Chinese campaign poster for World AIDS dayAfter years of denial, China finally admitted that HIV/AIDS threatened its public health and economic security. China's most senior AIDS researcher stated that China could soon have one of the highest numbers of HIV infections in the world. Infections were predicted to grow from about 600,000 to 6 million by 2005.91 It was believed that nearly 75% of China's HIV patients have contracted the disease through injecting drug use or transfusion with contaminated blood.92

Indian drug company Cipla offered to make AIDS drugs available at reduced prices to the international aid organisation Medecins Sans Frontieres (MSF). Cipla's offer to produce drugs at a price less than US$ 1 day put further pressure on multinational drug companies.93

The US Government threatened Brazil with legal action over production of generic HIV drugs.94 The complaint was dropped later on in the year and Brazil promised to give the USA advance warning before going ahead with the patent law for drugs.95

39 pharmaceutical companies withdrew their case against the South African government for wanting to lower drug prices. This victory was, however, overshadowed by an announcement by the health minister Manto Tshabalala-Msimang, who said that the government already offered adequate treatment to AIDS patients and the proposals to buy antiretroviral drugs were being considered.96 The South African government released its annual HIV/AIDS figures estimating that 4.7 million people were infected with HIV/AIDS and that 24.5% of pregnant women were HIV-positive in 2000.97

In August, AIDS activists took legal action against the South African health ministry over its continuing refusal to supply antiretrovirals to prevent mother to child transmission (MTCT) of HIV.98 In December, it was ruled that the South African government should give free access to nevirapine to reduce the risk of MTCT of HIV. The judge ordered the government to set up a nationwide MTCT programme with a deadline for implementation report to be handed back to the court by March 2002.99

According to a CDC study of six large cities in the U.S. 30% of young gay black men were infected with HIV.100

"When people think 'gay', they think 'white'. But the people still at the greatest risk are sexually active gay men, and that cuts across all races."

- Helene Gayle of the CDC -101

CDC also reported that the incidence of HIV in people aged over 50 is increasing twice as the rate for those younger.

"Officials have speculated that a more open society, people entering the dating scene after the monogamy of marriage and the absence of a fear of pregnancy is causing the alarming rise in sexually transmitted infections.".102

Zimbabwe's government announced that it would dissolve the board of the National AIDS council, after allegations of inappropriate political support and mismanagement of funds. Zimbabwe has one of the highest HIV infection rates in Africa. It was estimated in 2001 that AIDS had orphaned 1 million children and 25% of Zimbabwe's 12 million population were HIV positive.103

In April 2001, it was reported that the year 2000 saw by the far the largest number of new HIV cases yet recorded in the UK. The Public Health Laboratory Service (PHLS) recorded 3,435 new diagnoses in 2000.104

"Many of those being diagnosed are people infected some years ago, but who are now coming forward for testing. This is good news because once people are diagnosed they can seek treatment."

- Barry Evans - 105

Kofi AnnanIn April, Kofi Annan called for spending on AIDS to be increased 10-fold in developing countries at the African Summit in Nigeria.106 He suggested 'a war chest' of $7bn-10bn to be spent annually on a global campaign against AIDS, a massive increase on the $ 1bn a year that was currently being spent.107 A few weeks after, it was announced that the Global AIDS and Health Fund was not only going to target AIDS as first suggested, but to also ******* TB and malaria.108

"In this effort, there is no us and them, no developed and developing countries, no rich and poor- only a common enemy that knows no frontiers and threatens all people."

- Kofi Annan at the G8 summit in Genoa - 109

There were some concerns about how the Fund was going to be governed and implemented. The US government was criticised for only contributing $200 million to the Global Fund. Later on in the year, the fund was officially named as The Global Fund to fight AIDS, Tuberculosis and Malaria.110 The amount of money donated to the Fund was disappointingly low $1.6 bn111 and much less than the $10bn that Kofi Annan had called for.

Newspapers all over the world marked the 20th anniversary of the first published report on the disease that came to be known as AIDS.

"At the time, I read the report with great interest, but I never imagined I was looking at the first sign of an epidemic, that in just 20 years would have infected 60 million people, killed 22 million and achieved the status of the most devastating epidemic in human history."

- Peter Piot recalling the first mention of the virus- 112

The Ugandan president, Yoweri Museveni opened a regional centre for treatment of HIV-positive patients in Kampala. One of the main aims of the centre was to train health workers from all over Africa.

"Our hope is that the hundreds trained here will train thousands who will treat millions."113

Stephen LewisKofi Annan appointed Stephen Lewis as his 'special envoy for AIDS in Africa'.114

Publicty for the UN special sessions on HIV/AIDS 2001The United Nations Secretary-General Kofi Annan opened the UN General Assembly Special Session on HIV/AIDS in New York. This was the first ever UN meeting devoted to a public health issue.115

There was a sudden explosion in HIV cases among injecting drug users in Dublin, Ireland. It was reported that diagnoses jumped fivefold between January 99 and June 00. Diagnoses fell to a low of 12 in 1998, but in the next 18 months 96 people tested positive. Doctors blamed this on a sudden tightening of regulations around the supply of the heroin substitute methadone, so more people started injecting street heroin. 116

Stephen Kelly was found guilty at Glasgow High Court of 'culpable and reckless conduct' for having unprotected sex knowing he had HIV. He infected his girlfriend in 1994. Kelly was the first person to be tried under Scottish law for culpable and reckless conduct in giving HIV to someone else. It was feared that this would lead to a reduction in HIV testing because people may be more reluctant to be tested.117

President George Bush appointed an openly gay man, Scott Evertz, as Director of the Office of National AIDS policy, but did not find any extra money in his 2002 budget for AIDS prevention or treatment.118

The US Food and Drug Administration (FDA) issued a warning letter to manufacturers of HIV/AIDS drugs, cautioning them to tone down the optimistic tone of their antiretroviral drug advertisements.119

"Examples of such images range from robust individuals engaged in strenuous physical activity to healthy-looking individuals giving testimonials of a specific drug's benefit. However, not all individuals have a response to ARV therapy; in fact, some patients will still have disease progression despite ARV therapy."120

A former Japanese Health Ministry official was found guilty of negligence for failing to stop the sale of untreated blood products. Over 1,800 haemophiliacs had contracted HIV in Japan since the early 1980's from untreated blood and more than 500 have died.121

It was reported that some Asian countries had reduced the transmission of HIV through widespread condom use. In Thailand, new infections had plummeted from 143,000 in 1991 to 20,000 in 2000.122

A senior Iranian health official warned that the number of AIDS cases in the country has risen dramatically. In the past, Iranian officials estimated the number of HIV-positive people to be around 2,000 but the Deputy Health Minister said that the real figure was now more than 15,000.123

AIDS was the leading cause of death in sub-Saharan Africa. It was also reported that the rates of HIV infection were rising fastest in Eastern Europe and Russia.124
2002 history

Ukraine became the first nation in Europe to have 1% of its adult population infected with HIV.125

The US Secretary of State Colin Powell strongly advocated condom use to prevent the spread of AIDS and other sexually transmitted diseases setting himself apart from President Bush's views on sex education in a MTV broadcast.

"In my own judgement, condoms are a way to prevent infection…Therefore, I not only support their use, I encourage their use among people who are sexually active and need to protect themselves."126

A new line of condoms carrying the logos of most important Brazilian football teams went on sale. The campaign was helped by a TV advertisement in which supporters wore caps with their team colours in the shape of a condom.

"The level of success was more than we had expected…We are selling the condoms in places not normally associated with this sort of product, such as news stands and bakeries."127

Later on in the year, for the first time ever in Brazil, a HIV prevention campaign was being aimed at male homosexuals.128

A study showed that approximately 50% of Americans still believed that they could acquire HIV through everyday contact and supported the mandatory testing of groups most at risk of HIV infection.129

The Chinese Government announced a 17% jump in AIDS cases. The government estimated that the number of people with AIDS was as high as 200,000 of which more than half of this number were presumed already dead. It was also estimated by the government that up to 850,000 people were infected with HIV by the end of 2001 in China. These figures were still way below the estimates by experts at the UN and the WHO - who said that as many as 1,5 million could have been infected.130

The National Statistics Institute in Lisbon announced that there were 104.2 HIV cases per one million Portuguese residents in 2000, compared with 88.3 cases in 1999. This was the highest rate of HIV infection in the European Union. The European average is just under 25 cases per million residents. It was believed that injecting drug use is the main source of HIV infection in Portugal.131

The Global Fund to Fight AIDS, Tuberculosis and Malaria board of directors selected Richard Feachem to be the first to head the organisation.132 In the first round of funding they received applications for more than six times the amount they had anticipated. During the year the Global Fund announced their first round of payments of $600 million over a two-year period and in December, the first $1 million was given out.133

The WHO published guidelines for providing antiretroviral drugs for HIV-infected in the resource poor countries. They also released a list of 12 essential AIDS drugs. These two moves were seen as "vital steps in the battle against the AIDS pandemic and should encourage both industrialised and developing country governments to make HIV treatment more widely available."134

In April, the South African government promised to start to provide nevirapine to HIV- positive pregnant women and their babies to reduce the risk of transmission of HIV. It was also going to be possible to offer women who have been raped AZT as post-exposure prophylaxis (PEP).135

A World Bank report said that HIV is spreading so rapidly in parts of Africa that it is killing teachers faster than the nations can train them. The report noted that for example in parts of Uganda and Malawi, nearly a third of all teachers were HIV-positive.136

"With more than 113 million children not in school in the poorest countries already presents a major challenge. However, HIV/AIDS makes this much greater in those countries where the education system is already struggling to grow, teachers are dying, or are too sick to teach. And every year more children are losing their parents and the support that allows them to go to school. Achieving education for all in a world of AIDS presents an unprecedented challenge to the world education community."

- World Bank President James D. Wolfensohn-137

A report warned that Papua New Guinea was on the brink of an HIV/AIDS epidemic and the country could face losing 13-38% of its working population by 2020. It was estimated that Papua New Guinea had between 10,000 to 15,000 people infected with HIV. In comparison, Australia with a population almost 5 times that of Papua New Guinea has less than 12,000 HIV positive people. It was feared that HIV/AIDS could spread rapidly since 90% of infections are through heterosexual sex.138

A major Spanish study found that over 19,000 instances of unprotected oral sex did not lead to a single case of HIV transmission among 135 HIV-negative heterosexuals in a sexual relationship with a person with HIV.139

The WHO warned that HIV could spread rapidly throughout Afghanistan due to high levels of injecting drug use and unsafe blood transfusions. It was also said that refugees were especially vulnerable to HIV infection because of sexual abuse, violence and lack of information & education. The WHO was also funding the first survey of HIV/AIDS in Afghanistan.140

Treatment activist protesting during the 2002 conferenceIn July, the 14th World AIDS Conference was held in Barcelona, Spain. Issues around providing HIV treatment for resource-poor countries dominated the mood and agendas of the conference.

"If we can get cold Coca Cola and beer to every remote corner of Africa, it should not be impossible to do the same with drugs."

- Joep Lange, the President of the International AIDS Society speaking at the closing ceremony - 141

At the Barcelona conference, there were encouraging results from trials with a drug known as T-20, an injectable drug from a new drug group called fusion inhibitors. The results provided good news for people who had become resistant to existing drugs and the fusion inhibitors were called 'the most exciting advance since protease inhibitors were introduced.142

The number of children orphaned by HIV/AIDS had risen three-fold in six years to reach an all time high of 13.4 million. It was estimated that India had the largest number of AIDS orphans of any country in the world, with an estimated at 1.2 million in 2001, and this was predicted to rise to 2 million in five years and 2.7 million in ten years.143

"Children are taking the role of adults in many places affected by HIV because a generation has disappeared. They can't go through normal development. They have to work 40 hours a week. The very fabric of society is disappearing, with family structures crumbling."

- Peter Piot -

Indonesia, the world's fourth most populous country demonstrated how suddenly HIV/AIDS epidemics could emerge. After more than a decade of low HIV prevalence rates, the country was seeing infections rates increasing rapidly among injecting drug users and sex workers with rates as high as 40% in drug treatment centers in Jakarta.144

Swiss researchers reported the first fully documented case of HIV-positive man who was additionally infected with a second strain of HIV through unprotected sex more than two years after he was first infected.145

Kami, a fluffy, mustard-coloured, HIV-positive character joined the cast of the South African version of Sesame Street. Kami's name is derived from the Tswana word for 'acceptance'. 146

Several batches of cut priced drugs that were destined for Africa were illegally sold at full European prices in the Netherlands and Germany. The drugs were exported to Africa for 10% of the European price.147

HIV+ woman South AfricaFor the first time, it was reported that women account for about half of all HIV-infected adults.

"The face of HIV/AIDS has become that of a young African woman - seven of 10 people living with the disease are in sub-Saharan Africa, and 58% of infected Africans are female. Of the 38.6 million adults living with the disease worldwide are women."148

A study suggested that more people in Africa may have been infected through medical injections and treatments than was previously thought.149

"Our observations raise the serious possibility that an important portion of HIV transmission in Africa may occur through unsafe injections and other unsterile medical procedures."150

The UN Secretary General, Kofi Annan used World AIDS Day as a platform to speak out against HIV-related stigma and discrimination. He said 'the impact of stigma can be as detrimental as the virus itself' and he urged people to replace 'fear with hope, silence with solidarity'. He went on to say that 'the fear of stigma leads to silence and when it comes to fighting AIDS, silence is death'. The use of phrase 'silence is death' was interesting, as it has been used around the world for many years by AIDS activists, initially by the group ACT UP.

[sppunk]

2003 History

It was suggested in the UK that potential National Health Service (NHS) workers would face tests for HIV and hepatitis B and C before they can take up certain posts.1

Swaziland was believed to have the world's highest rate of HIV with almost four out of 10 adults infected with HIV. The Prime Minister Sibusiso Dlamini said that the official rate had risen to 38.6% from 34.2% in January 2002. This figure was just under Botswana's rate 38.8%, which is still officially the world's worst. But health officials said that Swaziland's figures were already out of date.2

Jerry Thacker, a controversial Christian extremist chosen by the White House to sit on a presidential AIDS advisory panel and who once described the virus as the 'gay plague' was forced to withdraw his name after protests from gay rights groups. 3

In February, a rare case of female-to-female sexual transmission of HIV was reported. Doctors suggested the woman may have been infected through sharing sex toys after drug resistance tests found striking similarities between the HIV strains of the woman and her female HIV-positive partner.4

US president George Bush proposed spending US$ 15 billion in combating AIDS in Africa and the Caribbean over the next 5 years in his State of the Union address. He called the scheme ' a great mission of rescue'.5 The Senate approved this 'AIDS bill' in May.6

US Health Secretary Tommy Thompson was elected as the new chairman of the Global Fund for HIV, TB and Malaria. This move was hoped to prevent a conflict between the Bush administration and the international health community.7

A leading UK soap opera 'EastEnders' wrote out an HIV-positive character, Mark Fowler, after many years on the programme.8

There has been no dramatic increase in HIV transmission in Cuba since the beginning of the epidemic. The rate of infection was 3% and thought to be one of the lowest in the world. There has been virtually no transmission of HIV through injecting drug use, blood transfusion or newborns at birth. The government has ensured that all HIV-positive mothers are treated with prophylactic AZT therapy and then the babies are delivered by caesarean section. The country has produced enough antiretrovirals to supply the country's patients.9

HIV/AIDS reduced the global population estimates by 0.4 billion to 8.9 billion for 2050.

"The long-term impact of the epidemic remains dire…HIV/AIDS is a disease of mass destruction and we do not see a vaccine coming soon."

- Joseph Chamie, director of the UNPD -10

An expert group reaffirmed that unsafe sexual practises are responsible for the majority of HIV infections in sub-Saharan Africa. This review was in response to claims made in 2002 that unsafe medical practises were to blame for an important portion of HIV transmission in Africa.11

AIDS vaccine developmentVaxgen announced that their AIDS vaccine failed to reduce overall HIV infection rates among those who were vaccinated. The vaccine showed a reduction in certain ethnic groups, indicating that black and Asian volunteers may have produced higher levels of antibodies against HIV than white and Hispanic volunteers. However, many outside observers were sceptical of the ethnic group part of the study.12 In November, the AIDS vaccine also failed in clinical trial in Thailand.

"The outcome of this trial is one more reminder of how difficult it is to combat HIV and how important it is for the international public health community to redouble the effort to develop an effective vaccine."

- Donald P. Francis, Vaxgen President - 13

Researchers warned that the number of women being diagnosed with HIV in Europe was rapidly catching up with men. The researchers also noted that the initiatives that supply drug users with clean needles have been effective in Europe. HIV transmission through injecting drug use was said to be almost eliminated in France, Germany and the UK and significantly reduced in Spain and Italy.14

The Treatment Action Campaign (TAC) filed manslaughter charges against the health minister and the trade and industry minister in South Africa. The TAC held the ministers responsible for the deaths of 600 people a day who could have been saved if they had had access to ARV drugs.15

Russia received an approval for a long delayed loan from the World Bank to tackle HIV/AIDS and TB in the country. For its part, the Russian Government promised to match the loan with $ 134 million in new money over 5 years for HIV/AIDS and TB. This contribution from the government signalled growing recognition that both HIV/AIDS and TB epidemics represented a threatening crisis for Russia's development.16

The US Centers for Disease Control and Prevention (CDC) announced a new four -part initiative to reduce the number of new HIV infections in the US. The initiative proposed changes such as introducing HIV testing as a routine part of medical care, use of rapid test, to offer HIV-positive women routine HIV testing as part of their antenatal care and increased focus on people who are already infected with HIV and their partner tracing.

South Korean Lee Jong-Wook took office as the new Director- General of WHO and named HIV/AIDS as his top priority in his first speech.17

In 2003, the Global Fund faced a serious shortfall in funding that was needed to cover the grants for different countries.18

New HIV/AIDS figures were released in India and it was estimated that between 3.82 and 4.58 million people were HIV positive.19

The World Health Organisation declared that the failure to deliver treatment to nearly six million people with HIV/AIDS in developing countries was a global public health emergency. Only about 300,000 people in developing countries received the drugs at all, and in sub-Saharan Africa, where 4.1 million people were infected, just over 1% or about 50,000 people had access to antiretroviral treatment.20

Vatican cardinal Alfonso Lopez Trujillo stated that condoms were not safe and do not protect against the transmission of HIV.

"I simply wished to remain the public, sustaining the opinion of a good number of experts, that when the condom is employed as a contraceptive, it is not totally dependable, and that the cases of pregnancy are not rare. In the case of Aids virus, which is around 450 times smaller than the sperm cell, the condom's latex material obviously gives much less security."

- Cardinal Trujillo - 21

In response the WHO said:

"It is quite dangerous to claim the contrary when you realize that today we are facing an epidemic which has already killed 20 million people and 42 million people are infected today."22

There was a sharp rise in trafficking of heroin through central Asia. This caused an increase in drug addiction and cases of HIV in many impoverished states including Tajikistan. Since the fall of the Taliban, who banned growing of opium poppies- the raw material for producing heroin- production skyrocketed in Afghanistan.23

The UN World Food Programme said it would shift its humanitarian aid effort in southern Africa from traditional emergency food supply to a greater response to HIV/AIDS including providing nutritional support, awareness campaigns, food baskets and other services to HIV-positive people.24

Many drug manufacturers lowered their prices of antiretroviral drugs during the year. These price reductions were welcomed by many countries and organisations but it was also understood that 'lower price medicines alone will not deliver treatment'. But what was also needed was the ability of countries to deliver these drugs, building of stronger health systems and training of more health care workers in resource poor countries.25

South Africa approved the long-awaited provision of free antiretroviral drugs in public hospitals. The cabinet instructed the Department of Health to proceed with implementation of the plan. The plan envisaged that within a year there would be at least one service point in every health district across the country and within five years, one service point in every local municipality.26

The UNAIDS warned that the efforts to stem the world's AIDS epidemic were 'entirely inadequate'. It was estimated that every day in 2003, an estimated 14,000 people got infected with HIV. It was estimated that 40 million around the world including 2.5 million children were living with HIV/AIDS.27

The World Health Organisation announced a new plan, known as '3 by 5', to provide HIV/AIDS treatment for many resource poor countries. The plan had many different elements, but the WHO were not planning tp provide the drugs themselves. WHO was hoping to have 3 million people in resource poor countries on AIDS drugs by 2005.28

"Nothing close to this has ever been tried. It's not like finding babies with diarrohea and treating them for a week, or adults with tuberculosis and treating them for six months -both of which have been major efforts by the WHO in recent decades. …. HIV infection is a chronic disease. The 3 million - and the millions who will come after them - will have to take their medicine for years, until they die."29

Wen Jiabao became the first Chinese premier to shake the hand of an AIDS patient. Mr Wen's handshake broadcast in close-up was the most dramatic of a series of government moves that demonstrate a new determination to fight AIDS.

"This was like breaking the ice…It's something that a lot of people working in the AIDS field inside China and outside have been hoping for and waiting for." - Joel Rehnstrom, the co-ordinator in China for UNAIDS - 30

India's health minister said that there would never be an AIDS epidemic in the country.

"I will prove all experts wrong. We are taking on the disease from all fronts. We are tackling it very bravely."

- Sushma Swaraj - 31

The number of people infected with HIV in the UK increased by almost 20% between 2001 and 2002, from 41,700 to 49,500 with 31% remained undiagnosed.

"World AIDS day reminds us that the problems we face with HIV are not going away, despite it being a disease that is largely preventable."

- Kevin Fenton, a public health consultant -32
2004 History

Brazil's government reached a deal with pharmaceutical companies to reduce the price of HIV/AIDS drugs by around a third. It was believed that the deal saved the government about $100 million in 2004 and cut the average treatment cost per patients to a new low of $1,200.33 Also, 10 million free condoms were given out to people in Brazil during the carnival season as part of an AIDS-prevention campaign.34

In February, the president of Malawi, Bakili Muluzi announced that his brother had died from AIDS. This was intended to highlight issues of stigma and discrimination in talking about HIV/AIDS. President Muluzi made the announcement as he launched the first AIDS policy in a country where an estimated 15% of the 15 million population were HIV-positive.35

The Global Fund to Fight AIDS, Tuberculosis and Malaria suspended payments to three HIV/AIDS programmes in Ukraine, citing concerns over slow progress and management problems. It was the first time in its history that the Global Fund stopped funding to a scheme that it had supported. 36

In parts of Russia and eastern Europe, HIV was spreading at the fastest rate in the world. A survey by the United Nations Development Programme estimated that almost one in 100 Russians were HIV-positive and that AIDS could claim up to 20.7 million lives by 2045.37 The head of the UN Development Programme, Mark Malloch Brown, criticised Russia's efforts to combat the virus:

"President Putin mentioned it last May, but one speech is not enough and one reference in a speech is not enough."38

Stephen Lewis, the UN special envoy for HIV/AIDS in Africa warned that the WHO's attempt to get three million people onto treatment by the end of 2005 was compromised because of lack of financial support from the world's richest countries.

"There has never been a more determined plan of action…If 3 by 5 fails, as it surely will without the dollars, then there are no excuses left, no rationalizations to hide behind, no murky slanders to justify indifference. There will only be the mass graves of the betrayed."

- Stephen Lewis, UN Special envoy for HIV/AIDS in Africa - 39

In April, the Chinese government announced that it was starting to offer everyone free HIV tests.40

South Africa began a programme to give out free HIV/AIDS drugs after years of confusion and delays. The program started in South Africa's richest province, Gauteng, where five major hospitals, including Chris Hani Baragwanath, the largest in Africa, were selected to administer the drugs.41

"To me, it means a lot," said the frail man, whose girlfriend and 2-year-old daughter have also tested positive for HIV. "I have a child to raise. ... I want to take her to her first day of school, and I can only do that if I am healthy."

- 27-year-old HIV-positive South African man -42

A study found that the HIV prevalence rate in Uganda had been reduced by 70% since the early 1990s. It was estimated that half of million Ugandan are HIV positive in 2004, compared with 1.5 million a decade before. It was believed that the reduction in HIV prevalence was due to the fact that people limited their number of sexual partners as well as effective prevention efforts in local communities. 43

"In Uganda people became engaged with the epidemic at the community level. Local care groups, religious movements, non-governmental organisations and care networks all spread the message. Families, friends and neighbours began talking about HIV prevention and care, and sexually transmitted diseases stopped being a taboo subject."

A survey of US media coverage of the AIDS epidemic revealed that the number of AIDS-related stories peaked in 1987. This rapidly declined in the early 1990s, despite these being the peak years for AIDS deaths. The stories increased slightly in 1991, when Magic Johnson spoke publicly about his HIV-status. The amount of stories revived again in 1996-7 with the introduction of combination therapy.44

In May, five Bulgarian nurses and a Palestinian doctor accused of deliberately infecting children with HIV were sentenced to death by a Libyan court. The medical staff were detained in 1998 and the trial started in 2000.45

The US porn industry was hit by fears of HIV outbreak among its stars. By May, five porn actors had been found to be HIV-positive.46 The porn business in the US is believed to be worth billions of dollars every year and its stars are frequently monitored for HIV.47

A man jailed for eight years, in October 2003,for inflicting biological grievous bodily harm by infecting two lovers with HIV won the right to a retrial. Mohammed Dica, was the first person in 137 years to be convicted in England and Wales for sexually transmitting a disease. The Court of Appeal ruled that the judge at Dica's trial in October should not have withdrawn from the jury the issue of whether the women consented to intercourse, knowing Dica was HIV positive. The judge at the trial in October had held that consent was irrelevant and provided no defence because, under legal precedent, the women had 'no legal capacity to consent to such serious harm'.48

[Monte]

someone tell this girl to use google.

[aldango]

Someone tell this dude to use links and not ctrl-v.

[hendy]

Originally posted by sppunk

.
.
.

tl/dr

[Dead]

"Gay Cancer"

I guess they didn't have political correctness back then.

[mewl]

i read that. i don't know why. scary shit...

[Toby]

Originally posted by Monte
someone tell this girl to use google.

Why use google when you have netphoria.

[Monte]

Originally posted by Toby
Why use google when you have netphoria.

because netphoria is slow.

[Toby]

Originally posted by Monte


because netphoria is slow.

:erm since when?

[Ketchup]

Originally posted by Ihaman
People like you.

i do not disagree with this statement.

[Bobbin TB]

Originally posted by Ihaman
People like you.

oh snap!

[Tchocky]

The long and short of it:

Homosexual African men who also practiced beastiality started having sex with chimps, many of which are infected with AIDS but are more or less immune to it. They soon immigrated to all corners of the world spreading the virus to their fellow gay men.

Thus a plague was born

[Monte]

Originally posted by Toby
:erm since when?

honestly in the time you search on google, you could get a lot father than to wait for netphoria to tell you anything. Based on the assumption that almost anyone here would use google to answer someone question.

Netphoria is just a slow as far as giving me information

[Dead]

Originally posted by Tchocky
The long and short of it:

Homosexual African men who also practiced beastiality started having sex with chimps, many of which are infected with AIDS but are more or less immune to it. They soon immigrated to all corners of the world spreading the virus to their fellow gay men.

Thus a plague was born

How did it jump from the gay people to the straight people?

[Tchocky]

Originally posted by Dead

How did it jump from the gay people to the straight people?

Bisexuals.

[ammy]

Originally posted by Dead

How did it jump from the gay people to the straight people?

i bet there were some bi people too, dude.

[smiling politely]

Originally posted by Tchocky


Bisexuals.

That, and I'm sure there were some gay junkies who shared needles with straight people.