November 30, 2003
World AIDS Day
The red ribbon and banner on the World Bank headquarters in Washington.
The first World AIDS Day was held in 1988. At the time I was working for a contractor that conducted clinical drug trials; the one I worked on most was a pediatric study. There were a lot of trials going then; AZT was the only drug approved and the research pace was finally picking up.
We had a few hundred kids enrolled, many of them "boarder babies" living in hospitals because they had been orphaned or abandoned. In May of '88, there had been 981 pediatric AIDS cases reported to the Centers for Disease Control. That doesn't sound like that many, but the numbers were going up steadily as children were born to HIV-positive mothers. Another study my company worked on was a maternal AZT trial; when that study concluded in 1994 they'd found that AZT therapy cut maternal transmision from 25% to 8%. I don't keep up with the research as much now, but I believe the protocols used today are even more effective.
I remember sitting in an NIH auditorium back then and hearing a speaker say that someday HIV would be a managable disease, like asthma or diabetes, not an automatic death sentence. For some people this has indeed come to be. Some of them are friends of mine. Some of them, I hope, are the children from the study I worked on fifteen years ago.
A press release I saw last week from the United Nations and the World Health Organization reminded me not to be so complacent about how far we've come in fifteen years, though. Instead I'm reminded by how much worse it has gotten. There are five million new HIV infections in the world this year, and the three million deaths from AIDS is the highest annual death toll. The number of people living with HIV/AIDS is somewhere between 34 and 46 million.
It is a crisis in Africa. Eastern Europe and central Asia have epidemics on the horizon. And we aren't out of the woods in the U.S.: the CDC estimate that a quarter of the 850,000 to 950,000 HIV-positive Americans are unaware of their infections and therefore aren't being treated. And if they don't know they are infected, they aren't necessarily taking steps to prevent transmitting the virus to more people either.
The 1988 numbers seem like drops in the ocean when I look at the number forty six million. It is frighteningly overwhelming...in 1988 I felt like my small contribution made a difference. Does it make a difference now, my bit of volunteer work at a local AIDS service organization, the occasional check? Such little drops, such a big, big ocean.
Yes.
World AIDS Day, December 1, is a backdrop for the big numbers and the huge challenges and actions on a global scale.
But it is also about little drops, things I can do, things anyone can do: Get a blood test. Teach a kid. Take part in a fundraiser. Volunteer.
Think about it.
Posted by Nic at November 30, 2003 11:46 AM | TrackBack