McLaughlin, L. The Next AIDS Decade: Acknowledging a Grim New Era in the Fight against the Disease. (1994, August 7). The Boston Sunday Globe.

Leaders in AIDS research say the prospects of finding successful treatments and vaccines to combat AIDS "are incredibly slim...The outlook for substantial new developments is at an all-time low, with little to nothing on the horizon for effectively and directly treating or preventing AIDS."

The lack of new weapons against AIDS, despite prodigious efforts to create them, coupled with the heterosexual spread of AIDS into the general population in Asian countries, are grim messages from the 10th International Conference on AIDS held in Yokohama, Japan. Another theme from the conference is that the struggle against AIDS will be much longer and harder than once thought, and that long-range strategies are needed in order to combat the disease.

Dr. Clyde Crumpacker, head of AIDS research at the Beth Israel Hospital, explains:

We are at the end of a major era in the fight against AIDS. When we first confronted the challenge of AIDS, we never expected it would be so difficult. Contributing to the spread of AIDS were the Reagan-Bush presidencies. Twelve years lost, years without public leadership about the seriousness of the disease, its threat to all of us...As a nation we just closed our eyes to the complexity of the virus and to the steady spread of its infection. We were overly enthusiastic and full of misguided hope about past approaches to therapies for treating it...The virus multiplies and mutates so rapidly, it has a unique ability to evade standard medicines and traditional vaccines. But we don’t have to cure it in the usual sense. We don’t have to rid a person of every virus particle. A person could live with the AIDS virus, if the quantity of the virus cold be kept under control, be limited like insulin in diabetes.

The article includes unsettling global trends:

• In North America and Western Europe, AIDS has spread primarily through contact with infected blood; but in recent years, these countries are also seeing increased heterosexual spread of AIDS, especially to women and teenagers.
• In Asia, AIDS seems to be spreading far more quickly and dramatically, and is becoming markedly heterosexual. The spread of the disease among heterosexuals in Asia is so intense it is already being likened to the most severe AIDS scenarios in Africa, and may exceed them in the next five years.
• An initial sweep of drug-abusing sex workers in Thailand shows that the first evidence of heterosexual transmission appeared in 1988. Now, in some Thai cities, up to 20 percent of young adults—women and men—are known to be heterosexually infected.
• In India, well over 1 million people are infected with AIDS, and the Indian health ministry projects that 10 million infections will have occurred there by the year 2000.
• In Myanmar (formerly Burma), 60 percent of drug abusers are believed infected. Cambodia, Indonesia, Malaysia, Pakistan, the Philippines, and Vietnam are expected to experience Asia’s next major wave of infection.
• Beginning in the year 2000, more people in Asia will become infected with the AIDS virus each year than in the rest of the world.
• In the U.S., AIDS now claims more than 50,000 lives a year. It has become the leading cause of death in men aged 25 to 44 and is now the fourth-leading cause of death in women in that age group.

The Yokohama meeting concludes a decade of annual conferences unprecedented in the scope of research presented and the prominence of reporting scientists. Dr. Rick Marlink, director of the Harvard AIDS Institute, sees the Yokohama conference as a turning point:

We’ve won many small victories against AIDS, but it’s time now to hunker down for the long, hard fight. Many people have grown tired of hearing about AIDS, but they’re mistaken if they think this disease is going away or that they can escape it. AIDS is still expanding in the U.S. and the rest of the world. We’ve never had a real war on AIDS...But it’s time to.

QUESTIONS FOR REFLECTION AND DISCUSSION

1. In reviewing ten years (1985-1995) of AIDS research, what lies ahead, according to the scientific community? What do you think lies ahead?
2. As AIDS reaches pandemic stages in a number of countries around the world, what can be done to unify efforts to fight the disease?
3. As the disease increasingly targets the heterosexual population, what can be done to educate society about the way the disease spreads among heterosexual people?

IMPLICATIONS

1. Early apathy regarding AIDS ("a nation closing its eyes") has allowed the spread of AIDS on a global scale. As the scientific community continues its efforts at successful treatments and vaccines, educational efforts must be continued to help slow the spread of the disease through AIDS-infected drug paraphernalia shared by drug users or during unprotected homosexual or heterosexual sex.
2. Early efforts regarding the control of AIDS were full of misguided hope. Now it is time to wage war on the disease, to find some therapy that could keep the virus in check.