The Aids Pandemic: The How and Why of Where We Are Today

The AIDS Pandemic: The how and why of where we are today

Christian MacMillan

Crisis Communication Management - MSL-5200

Dr. Richard Bell

9 November, 2010

HIV/AIDS - The Long Road

100,000,000. That is the projected death toll from HIV/AIDS by the year 2025 - in Africa alone. The disease, or related complications, has already claimed 25 million lives since June 5, 1981 and infected another 40 million others (Leonard, 2006) averaging over 2361 deaths per day. No other single disease in history has caused this level of devastation. Nor has any other disease caused as much controversy, pitting social advocates from different ideological camps against one another while causing the medical community to raise its hands in despair, unable to find a cure.

Scientists have traced the origins of HIV/AIDS to a death in 1959 in Kimshasha, Republic of Congo, where an African tribesman died of a mysterious death (Krieger, 1998). To this date, it remains the first known human death from HIV/AIDS. Scientists have long known the disease originated in chimpanzees, but still do not know what caused it to make the leap to humans. There is speculation it was transmitted through the food chain; African tribes included monkeys and chimpanzees in their dietary menu. Those chimpanzees carried the original virus, Simian Immunodeficiency Virus (SIV). Scientists have used the blood sample from the African tribesman to determine the likely timeframe the jump was made, based on the known mutation rate. That knowledge has led them to calculate the jump occurred in the 1940's or early 1950's. Those same calculations, used on cases discovered later, indicate HIV/AIDS likely arrived in the United States in 1968, yet it remained unrecognized as a disease for another 12 years. The irony of the situation is we can calculate the timeline of the mutation from a relatively harmless disease in monkeys to perhaps the most dangerous disease the human race has ever been exposed to, yet 51 years later we still cannot seem to staunch the death toll.

All this brings us to 1980. Ken Horne has the dubious honor of being the first recognized case of HIV/AIDS in the United States. There were a total of 4 deaths in 1980 attributed to HIV/AIDS. Over the next decade the deaths in the US were as follows (Aids Timeline, 2006):

1981 234 Deaths

1982 853 Deaths

1983 2,304 Deaths

1984 4,251 Deaths

1985 5,636 Deaths

1986 2,960 Deaths

1987 4,135 Deaths

1988 4,855 Deaths

1989 14,455 Deaths

During this period, a number of high profile items occurred highlighting the growing epidemic (24 Years of AIDS, n.d.). Rock Hudson admitted he was gay and had AIDS; he died within a year. Ryan White, a 13-year old hemophiliac was barred from attending public school because he had HIV/AIDS, but not before becoming the poster-child for the growing stigma attached to the disease; he died at 19. The Mayor of San Francisco had the bath houses, a popular gathering place for the city's gay men, closed as a preventive measure; it was highly unpopular and fueled the "lifestyle" debate swirling around the virus and its predominance in gay men. Two popular plays, "The Normal Heart" and "And The Band Played On" were written and produced on Broadway. The US Surgeon General recommended the use of condoms and sex education as the best means of prevention and mailed AIDS information to every US household. The efforts of medical researchers led to the development of Azidothymidine (AZT) as a treatment; extremely expensive, within one year the cost was driven down by 20% due to protests by the activist group, ACT UP. By the end of the decade, there was at least one case of HIV/AIDS reported in every region of the world, prompting the World Health Organization (WHO) to designate and organize the first World AIDs Day on December 1, 1988.

The Response

One might look at this growing epidemic and say "We have to do something." In fact, much was being done. Researchers were working feverishly to develop drugs for prevention and treatment; the US Surgeon General was communicating with the people, something which rarely happened before; and the WHO was setting aside a day for the entire world to realize the scope of the problem facing mankind. There was recognition of the problem and an outcry from people to address the issue. Then why does the death toll still continue to climb? With all the money being spent on the problem, why is it continuing to worsen?

As preposterous as it may sound, perhaps the problem is there are too many people involved; there is no single, authoritative spokesperson and there are multiple agendas which are linked to the spread of the disease. All one needs do is search the internet for HIV/AIDS and they will be inundated with intelligent insight and ignorant stupidity; there are claims of conspiracy to eradicate populations, particularly in under-developed areas like Africa, mixed in with claims that this is all a G8 conspiracy to privately channel money to the pharmaceutical companies.

Early messages were focused on awareness and prevention and disseminated through posters and brochures, conspicuously placed in areas were those most at risk of infection might see them. Many focused on what were likely causes (shared needles, sex without condoms, etc.) and myths about transmission (infection from toilet seats, doorknobs, swimming pools, etc.) Most fell on deaf ears. The US Surgeon General's message, mailed in 1988 to all American households, included the following excerpt:

"I feel it is important that you have the best information now available for fighting the AIDS virus, a health problem the President has called 'Public Enemy Number One.' Stopping AIDS is up to you, your family, and your loved ones."

I doubt that most of those families made the connection between this disease, spreading through the gay community and drug users, and their typical American family. The mailing included a great deal of information, at that time considered cutting edge. It was well thought out and organized. It did not make accusations; it only provided advice and assistance. Yet there is little if any evidence it made any difference. Quite the contrary; many individuals who were involved in high-risk behaviors associated