The challenges of AIDS - past and present

Hands1 December 2011

By Alex Klaushofer

Thirty years after the first reported cases of AIDS, a unique gathering of experts are examining the early response to the epidemic. The lecture series "AIDS @ 30: Three decades of responding to HIV/AIDS", organised by ESRC-funded post-doctoral research fellow Dr Richard McKay, is thought to be the first time clinicians and historians from around the world are gathered to offer a historical reflection on the outbreak of AIDS.

"These stories matter," says Dr McKay. "Whether they are told by surviving participants, or captured in records for historians to reinterpret and contextualise, it is important to reflect on the journey so far."

Culminating in a last lecture on World AIDS Day 1 December, the lectures are giving rare insights into the challenges faced by those at the forefront of the fight against the disease.

Professor Peter Piot, executive director of UNAIDS 1994-2008, spoke of the difficulty in getting co-operation from key institutions to develop a strategy against the epidemic. "We talk about resistance in disease in a clinical sense, but the biggest resistance is what we've seen from society," he said.

During the 1990s, politicians, experts and aid agencies routinely refused to address the issue, added Professor Piot. "They didn't want to deal with it, because AIDS was not in their plans. It was 20 years before we had a serious global response - which meant that millions of people died."

One study, conducted by researchers at the Harvard School of Public Health, estimated that 330,000 people in South Africa died as a direct result of that failure, Professor Piot added.

Jason Warriner, service quality and governance director at the AIDS charity the Terrence Higgins Trust, highlighted what is seen by some as the downside of the 1980s AIDS publicity campaign. "It did increase public awareness, but it did help stigmatise people with HIV as well," said Warriner.

Professor Anthony Pinching, who was involved in the development of the campaign, took an opposing view, arguing that the publicity made possible frank discussions which may have been life-saving.

Dr McKay's historical research, funded by the ESRC, was the subject of a lecture examining the myth-making of the man deemed to be 'Patient Zero' in the North American epidemic, bringing AIDS to the continent. The "promiscuous" flight attendant Gaétan Dugas was seen as a cold-blooded spreader of the disease - but the research challenges this portrayal, revealing a more nuanced picture of the man and his alleged role.

The lecture series comes soon after the publication of a report by a House of Lords select committee which condemns the provision of resources to HIV/AIDS prevention in the UK as 'woefully inadequate'.

"The challenges remain, and the fight needs to continue," says Dr McKay. "There are very real, long-term costs of not addressing the risks of infection."