Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.
San Francisco Chronicle - Sunday, June 3, 2001
There is no cure, no vaccine is in sight and the disease is spreading like wildfire to every corner of the map, especially in developing countries.
And there is alarming new evidence that AIDS is on the rebound in the United States and is spreading especially fast among gay and bisexual black men.
That is ominous news on the eve of the somber 20th anniversary of the AIDS plague breakout.
On June 5, 1981, the federal Centers for Disease Control (CDC) in Atlanta reported "a mysterious outbreak of a sometimes fatal pneumonia among gay men." Similar cases had turned up in San Francisco. It marked the start of a medical catastrophe.
Since then, San Francisco has recorded 27,484 AIDS cases and 18,605 AIDS- related deaths. About 800,000 cases have been reported in the United States, and 450,000 of those patients have died.
Pernicious, insidious and incurable, AIDS is the deadliest pandemic since the Black Death wiped out half the population of Europe in the 14th century. Soon, AIDS will surpass that plague's terrible toll.
The numbers of infected people are so huge and the suffering so vast as to be almost beyond comprehension.
Besides the nearly 22 million people who have succumbed to AIDS-related ailments, another 36 million are infected and living with the disease. About 25.3 million victims await a dreadful death in sub-Saharan Africa, hardest hit of any region.
In Africa alone, there are some 13 million AIDS orphans. Epidemiologists predict there will be 40 million within 10 years.
Meanwhile, the human immunodeficiency virus (HIV), the deadly pathogen that causes AIDS, looms over India, China and Southeast Asia where teeming populations, poverty and a shortage of medical care provide fertile fields for contagion.
Worldwide, there were 5.3 million new infections last year and they continue at a rate of 16,000 every day.
Faced with a widening global disaster, governments, scientists and public- health workers are struggling to hold back the malignant tide with a three- pronged strategy: prevention programs, virus-suppressing drugs and the search for a vaccine.
Prevention and education programs are helpful. But social, religious and cultural barriers in many countries make it difficult to even discuss AIDS. Powerful drug combinations work to suppress symptoms and allow patients to live longer, healthier lives, but it's not known how long drugs can stave off fatal relapses.
A vaccine, the Holy Grail of AIDS research, offers a glint of hope on a far horizon, but the ever-mutating virus is as elusive as it is deadly. One researcher likens the quest for an AIDS vaccine to finding a vaccine for cancer.
About 30 clinical trials are under way, but even optimistic researchers do not expect an effective vaccine for 10 or 15 years.
Only lately have the big pharmaceutical companies reluctantly reduced the cost AIDS medicine to impoverished countries, but the drugs are still far beyond the medical budgets of the countries most at risk.
With a firestorm of AIDS raging out of control in Africa and threatening the rest of the world, radical solutions are needed.
The United Nations General Assembly will hold a special session this month, when world leaders will gather for the first time to create a global plan to attack AIDS.
U.N. Secretary General Kofi Annan's call for a $10 billion Global AIDS Fund to treat and prevent the disease in the developing world is a start.
As the richest country in the world, the United States has a moral obligation to take a leading role and to provide a healthy portion of the funding. President Bush's commitment of only $200 million to the fund is woefully inadequate.
Twenty years into the AIDS calamity, world leaders must be willing to ignore borders, forgo profits and take fast action to halt the advancing plague before it is too late.
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