News / Africa

Reflections on 30 Years of HIV/AIDS

A child with HIV is given medication by a care-giver in Durban, South Africa
A child with HIV is given medication by a care-giver in Durban, South Africa

Multimedia

Audio
Joe DeCapua

The HIV/AIDS epidemic is 30 years old. Nearly 30 million people have died from complications of the disease and more than 33 million are currently living with it. There’s a better chance than ever of living a long, productive life despite infection. But there’s still no cure or vaccine. The top U.S. official on HIV/AIDS talked recently about the early days of the epidemic and the progress that’s been made since then.

On June 5, 1981, the first official cases of HIV/AIDS were reported in the United States among gay men in Los Angeles. The disease was around long before that. It’s just that no one knew what it was or what to call it. It was already taking a toll in Africa, where it was called slim disease. That’s because people lost so much weight before they died.

Ambassador Eric Goosby
Ambassador Eric Goosby

Ambassador Eric Goosby is the U.S. Global AIDS coordinator and is in charge of PEPFAR, the President’s Emergency Plan for AIDS Relief. But it wasn’t always so. In the beginning of the epidemic, Dr. Goosby worked in San Francisco, where a lot of gay men started showing up in the emergency room.

“I wanted to treat diseases that I could cure. Not chronic, progressive diseases, but diseases I could throw an antiretroviral drug at it or an antibiotic and end it. And the first group of physicians and nurses that cared for populations who were HIV impacted was mostly infectious-disease-oriented mindsets that came at it, not kind of oncology, hospice, chronic progress disease types,” he said.

He had 500 HIV/AIDS patients during his years in San Francisco. All 500 died.

“During a period of no effective antiretroviral therapy, we got very good at diagnosing and treating opportunities infections early. One infection, two infections, usually three or four infections and then the fourth or fifth one would take the patient,” he said.

Nothing worked

Goosby asked, “Was this a failure in my ability to be a physician? Was I failing the patient and the family that went through the death with the patient that I was caring for?”

When he met his patients, he knew he would be with them until they died. After seven years of this, it took a toll on Goosby and his colleagues.

“We all began to have more emotional liability than any of us had ever had before. I can remember seeing a stray dog on the street would upset me in a way that was disproportionate to what it should be. At the time there was a commercial about just phone home and that would well me up in an emotional kind of moment. And everybody who was in the clinic at the time had exactly the same thing. And it was really a post traumatic stress phenomena that we didn’t recognize at the time,” he said.

He and his colleagues began to gather and talk about their patients - and not just in a clinical way.

“You don’t get attached to every patient in the same way. But every once in a while you have a patient that for whatever reason you relate to on multiple levels and you grieve their loss. And acknowledging that we could do that and talk to each other about it, knowing all of us were in front of the same dilemma, made a huge difference for us,” he said.

Goosby says when he had his first son the realization of what was happening became most acute. Every one of his patients was somebody’s son and they all had parents who loved them as much as he loved his.

Africa

In the following years, Goosby played a major role in developing U.S. domestic HIV/AIDS policy. And then, in the early 90s, he visited Zambia, South Africa and Kenya.

“When I came to these countries, there were three, four people in the bed. There were people under the bed. People in the hallways. You stepped over people to get to patients on the ward. That was the norm in every hospital I visited and had mostly opportunistic infections that were TB related or cryptococcal meningitis toxoplasmosis,” said Goosby.

That’s a brain infection caused by a fungus. All the patients were in the late stages of HIV/AIDS. None had received antiretrovirals.

A lot has changed since then, not only due to scientific research and greater awareness, but also because of outspoken activism around the continent, including lawsuits demanding access to new AIDS drugs.

The PEPFAR program, which began under President Bush and continues under President Obama, is credited with helping to put millions of people on antiretrovirals. By the time the drugs reached Africa, it was known that a combination of drugs worked much better than using a single antiretroviral. That meant a lower chance of developing resistance.

“Africa has benefitted from starting from day one with three drugs. You will not develop resistance if you are not replicating with your virus. So, a person who’s been on antiretrovirals, they don’t develop resistant organism because the organism isn’t dividing,” said Ambassador Goosby.

The challenge now is to put more infected people on antiretrovirals during tough economic times. Goosby says hundreds of millions of dollars have been saved by switching to generic forms of the drugs and using trucks and trains to transport them, rather than planes. PEPFAR will also work with the Global Fund to Fight AIDS, TB and Malaria to combine their purchasing power to drive down the cost of the drugs even more.

Goosby says they have to be smarter and more effective. He adds the American people should be proud of the many lives the United States has saved. These days, he sees a lot more people living with AIDS than dying from it.

You May Like

Egyptian Human Rights Activist Gets 15-Month Prison Term

Well-known lawyer and human rights activist Mahinour el-Masry and two others have been sentenced to 15 months in prison on charges of attacking a police station More

Multimedia British Banks to Review of Possible Corrupt FIFA Payments

Barclays, Standard Chartered among dozens of banks mentioned in US indictment last week charging 14 media and marketing executives and officials at FIFA More

India Heatwave Death Toll Crosses 2,000

Showers and thunderstorms in parts of southern India Sunday brought some much-needed relief but officials said the intense heat was likely to continue for another day More

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Texas Floods Test Agencies' Ability to Coordinate in Emergencyi
X
June 02, 2015 2:00 AM
The recent floods in Texas have demonstrated the value of emergency management systems to coordinate the efforts of local, state and federal government agencies as well as private relief groups. VOA’s Greg Flakus filed this report from Houston on how the system worked during recent flooding.
Video

Video Texas Floods Test Agencies' Ability to Coordinate in Emergency

The recent floods in Texas have demonstrated the value of emergency management systems to coordinate the efforts of local, state and federal government agencies as well as private relief groups. VOA’s Greg Flakus filed this report from Houston on how the system worked during recent flooding.
Video

Video UN Appeals For $500 Million to Fund Aid In Iraq

The United Nations will launch an appeal this week at the European Parliament for $500 million to support humanitarian aid operations in Iraq. U.N. officials say the existing programs in Iraq are running out of funds at a time when many more Iraqis are getting displaced and need help. Zlatica Hoke reports.
Video

Video Heat-resistant Glassware Celebrates 100th Anniversary

One hundred years ago, a new brand of kitchenware named Pyrex entered the American market, firmly imprinting its name into the psyche of consumers. It is still being manufactured while the early models are now collectors’ items. VOA’s George Putic reports.
Video

Video Rescue Teams Try to Save Wildlife Affected by California Oil Spill

Dead animals have been found almost daily since a pipeline failed May 19, releasing thousands of gallons of crude oil into the ocean and beaches of central California, but rescue workers are trying their best to save stricken creatures. From SeaWorld San Diego, the primary care facility for mammals covered in oil, VOA's Elizabeth Lee reports.
Video

Video Legends of the Blues

As blues legend BB King is laid to rest in his hometown, Indianola, Mississippi, fans around the world are keeping his legacy and his music alive. Some of the musicians who played with King and other notable performers put out a recording under the name Original Legends of the Blues. Meet them and hear their music in this report written, narrated and directed by VOA Houston correspondent Greg Flakus.
Video

Video New York's One World Trade Center Observatory Opens to Public

From New Jersey to Long Island, from Northern suburbs to the Atlantic Ocean, with all of New York City in-between.  That view became available to the public Friday as the One World Trade Center Observatory opened in New York -- atop the replacement for the buildings destroyed in the September 11, 2001, attacks.  VOA’s Bernard Shusman reports.
Video

Video Seoul Sponsors Korean Unification Fair

With inter-Korean relations deteriorating over the North’s nuclear program, past military provocations and human rights abuses, many Koreans still hold out hope for eventual peaceful re-unification. VOA’s Brian Padden visited a “unification fair” held this week in Seoul, where border communities promoted the benefits of increased cooperation.
Video

Video Modular Robot Getting Closer to Reality

A robot being developed at Carnegie Mellon University has evolved into a multi-legged modular mechanical snake, able to move over rugged surfaces and explore the surroundings. Scientists say such machines could someday help in search and rescue operations. VOA’s George Putic reports.
Video

Video Shanghai Hosts Big Consumer Electronics Show

Electronic gadgets are a huge success in China, judging by the first Asian Consumer Electronics Show, held this week in Shanghai. Over the course of two days, more than 20,000 visitors watched, tested and played with useful and some less-useful electronic devices exhibited by about 200 manufacturers. VOA’s George Putic has more.
Video

Video Forced to Return Home, Afghan Refugees Face Increased Hardship

Undocumented refugees returning to Afghanistan from Pakistan have no jobs, no support system, and no home return to, and international aid agencies say they and the government are overwhelmed and under-resourced. Ayesha Tanzeem has more from Kabul.

VOA Blogs