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

Ebola Death Toll Nears 5,000 as Virus Advances

West Africa bears heaviest burden; Mali toddler’s death raises new fears More

Jordan’s Battle With Islamic State Militants Carries Domestic Risks

Despite Western concerns that IS militants are preparing a Jordanian offensive, analysts call the kingdom's solid intel a strong deterrent More

Asian-Americans Assume Office in Record Numbers

Steadily deepening engagement in local politics pays off for politicians like Chinese-American Judy Chu 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.
Talks to Resume on Winter Gas for Ukrainei
X
Al Pessin
October 25, 2014 4:21 PM
Ukrainian and Russian officials will meet again next week in an effort to settle their dispute over natural gas supplies that threatens to leave Ukraine short of heating fuel for the coming winter. VOA’s Al Pessin reports from London the dispute is complex, and has both economic and geopolitical dimensions.
Video

Video Talks to Resume on Winter Gas for Ukraine

Ukrainian and Russian officials will meet again next week in an effort to settle their dispute over natural gas supplies that threatens to leave Ukraine short of heating fuel for the coming winter. VOA’s Al Pessin reports from London the dispute is complex, and has both economic and geopolitical dimensions.
Video

Video Smugglers Offer Cheap Passage From Turkey to Syria

Smugglers in Turkey offer a relatively cheap passage across the border into Syria. Ankara has stepped up efforts to stem the flow of foreign fighters who want to join Islamic State militants fighting for control of the Syrian border city of Kobani. But porous borders and border guards who can be bribed make illegal border crossings quite easy. Zlatica Hoke has more.
Video

Video Comanche Chief Quanah Parker’s Century-Old House Falling Apart

One of the most fascinating people in U.S. history was Quanah Parker, the last chief of the American Indian tribe, the Comanche. He was the son of a Comanche warrior and a white woman who had been captured by the Indians. Parker was a fierce warrior until 1875 when he led his people to Fort Sill, Oklahoma, and took on a new, peaceful life. As VOA’s Greg Flakus reports from Cache, Oklahoma, Quanah’s image remains strong among his people, but part of his heritage is in danger of disappearing.
Video

Video China Political Meeting Seeks to Improve Rule of Law

China’s communist leaders will host a top level political meeting this week, called the Fourth Plenum, and for the first time in the party’s history, rule of law will be a key item on the agenda. Analysts and Chinese media reports say the meetings could see the approval of long-awaited measures aimed at giving courts more independence and include steps to enhance an already aggressive and high-reaching anti-corruption drive. VOA’s Bill Ide has more from Beijing.
Video

Video After Decades of Pressure, Luxembourg Drops Bank Secrecy Rules

European Union finance ministers have reached a breakthrough agreement that will make it more difficult for tax cheats to hide their money. The new legislation, which had been blocked for years by countries with a reputation as tax havens, was approved last week after Luxembourg and Austria agreed to lift their vetoes. But as Mil Arcega reports, it doesn’t mean tax cheats have run out of places to keep their money hidden.
Video

Video Kobani Refugees Welcome, Turkey Criticizes, US Airdrop

Residents of Kobani in northern Syria have welcomed the airdrop of weapons, ammunition and medicine to Kurdish militia who are resisting the seizure of their city by Islamic State militants. The Turkish government, however, has criticized the operation. VOA’s Scott Bobb reports from southeastern Turkey, across the border from Kobani.
Video

Video US ‘Death Cafes’ Put Focus on the Finale

In contemporary America, death usually is a topic to be avoided. But the growing “death café” movement encourages people to discuss their fears and desires about their final moments. VOA’s Jerome Socolovsky reports.
Video

Video Ebola Orphanage Opens in Sierra Leone

Sierra Leone's first Ebola orphanage has opened in the Kailahun district. Hundreds of children orphaned since the beginning of the Ebola outbreak face stigma and rejection with nobody to care for them. Adam Bailes reports for VOA about a new interim care center that's aimed at helping the growing number of children affected by Ebola.

All About America

AppleAndroid