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

Video Claims to Show Shia Forces in Iraq Executing Sunni Boy

While not yet independently confirmed, brutal killing already has gotten attention of Islamic State followers on social media More

After Six Years, Little Change for Niger Delta's Former Militants

Nigerians who laid down arms in exchange for government amnesty subsidies fear program may end with upcoming presidential elections More

Vietnam Pushes for More Educated Drivers to Curb Road Deaths

Transportation officials hope that making a greater effort to get drivers to learn the rules of the road will reduce fatal crashes 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.
NASA Spacecraft Approaches a Dwarf Planeti
X
George Putic
March 04, 2015 8:51 PM
NASA’s Dawn spacecraft will make history on Friday, March 6, when it becomes the first man-made object to orbit a dwarf planet named Ceres. It is located in the asteroid belt between Mars and Jupiter, almost 500 million kilometers from Earth. Among other objectives, Dawn will try to examine two mysterious bright white spots detected on the planet’s surface. VOA’s George Putic has more.
Video

Video NASA Spacecraft Approaches a Dwarf Planet

NASA’s Dawn spacecraft will make history on Friday, March 6, when it becomes the first man-made object to orbit a dwarf planet named Ceres. It is located in the asteroid belt between Mars and Jupiter, almost 500 million kilometers from Earth. Among other objectives, Dawn will try to examine two mysterious bright white spots detected on the planet’s surface. VOA’s George Putic has more.
Video

Video Young Muslims Radicalized Online

Young Muslims are being radicalized ‘in their bedrooms’ through direct contact with Islamic State or ISIL fighters via the Internet, according to terror experts. There are growing concerns that authorities and Internet providers are not doing enough to counter online extremism - which analysts say is spread by a prolific network of online supporters around the world. Henry Ridgwell reports from London.
Video

Video African Americans Recall 1960's Fight For Voting Rights

U.S. President Barack Obama and thousands of people will gather in the small southern U.S. city of Selma, Alabama, Saturday, March 7th to commemorate the 50th anniversary of a historic voting rights march that became known as “Bloody Sunday." VOA’s Chris Simkins traveled to Alabama and introduces us to some of the foot soldiers of the voting rights struggles of the 1960’s.
Video

Video Positive Messaging Transforms Ethiopia's Image

Ethiopia was once known for famine and droughts. Now, headlines more often point to its fast-growing economy and its emergence as a regional peacemaker. How has Addis Ababa changed the narrative? VOA's Marthe van der Wolf reports.
Video

Video Cyber War Rages Between Iran, US

A newly published report indicates Iran and the United States have increased their cyber attacks on each other, even as their top diplomats are working toward an agreement to guarantee Iran does not develop a nuclear weapon and to free Iran from international sanctions. The development is part of a growing global trend. VOA’s Al Pessin reports from London.
Video

Video Answers Elude Families of MH370 Passengers

For the families on board Malaysia Airlines flight MH370, an airline official’s statement nearly one year ago that the plane had lost contact with air traffic control at 2:40 AM is the only thing that remains confirmed. William Ide reports.
Video

Video Land Disputes Arise Amid Uganda Oil Boom

Ugandan police say there has been a sharp increase in land disputes, with 10 new cases being reported each day. The claims come amid an oil boom as investors appear to be cashing in by selling parcels of land to multiple buyers. Meanwhile, the people who have been living on the land for decades are chased away, sometimes with a heavy hand. VOA's Serginho Roosblad reports.
Video

Video In Russia, Many Doubt Opposition Leader's Killer Will Be Found

The funeral has been held in Moscow for Boris Nemtsov, the opposition leader who was assassinated late Friday just meters from the Kremlin. Nemtsov joins a growing list of outspoken critics of Russia under the leadership of President Vladimir Putin who are believed to have been murdered for their work. VOA’s Daniel Schearf reports from Moscow.
Video

Video Simulated Astronauts Get Taste of Mars, in Hawaii

For generations, people have dreamed of traveling to Mars to explore Earth's closest planetary neighbor. VOA's Mike O'Sullivan reports that while space agencies like NASA are planning manned missions to the planet, some volunteers in Hawaii are learning how humans will cope with months in isolation on a Mars base.
Video

Video Destruction of Iraq Artifacts Shocks Archaeologists

The city of Mosul was once one of the most culturally rich and religiously diverse cities in Iraq. That tradition is under attack by members of the Islamic State who have made Mosul their capital city. The Mosul Museum is the latest target of the group’s campaign of terror and destruction, and is of grave concern to archaeologists around the world. VOA’s Kane Farabaugh reports.
Video

Video Smartphones May Help in Diagnosing HIV

Diagnosing infections such as HIV requires expensive clinical tests, making the procedure too costly for many poor patients or those living in remote areas. But a new technology called lab-on-a-chip may make the tests more accessible to many. VOA’s George Putic reports.
Video

Video Afghan Refugees Complain of Harassment in Pakistan

Afghan officials have expressed concern over reports of a crackdown on Afghan refugees in Pakistan following the Peshawar school attack in December. Reports of mass arrests and police harassment coupled with fear of an uncertain future are making life difficult for a population that fled its homeland to escape war. VOA’s Ayesha Tanzeem reports from Islamabad.

All About America

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More