AIDS tells the story of mankind’s powers of observation, the capacity of science to figure things out, the importance of citizen movements, the globalization of problem-solving, the intolerance of extreme inequality, the impulse for generosity, the ability of government to do good. It captures everything that has made the turn of the millennium a time of optimism as well as crisis.
“There is no other infectious disease in the last 100 years that has caused so much suffering and so much death and appeared so unexpectedly,” said Diane V. Havlir, an AIDS physician at the University of California at San Francisco and co-chair of this year’s International AIDS Conference. “Also no other disease where the benefits of the investment in science and response have been so great.”
AIDS conferences are the stop-action frames of that narrative.
The 19th International AIDS Conference opens Sunday in Washington.
It is in the United States for the first time in a generation. Its convening on American soil acknowledges the end of a long and controversial U.S. policy — a ban on known HIV-positive people from entering this country. As a result, 25,000 researchers, activists, clinicians, social scientists and journalists will be around town and underfoot this week.
If by some chance there were a Rip Van Winkle character among them and he asked what had happened in the 22 years since an international AIDS conference was held in the United States, the answer would be simple.
Just about everything.
In 1990, when the meeting was held in San Francisco, AIDS was an almost uniformly fatal disease. The public and much of the medical profession feared it and its victims, mostly white homosexual men and intravenous-drug users. The one AIDS drug worked poorly.
AIDS advocates waged angry and occasionally violent protests for more research and better drugs. Pharmaceutical companies and many scientists resented the meddling by “non-experts” (but eventually came to include them in decisions). Preventing infection required difficult changes in behavior. The biological workings of the infecting agent, human immunodeficiency virus (HIV), was mostly a mystery.
In 2012, HIV infection is a dangerous but treatable disease. Many people will live with it for decades and die of other ailments. It is less feared and stigmatized, although many sufferers still live at society’s margins. There are now two-dozen drugs to fight the virus. They are expensive but available to nearly everyone who needs them in wealthy countries and taken by more than 8 million people in poor ones.
A vaccine against AIDS remains elusive. But there are strategies afoot that may further quench the global epidemic, which peaked during two decades separating the 1990 conference and this one. And now there are phrases such as “AIDS-free generation” and “cure for AIDS” in the air.