|THE CHANGING FACE OF AIDS
The fight against AIDS shifts to the developing nations.
July 17, 1998
in this forum:
Are we using the third world as guinea pigs? What is the status of vaccine research? Will funding for a vaccine limit ressearch into drug treatments? Do drug-resistant AIDS viruses mean that drug treatments will become obsolete? Has a drop in public attention hurt the fight against AIDS? Mark Heller of Newark, DE asks: Do you believe it will be more difficult to keep public interest in and public money for AIDS research if the disease is relatively under control here, but spreading like wildfire abroad? I know it is an unpleasant question, but I wonder if America is becoming a bit too comfortable.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, responds:We are, I fear, becoming a "bit too comfortable." There is, unfortunately, a growing misperception that AIDS is no longer a problem in this country. Although the mortality rate from AIDS has declined due to the introduction of highly active antiretroviral regimens, the number of new infections in the USA has plateaued at approximately 40,000 each year. This is an unacceptably high level, and much remains to be accomplished in terms of prevention, notably the development of a safe and effective vaccine.
In addition, although substantial improvements have been made in the care of HIV-infected individuals, the currently available drugs are plagued by substantial toxicities and the inevitable development of drug resistance. The next generation of anti-HIV drugs, and better access to therapy, is urgently needed to help the 650,000-900,000 Americans who are currently HIV-infected.
As you note, the epidemic continues to accelerate in other parts of the world, notably in sub-Saharan Africa and southeast Asia. These realities underscore the importance of policymakers, public health officials and concerned citizens in combatting misperceptions that "AIDS is over" by cogently and soberly discussing these realities in whatever fora are available to them.