Thursday is World AIDS Day.
Good morning Year 12/13
AIDS, as you may know, is caused by HIV – or the human immunodeficiency virus - which when it infects humans, destroys the immune system making the person susceptible to other infections such as bacterial and other viral infections or cancers.
Since the early 1980s when it was first publicised, such infections have worldwide led to the deaths of somewhere approaching 40 million people, with current projections suggesting annual death rates of over 0.5 million and infections as high as 1.7m. About 40 million live with the virus today. Fortunately research has led to the development of powerful anti-viral drugs which, while not providing a cure or a vaccine, have thankfully meant that many can live with the disease and lead a pretty near normal life with normal life expectancy.
So what have we learnt as a result of the AIDS pandemic? Thinking about World AIDS Day made me reflect on what the lessons are to be learnt - and here are mine:
Lesson 1: Collective amnesia exists
The recent covid pandemic has been estimated to have killed 6-7million people in the past 3 years. Many of us have compared the covid pandemic with the flu pandemic of 1918 which it was estimated killed between 50-100 million. Such comparisons have almost stated that the 1918 pandemic was ‘the last great pandemic’ before covid. And of course while the symptoms might be similar, others have pointed out our collective amnesia of the AIDS pandemic - and probably the reason for this has been the result of Lesson 2…
Lesson 2: Our response to events is sometimes conditioned by pre-existing prejudices which are poorly informed and created by group- think psychologies.
Much of the public’s response to the AIDS pandemic in the 80s was conditioned by discriminatory attitudes towards homosexuality. At a time when the government’s Section 28 prohibited schools from teaching about the acceptance of same sex relationships [and not the promotion as some people suggested] and when 3 in 5 people openly expressed views in surveys that homosexuality was morally wrong, one can see why a disease that was initially associated with the gay community was seen as either a punishment for sexual deviancy or indeed, as some groups saw it, a punishment from god. That response in turn stigmatised an entire whole group of people.
It is true that individuals who either practise unsafe sex and with different partners are more exposed to the infection - and often this included members of the gay community in the 1980s - but this was by no means a ‘gay disease’ and public ignorance that HIV could be spread by unprotected sex between heterosexual couples, blood transfusions, unclean needles, and pregnancy was poorly understood. This in turn links to Lesson 3…
Lesson 3: Governments are often slow to act
Just as many were critical of the slow response of our government to the covid response - particularly in countering the spread of the virus in the care homes, so in the early 1980s the government’s initial response was slow. There were of course reasons for this - a failure to understand the significance of the disease, prejudice, and competing priorities. But it was only by the mid-1980s that governments began to wake up to the crisis and began to publish health advice which attempted, somewhat imperfectly, to counter the contemporary prejudices which saw AIDS as a ‘gay disease‘. Of course the power of government to act varies country by country which links to my Lesson 4…
Lesson 4: Death rates around the world vary according to wealth - and the ability of a country to educate, protect and support their population with antiviral drugs.
AIDS has become a chronic disease whose prevalence is greatest in sub-Saharan Africa where an estimated 68% of all cases and 66% of all deaths in 2016, by way of illustration, can be located. This means infection rates of 5% of all adults in countries such as Botswana and parts of South Africa with life expectancy almost halving in those countries amongst certain groups. The knock-on economic effects have been equally catastrophic with lost days at work, orphaned dependent children, strains on medical care by way of example. But even wealth and public education can find it hard to counter misconceptions which links to my Lesson 5…
Lesson 5: Misconceptions and conspiracy theories are hard to eliminate
Even in a recent British survey in 2014 - 16% of the public thought AIDS could be spread by kissing, 4% from a public toilet seat and 5% from sneezing. Similarly the prevalence of conspiracy theories remain - AIDS as a disease created by the US government to kill members of the gay community, or a belief that AIDS was created in a western lab to infect either African or African American communities. The prevalence of such theories has declined as public knowledge and the rise of trusted scientific research has developed. Which thankfully leads to my Lesson 6…
Lesson 6: Human ingenuity, human interaction, human support can help combat pandemics.
Diseases – like Covid - which infect large swathes of the population can be countered by a combined effort of coordinated and swift government action, the work of the scientific community, the targeted support for communities with education and public information, financial support for drug therapies and equal access to such therapies, and a collected effort to challenge prejudice and counter ignorance. The legalisation of same sex marriage in 2013 in the UK has probably had as profound an effect on social attitudes as any other act to date.
So while AIDS may not present today the same apocalyptic message as it did to me growing up in the 1980s , reflect on the significance of this ‘forgotten epidemic’ but one which still presents a major problem in many countries – particularly in the poorer corners of the world.