AHC: Stop AIDS

With a POD of June 6th 1981 what can be done by medical authorities, community leaders, and the White House to either soften the impact of HIV/AIDS or completely eradicate it?

It was on May 18th 1981 that the first report on AIDS was printed in the media, a gay-aimed tabloid The New York Native under the headline of "Disease Rumors Largely Unfounded

“Last week there were rumors that an exotic new disease had hit the gay community in New York. Here are the facts. From the New York City Department of Health, Dr. Steve Phillips explained that the rumors are for the most part unfounded….”

(Sources: http://1981.nyc/first-appearances-gay-cancer/ http://www.nytimes.com/2001/06/03/w...ad-20-years-ago-first-clues-birth-plague.html )

Later that year on June 5th AIDS receives it's first mention in a CDC published medical journal Morbidity and Mortality Weekly Report

In the period October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died. All 5 patients had laboratory-confirmed previous or current cytomegalovirus (CMV) infection and candidal mucosal infection. Case reports of these patients follow...

(Full article here: http://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm )

The New York Times did a brief story on a CDC report on July 3rd titled

'Rare Cancer Seen in 41 Homosexuals.''


HIV/AIDS then vanishes from the mainstream media until the Wall Street Journal runs a February 25th 1982 story with the headline


''New, Often-Fatal Illness in Homosexuals Turns Up in Women, Heterosexual Males.''

On May 11th of that year the New York Times issues yet another, more detailed story, as the Federal government starts to notice.

"New Homosexual Disorder Worries Health Officials"


A SERIOUS disorder of the immune system that has been known to doctors for less than a year - a disorder that appears to affect primarily male homosexuals - has now afflicted at least 335 people, of whom it has killed 136, officials of the Centers for Disease Control in Atlanta said yesterday. Federal health officials are concerned that tens of thousands more homosexual men may be silently affected and therefore vulnerable to potentially grave ailments.
Moreover, this immune-system breakdown, which has been implicated in a rare type of cancer, called Kaposi's sarcoma, and seems to invite in its wake a wide variety of serious infections and other disorders, has developed among some heterosexual women and bisexual and heterosexual men.
At a recent Congressional hearing, Dr. Bruce A. Chabner of the National Cancer Institute said that the growing problem was now ''of concern to all Americans.''
The cause of the disorder is unknown. Researchers call it A.I.D., for acquired immunodeficiency disease, or GRID, for gay-related immunodeficiency. It has been reported in 20 states and seven countries. But the overwhelming majority of cases have been in New York City (158), elsewhere in New York State (10), New Jersey (14) and California (71)


Thirteen of those affected have been heterosexual women. Some male victims are believed to have been heterosexual, and to have been chiefly users of heroin and other drugs by injection into their veins. But most cases have occurred among homosexual men, in particular those who have had numerous sexual partners, often anonymous partners whose identity remains unknown.
According to both the Centers for Disease Control and the National Cancer Institute in Bethesda, Md., GRID has reached epidemic proportions and the current totals probably represent ''just the tip of the iceberg.'' Preliminary results of immunological tests have led some Federal health officials to fear that tens of thousands of homosexual men may have the acquired immune dysfunction and be at risk for developing complications such as Kaposi's cancer, infections and other disorders at some future date.
GRID is ''a matter of urgent public health and scientific importance,'' Dr. James W. Curran, a Federal epidemiologist who coordinates the Centers for Disease Control's task force on Kaposi's sarcoma and opportunistic infections, told the Congressional hearing. Opportunistic infections are those that rarely cause illness except in those whose immunological resistance has been lowered by drugs or disease.



More than human suffering is involved. Hospital costs have reached more than $64,000 per patient, and Dr. Curran said that if such costs are typical, ''the first 300 cases account for an estimated $18 million in hospital expenses alone.''



Experts currently think of GRID as a sort of immunological time bomb. Once it develops, it may stay silent for an unknown period, and then, at a later date, go on to produce Kaposi's sarcoma, an opportunistic infection, a so-called auto-immune disorder, or any combination of these.
Further, no one is certain that the immune disorder can be reversed. Many patients have survived a bout of pneumonia or other illness, only to succumb to another or to go on to develop Kaposi's sarcoma or some other fatal cancer. 'Natural' Immunity Suppressor..."

(Full article here: http://www.nytimes.com/1982/05/11/s... homosexual disorder worries officials&st=cse )




Of course throughout all this there were countless other issues: Larry Kramer work in spreading the word that something was wrong, NYC Mayor Koch's hesitation to act because he was a bachelor and was worried he would be smeared as gay, Gaëtan Dugas possibly spreading the epidemic, the panic that "poppers" were the cause of the infections, and the debate among the LGBT community whether to close the bathhouses in San Fransisco.


So, what can be done? It could be argued if the White House even wanted to act so little was known about HIV/AIDS that there was little they could do. I don't know about that though.
 
I think a large part of the problem is that when any new disease comes out, unless people think it's hugely infective and might affect them (e.g. the various SARS/Bird Flu panics) they tend not to be interested. HIV being associated with homosexuality really doesn't help here - it causes people to think that "it won't affect me then" and so leads to a lack of interest in doing anything about it. So to be very cold-blooded about it you need a series of high-profile infections of "normal" members of the public to get any attention.
One possibility is that a cluster of infection is identified in sailors, say if a USN warship had a port call in West Africa and a significant number of sailors came back with the infection. Another possibility would be if it was found to have got into the blood supply - this was known about fairly early (e.g. Ryan White being diagnosed in 1984), but if this is detected earlier and in greater numbers that may also get the PR required.
 
That's... not really going to stop AIDS. Remember, the vast majority of people with AIDS, and an even larger majority of people dying of AIDS, are not American. I saw the same issue when I posted a thread about what if HIV had never evolved in early-20c Leopoldville; the answers I got were about US gay rights and not, say, what the virus did to Southern Africa.
 
Australia responded quickly and effectively to AIDS in the early/mid 80s with needle exchanges and the famous 'grim reaper' ads on TV and thus had one of the lowest AIDS infaction rates in the world. Perhaps the US could do this. although I'd think US politics and social mores would preclude it.
 
Australia responded quickly and effectively to AIDS in the early/mid 80s with needle exchanges and the famous 'grim reaper' ads on TV and thus had one of the lowest AIDS infaction rates in the world. Perhaps the US could do this. although I'd think US politics and social mores would preclude it.

Before tests were available an effective reaction would require a lot of foresight.
The needle route and the gay transmission did point to sexual transmission, but is not a proof. To,at this time go out and say, publically that there is a probably blood and sex transmitted infection and distribute needles and condoms is asking a lot. Possible, but no more than my TL's.
That off course would not have helped Africa, where most cases and deaths have been.
Later, with tests developed a lot more could have been (and Can be) done, tracking cases, condoms again and so forth.
 
The POD is far too late to stop AIDS as the infections that led to the symptoms being noticed then happened up to a decade earlier. You may at best be able to limit the spread of the disease, but that's about it.
 
That's... not really going to stop AIDS. Remember, the vast majority of people with AIDS, and an even larger majority of people dying of AIDS, are not American. I saw the same issue when I posted a thread about what if HIV had never evolved in early-20c Leopoldville; the answers I got were about US gay rights and not, say, what the virus did to Southern Africa.
Maybe if there had been an early Gates Foundation type of charity. And not in the sense of preaching at people, but in the sense of working with people and providing the supplies which African doctors and nurses very much want, such as more new needles, more high-quality disinfectant to clean needles, etc.

Please tell me more about Leopoldville. I've read AIDS most likely came from hunting and butchering a certain type of monkey.
 
The POD is far too late to stop AIDS as the infections that led to the symptoms being noticed then happened up to a decade earlier. You may at best be able to limit the spread of the disease, but that's about it.

I think you are absolutely right. Any POD is going to have be much earlier ... and probably inadvertent. any ideas of what would do it?
 
Maybe if there had been an early Gates Foundation type of charity. And not in the sense of preaching at people, but in the sense of working with people and providing the supplies which African doctors and nurses very much want, such as more new needles, more high-quality disinfectant to clean needles, etc.

Please tell me more about Leopoldville. I've read AIDS most likely came from hunting and butchering a certain type of monkey.

https://www.theguardian.com/science/2014/oct/02/hiv-aids-pandemic-kinshasa-africa

The virus indeed jumped the species barrier via bushmeat, but SIV is not as aggressive as HIV, and the human body can neutralize it in a few weeks; it required rapid reinfection via human-to-human contact for it to mutate to HIV, and this came about as a result of unsterilized needles as well as widespread prostitution in Leopoldville.
 
The POD is far too late to stop AIDS as the infections that led to the symptoms being noticed then happened up to a decade earlier. You may at best be able to limit the spread of the disease, but that's about it.

Before tests were available an effective reaction would require a lot of foresight.
The needle route and the gay transmission did point to sexual transmission, but is not a proof. To,at this time go out and say, publically that there is a probably blood and sex transmitted infection and distribute needles and condoms is asking a lot. Possible, but no more than my TL's.
That off course would not have helped Africa, where most cases and deaths have been.
Later, with tests developed a lot more could have been (and Can be) done, tracking cases, condoms again and so forth.

It is true that when the first 10's of cases were identified, the number of infected people were in the hundreds or early thousands. The initiatives above would not roll back the epidemic to zero, but if vigorously implemented may have kept the incidence at the low thousands in the US.
It is a good question if the drive for treatment development would have been strong enough in such a case, so globally it may have done little good, while obviously beneficial to the, in this case US residing homosexual men.

If you want an earlier, more effective POD, you could imagine earlier awareness and fear of STD's. Maybe earlier identification of HPV as cause of anal, penile and cervix cancers
 
and on the research front, wasn't the early research mainly just the French and Americans?

and right now in Africa, there is an unheralded miracle. A mother has from a 15% to 45% chance of passing HIV onto her newborn child. It's way less than a hundred percent. Because AIDS can be a pretty hard disease to get. A person has to keep taking the risk and will evetually draw the unlucky card, which to my mind is a good argument to play percentage baseball and do smart risk reduction, although other people may look at it differently.
http://www.who.int/hiv/topics/mtct/about/en/

And so, with the newborn baby, if the mother takes antivirals during pregnancy and especially shortly before giving birth and the baby is given short-term antivirals, the risks drop to less than 5%. In fact, the mother can often breastfeed and this is often recommended as the best bet for good overall health.

It really is a modern day miracle. But largely uncovered in western media. It's a boring science story, not the celebrity angle to grab your interest. Well, it should be covered.

And with multiple research centers earlier, maybe 10 years before OTL?

*I was somewhat off on the numbers before. The above are the best current numbers I can find.
 
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and on the research front, wasn't the early research mainly just the French and Americans?

and right now in Africa, there is an unheralded miracle. A mother has about a (?)20% chance of passing HIV onto her newborn child. It's way less than a hundred percent. Because AIDS is a pretty hard disease. A person has to keep taking the risk and will evetually draw the unlucky card, which to my mind is a good argument to play percentage baseball and do smart risk reduction, although other people may look at it differently.

And so, with the newborn baby, if the mother takes antivirals shortly before giving birth and the baby is given antivirus for a while afterwards, the risks drop to around (?)5%.

It really is a modern day miracle. But largely uncovered in western media. It's a boring science story, not the celebrity angle to grab your interest. Well, it should be covered.

And with more research, maybe 10 years before OTL?

The roll out of AZT for reducing mother to child transmission is a major achievement. It is a special case of a very cost-effective treatment and it also has been based on a large part of private donations. Bill gates may be the big bully in IT business, but he is a true mother Theresa when it comes to health issues in impoverished countries.

He, a collapse of Microsoft competition could have pulled this off earlier, if you want a globally effective pod.
 
Bill gates may be the big bully in IT business, but he is a true mother Theresa when it comes to health issues in impoverished countries.
That is interesting, isn't it? :) And maybe in part because he takes a nerd approach to ethics? That a life of a person in a far-off country is just as important as my life, your life, and the lives of people we know. And maybe that he trusts the logic somewhat more than is usual, although heck, this is a whole lot like the golden rule.

I'm going to do a couple of google searches using site:who.int to try and get better numbers. This one from 2012 looks like a success story (WHO states names are changed).

http://www.who.int/features/2012/pmtct_swaziland/en/

" . . Like all women who go for antenatal [prenatal] care in Swaziland, she was offered counselling and testing for HIV. When Sibongile tested positive, she enrolled in the government programme for the prevention of mother-to-child transmission (PMTCT), where she got antiretroviral drugs to block transmission of the virus to her baby. She also had support from mothers2mothers (m2m), a civil society group that provides counselling to HIV-positive pregnant women enrolled in PMTCT programmes, helps them with disclosure, and works to eliminate stigma. . "

.

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" . . Based on WHO’s 2010 guidelines on the use of antiretrovirals for treating pregnant women and preventing HIV infection in infants, the country has made more effective drug regimens available that reduce the risk of mother-to-child transmission to less than 5% [emphasis added]. In addition, all HIV-exposed infants are tested at six weeks of age. . "
 
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If treatment is not available, there's actually a range of chances a pregnant woman will pass on HIV to her baby.

http://www.who.int/hiv/topics/mtct/about/en/

" . . In the absence of any intervention, transmission rates range from 15% to 45%. This rate can be reduced to below 5% with effective interventions during the periods of pregnancy, labour, delivery and breastfeeding.

"These treatments involve primarily antiretroviral treatment for the mother and a short course of antiretroviral drugs for the baby. . "
 
https://www.theguardian.com/science/2014/oct/02/hiv-aids-pandemic-kinshasa-africa

The virus indeed jumped the species barrier via bushmeat, but SIV is not as aggressive as HIV, and the human body can neutralize it in a few weeks; it required rapid reinfection via human-to-human contact for it to mutate to HIV, and this came about as a result of unsterilized needles as well as widespread prostitution in Leopoldville.

HIV is indeed a dramatic incidence for human health, though by no means unprecedented. Looking at our genome, about 9% consists of reasonable recognizable retrovirus sequences.
Some of these have beneficial functions and allowed us, via cell fusion and immunosuppression to develop placentas.
 
As far as bushmeat and SIVs (Simian Immunodeficiency Viruses) . . .

I understand it's not the eating, it's the butchering. You have a cut on a finger or an abrasion, and then you're wrist deep in the animal's carcass trying to take out a tasty internal organ, or split the ribs, etc.

And if you or I were in resource-deprived settings, we'd be hunting monkeys, too. We'd be very happy to have any bushmeat we could get.
 
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