Reflections on 30 Years of AIDS—Part 2
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[Maureen Marshall] Hello, I’m Maureen Marshall. I'm talking with CDC's Dr. Harold Jaffe, Associate Director for Science, and Dr. James Curran, Dean of the Rollins School of Public Health and Co-Director of Emory's Center for AIDS Research. This conversation is based on their reflections of 30 years of AIDS, which appears in the June 2011 issue of CDC's journal, Emerging Infectious Diseases. Welcome, Dr. Jaffe.
[Harold Jaffe] Thank you for inviting me.
[Maureen Marshall] And welcome Dr. Curran.
[James Curran] Thank you, Maureen.
[Maureen Marshall] Dr. Curran, what are the important lessons we have learned from the AIDS pandemic?
[James Curran] Well, Maureen, AIDS is essentially a new disease. It's very complex, both biologically and socially. Biologically it produces a silent infection which is essentially incurable, and the long-term infection leads to millions of carriers throughout the world. Socially, it is characterized by stigma and discrimination, and many people hide their infection and avoid getting tested. Prevention remains the most important message of all. It's really important to take precautions to prevent HIV to begin with.
[Maureen Marshall] There have been many accomplishments since the AIDS pandemic began. Dr. Jaffe, tell us about the scientific advances.
[Harold Jaffe] There've really been a number of advances as a result of the studies that have been done looking at the HIV/AIDS epidemic, so for example in the basic sciences there've been a number of advances in understanding the biology of retroviruses and how the immune system responds to chronic viral infections. To me, the most spectacular advances have been in clinical sciences because at the beginning of the epidemic we had no drugs to treat HIV. Within fifteen years we had a variety that could be used in combination to dramatically increase the quality and length of life for infected people. We also now have a much better understanding of the importance of animal reservoirs for human disease, and how interactions between humans and animals can lead to some unexpected health consequences for humans. And finally we've learned a lot about the social determinant of disease. For example, how factors such as poverty and gender inequality can affect the risk of infection.
[Maureen Marshall] And Dr. Curran, what about international collaborations?
[James Curran] Well, Maureen, in a very short period of time, AIDS has spread throughout the world to most countries. It is the fourth leading cause of death in the world, and the highest incidence and prevalence is in sub-Saharan Africa. The problem greatly outweighs our ability and capacity to deal with it from a health-care resource point of view. Many studies have been done throughout the world including landmark studies in Africa and we have learned a great deal from our international collaborations about how to prevent and treat HIV.
[Maureen Marshall] Dr. Jaffe, what can you tell us about private sector engagements with public health?
[Harold Jaffe] In the HIV/AIDS epidemic the private sector has been very involved in several different ways. For example, companies that develop diagnostic products have given us a whole range of sensitive and specific diagnostic tools, including rapid tests that we can use in field settings and in the developing world. Pharmaceutical industry has now given us a broad range of drugs for the treatment of HIV, and private charities such as the Bill and Melinda Gates Foundation and the Clinton Foundation have played a very important role in the global response to the epidemic.
[Maureen Marshall] What's been the greatest disappointment?
[Harold Jaffe] To me the greatest disappointment is that the epidemic is still with us 30 years later. We still don't have an effective vaccine and even with the very substantial funding that’s been available in this country to prevent HIV infection, each year between about 50 and 60 thousand Americans become newly infected.
[Maureen Marshall] Dr. Curran, after 30 years of AIDS, what comes next?/p>
[James Curran] The epidemic is still with us, there's no time for complacency. Everyone should be knowledgeable about HIV and how it's transmitted and get tested if they have any chance of being exposed. It's time to be safe. Always use a condom with a new partner or if you don’t know their status.
[Maureen Marshall] Thank you, Dr. Curran and thank you Dr. Jaffe. I've been talking with Drs. Harold Jaffe and James Curran about Reflections on 30 Years of AIDS, which appears in the June 2011 issue of CDC's journal, Emerging Infectious Diseases You can see the entire article online at www.cdc.gov/eid. If you'd like to comment on this podcast, send an email to eideditor@cdc.gov. That’s e-i-d-editor – one word - at c-d-c-dot-gov. I'm Maureen Marshall, for Emerging Infectious Diseases.
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