1) Identifying pertinent political, social, cultural, religious, economic, and affected population players in the situation (e.g., stakeholders) (who were they? Why were they important? How did they either positively affect or negatively affect the definition of the problem?) (Note: look at timelines available on the site)
Frontline’s film “The Age of AIDS” is an educational documentary that maps out the history of the AIDS pandemic. The film is set up to highlight key points from the time periods between 1957 through 2006. There were many stakeholders who had a positive and negative influence on how to handle the disease that was gaining an increasing awareness. Positive influences included scientists such as Dr. David Gallow, who realized that it would take multiple drugs to treat AIDS and Dr. Anthony Faucy, who was a well-known respected advisor of AIDS at the National Institute for Allergic and Infectious Diseases. Scientists were an important figure in the social spotlight because they debunked rumors to how the disease transmitted. Other positive influences included political figures like former United States President Bill Clinton and George W. Bush, who both led a humanitarian campaign to raise money for AIDS research. Negative influences include cultural viewpoints, which got in the way of infected AIDS patients seeking treatment. In the country of Africa, for an example, former African Thabo Mbeki ignored the AIDS epidemic occurring in his country because in African culture it is taboo to talk about sex, which is one of the ways AIDS is transmitted. Another negative influence was religion. In the Christian churches, priests were claiming that AIDS was a disease created by God to punish homosexual people, which are considered to be a sin in the bible. Economics can also be considered a negative influence because the price of AIDS medication is $16,000 annually, which has caused AIDS patients to opt out from receiving treatment due to price or become impoverished from receiving treatment.
2) Investigate and describe the nature of the disease (various mutations and timelines for mutations; identification as a virus/bacterial infection); (what were the various mutations & why did these pose difficulties? Why was the identification of it as a virus or bacterial infection important? Was a vaccine possible?)
Acquired immunodeficiency syndrome (AIDS) is the final stage of the human immunodeficiency virus (HIV). Scientists who first studied HIV/AIDS postulated the question if whether this new disease was a bacteria or a virus. To answer this question, scientists had to observe how the disease replicated. When looking at cultures of HIV/AIDS on human blood, scientists noticed that the disease would cause cell death in the culture and disappear. This ruled out the possibility of HIV/AIDS being a form of bacteria because bacteria replicates by binary fission. In binary fission, an organism performs asexual reproduction, where it capable of duplicating its genetic material into two separate organisms. This type of replication allows bacteria to live outside the host. Scientists were frustrated on how to isolate the disease since they couldn’t see it or grow it, which made it increasingly difficult to perform experiments on it. Further research was halted until Dr. Robert Gallow, from the National Institute of Health had a scientific breakthrough in AIDS research.
Dr. Gallow, like other scientists, speculated that AIDS was a virus. A virus is not active until it enters its host, where it is able to manifest itself and multiply. Dr. Gallow believed that AIDS was a type of retrovirus. A retrovirus is a type of virus that carries its genetic material in the form of ribonucleic acid (RNA). What makes a retrovirus unique is the fact that it is able to convert its RNA into deoxyribonucleic acid (DNA). This continuing process of reverse transcriptase allows a retrovirus to permanently imbed its genetic material in a cells DNA. (Britannica) Reverse transcriptase is clumsy transaction where RNA to DNA conversion may not copy itself exactly, which causes a mutation in the virus.
Dr. Gallow hypothesized that AIDS was related to the retrovirus human type leukemia virus (HTLV). His hypothesis was partly proven wrong by French scientists in 1983 at the Pasteur Institute where they were able to successfully isolate the AIDS virus. The French scientists fed the AIDS culture by continuously adding white blood cells to the specimen. They then took an electron micrograph, which is a photo from a microscope, of the virus and the results were shocking. The French scientists concluded that AIDS was not related to leukemia like Dr. Gallow suspected but was indeed a new type of retrovirus.
The HIV virus, like all viruses, is not active until it enters the human body. This retrovirus is designed to attack white blood cells, which protect the body against infection and disease by ingesting foreign materials, destroying infectious agents and producing antibodies. The HIV virus then multiplies itself continuously until the white blood cells burst and die. As a result, the carrier’s immune system is shut down. HIV is unique in a sense because it hides behind a layer of sugar. The body is used to sugar and doesn’t attack it. Behind the sugar is a foreign protein and the body is unable to find any crevice within that virus and kill it. Thus, HIV can protect itself from our immune defenses. Since the body’s defense mechanisms are unable to detect HIV, the virus is able to successfully replicate itself billions of times a day. What makes HIV equally as dangerous is the fact that it can lie dormant in the body for up to ten years. The HIV virus also doubles as a provirus, meaning that it can lie dormant for a period of time until it is activated. Once HIV is activated, the replication process continues.
The AIDS virus went through a series of mutations. HIV had two dominant strains: HIV-1 and HIV-2. HIV-1 is main strain that caused the pandemic and HIV-2 is a strain that is mainly in West Africa. Within HIV-1, there are at least 10 subtypes that are spread throughout the globe. Due to the constant mutation of the HIV/AIDS virus, scientists have struggled to develop a vaccine. Scientists are now looking into a preventative vaccine, which would be used in HIV negative patients as a barrier. Scientists believe that they would have to create multiple vaccines do combat the mutating strains of HIV.
3) What were/are the symptoms and how were/are they manifested in the patient; (what were the common symptoms in most patients?)
Once the body is infected with HIV/AIDS, it attacks the immune system. HIV/AIDS is designed to effectively eliminate white blood cells from the body, which is a body’s natural defense toward an attack on the immune system. Due to the nature of the attack, people report having a fever, flu symptoms and experience body rashes upon three weeks of infection. These symptoms represent the body creating billions of T-cells as an attempt to eradicate HIV from the system. Since HIV attacks CD4 cells, the body faces the dilemma of getting newly created CD4 cells infected by the virus. As a result the infected CD4 cells multiply and help spread the virus. This constant battle of the body actively producing CD4 cells to battle the spreading virus can last up ten years. During this time period, the infected person may feel healthy and if they go untested, may unknowingly transmit the virus to others. Once the HIV virus reaches an optimal level of supply, the infected person will have a weak immune system. At this point, the HIV infection will worsen and the patient will experience symptoms such as weight loss, night sweats, fatigue, and swollen lymph nodes. The patient will now be vulnerable to rare diseases induced by AIDS destroying the immune system. Such diseases include pneumocystis pneumonia, which is caused by an infectious organism the body can normally fight off; toxoplasmosis, which is caused by a parasite that attacks the brain; candidiasis, which is an overgrowth in fungus the body naturally produces in the skin, mouth, throat, windpipe, and in the genital region in females; Cytomegalovirus, a herpes virus that attacks the body and eyes in AIDS victims; and Kaposi sarcoma, which is a skin cancer that causes purple lesions- although doctors have now learned to prevent control Kaposi sarcoma. These diseases are opportunistic infections that manifest themselves as a result of HIV/AIDS infecting the immune system. Symptoms solely caused by the HIV/AIDS virus include the virus attacking other cells in the body besides white blood cells. Patients with HIV/AIDs can attack the victim’s internal organs and cause them to have balance problems, dementia, and trouble moving body parts such as the arms and legs.
4) The mode(s) of transmission; (what were they and how did the identification of modes change over time?)
The first cases of the reported “mystery disease” of HIV/AIDS occurred in 1981 when there were several cases of gay men dying from a rare infection that attacked their immune systems. Early HIV/AIDS research insinuates that this disease is exclusive to homosexual males because of anal sex. The mystery deepens, as there were cases of a similar disease occurring in men and women in Haiti. Scientists were stunned since the cases in Haiti involved heterosexual peoples. Back in the United States, This caused a negative social stigma around the gay community especially during the 1980s. The United States government took action and closed “bath houses,” which are venues where gay men can openly socialize and participate in sexual activities. It wasn’t until there cases in Haiti and Paris of both heterosexual men and women suffering from a mysterious disease that caused pulmonary problems and fever. Scientists realized that HIV/AIDs was not secluded to the gay community and could reach the general population through vaginal sex. In the Bronx, New York, there were three heterosexual men who contracted pneumocystis pneumonia, which is caused by an infectious organism the body can normally fight off. Scientists realized that the three men were drug users who contracted the HIV/AIDS from sharing infected needles. During this period of time, there has been a growing popularity of cocaine/drug shooting up galleries opening up in New York where people would rent a needle and syringe to shoot up drugs. This type of social system caused exploding cases of HIV in the injecting drug use community in New York and other places. In Africa, HIV/AIDS became an epidemic. Scientists believe that the epidemic occurred because of sex and mainly the polio vaccine. When the polio vaccine became available in Africa, a large amount of the people got the vaccine. What they didn’t realize though, was that medical administrators was using the same needle from patient to patient, thus spreading the disease. Also, blood transfusions spread the disease rapidly due to the blood not being tested.
The HIV virus is unable to live outside the body for a few minutes. Therefore it cannot be passed on surfaces or through the hair. It can only be transmitted by blood, semen, vaginal fluid, and breast milk. To clarify, the main ways HIV/AIDS spreads is through sex (both vaginal and anal), blood transfusions, contaminated needles (either from drug users or shots in Africa), from mother to child at birth (where the baby inherits the disease from infected mother), and breastfeeding (infected mother transmitting virus through breast milk to infant). HIV/AIDS can sometimes be passed through oral sex if there is a lesion in the mouth or it is already inflamed.
5) The various theories of how the disease developed and was/is transmitted; (what were they & who posited them?)
There were three main theories to how HIV/AIDS developed and was transmitted. The first theory is the God theory. The God theory is based upon the Christian belief that homosexuality is a sin. Various churches in the U.S. labeled AIDS as God’s punishment for homosexual people, since homosexually is supposedly referred to as a sin in the bible. The second theory is the bush meat theory. This theory states that AIDS is a mutation of Simian Immunodeficiency Virus (SIV). SIV is a disease exclusive to primates that attacks a primate’s immune system the same way that AIDS does. Scientists hypothesize that African butchers contracted a mutation of the disease from Chimpanzees, which is an African delicacy. Scientists think that the infected butchers spread the virus through having multiple sex partners while living in urban regions. The third theory is the oral polio vaccine (OPV) theory. The OPV theory states that the oral polio vaccine contained traces of SIV infected chimpanzee cells from a lab culture.
From the years 1957 to 1950, over 1 million Africans received the oral polio vaccine, which occurred around the same time that AIDS became a growing disease.
Out of all the theories, scientists can automatically disregard the God theory because it relies on religious beliefs and cannot be proven by science. As for the bush meat theory and the oral polio vaccine theory, scientists lean more toward the bush meat theory based upon scientific evidence of AIDS connected to SIV and by the ways of transmission. Scientists can physically trace AIDS outbreaks on a map and have connected it urban areas. Scientists believe that the OPV theory is conspiracy theory that was spread by rumors in the population. Plus, AIDS can only live outside a host for a few seconds, so it would be impossible for it to transmit to people since the vaccine was taken orally and not by a needle.
6) Timeframes for disease conversion/activation within the host; (a significant piece in terms of prevention, intervention, and eradication)
In order to prevent getting infected with the HIV virus, an individual must be aware of how the disease is transmitted. It can only be transmitted by blood, semen, vaginal fluid, and breast milk. Effective preventative measures include 1) practicing safe sex by either being abstinent or using a condom during intercourse, 2) avoiding getting contaminated by infected blood by using clean needles at hospitals and getting tested blood transfusions, and 3) having HIV positive mothers be aware that HIV can be passed through breast milk and opt for baby formula instead.
If an individual still manages to get infected with HIV, they need a proper intervention to educate them on how the disease is transmitted and what to expect. Societies need to stress the importance of getting STD tested if they are sexually active so then they can catch any infections early. Due to the nature of AIDS, a person may not know that they are infected for up to 10 years upon infection. During this time frame, the HIV virus is an incubation period. The body is producing large amounts of CD4 cells to battle the HIV infection. This battle in a way neutralizes itself during the early period because there is still a significant amount of CD4 cells fighting the infection. Once the virus eradicates almost all the CD4 cells in the body, the victim’s immune system will shut down and leave them vulnerable to getting rare life-threatening diseases. Without medication, the victim is a ticking-time bomb.
Medication is a solution to the eradication of HIV although it cannot fully eliminate it from the body. Medical researchers have stumbled across a medication called AZT, which is the first effective drug in suppressing the HIV virus. Although the medication looses its effectiveness over a period of time, AZT is known to be effecting in preventing AIDS transmission from an infected mother to her infant. Another more promising treatment for AIDS is the “triple cocktail,” which is a series of medications used to fight the constantly mutating virus. Another solution to the eradication of AIDS goes back to education as mentioned above. Knowledge is power. Properly educating the public about AIDS can help people protect themselves from it.
7) How was personal stigma and discrimination manifested for the different populations? (e.g., give specific examples of)
In the United States, the first cases of the reported “mystery disease” of HIV/AIDS occurred in 1981 when there were several cases of gay men dying from a rare infection that attacked their immune systems. Early HIV/AIDS research insinuates that this disease is exclusive to homosexual males because of anal sex. This caused a negative social stigma around the gay community especially during the 1980s. The “mystery disease” was occurring in large cities, which are the centers for the gay lifestyle. Scientists believed that gays were vulnerable to the disease due to their complicated social lifestyle, usage of recreational drugs, and having multiple sex partners. The United States government took action and closed “bath houses,” which are venues where gay men can openly socialize and participate in sexual activities. Gay activists believed that the stigma of HIV/AIDS caused society to bash on their sexual practices and limit their personal freedom.
Rock Hudson, a famous actor who was depicted as the “all American” male, was speculated to have HIV/AIDS. He was ill with AIDS for a long time and went to Paris discreetly to receive therapy. Hudson rushed to American hospital in Paris, where officials denied that he was being treated for AIDS. The press followed his every move, even when flew back to Los Angeles to the UCLA medical center to receive treatment. Hudson eventually let it be known that he had HIV/AIDS. He was the first well-known famous person to being diagnosed with AIDS. The Rock Hudson case is significant because it was the first case of HIV/AIDS that shook the public. Hudson brought a national consciousness to AIDS and made it official that anyone was at risk for aids. Due to a lack of knowledge of how the disease was transmitted, there was constant fear that anyone could catch HIV/AIDS. It was reported that the police and other public officials were wearing rubber gloves; people feared that it could be caught from toilet seats. The public was so suspicious of anyone who had HIV/AIDS to the point that certain individuals were denied medical coverage and people were getting fired from their jobs. There was a related controversy for the use of a new blood test to detect HIV/AIDS. People were afraid to be tested for a condition where there is no cure and be labeled for it, people afraid that the community would find out, or who else could see their blood test, would it go to the government, the IRS, insurance company, loved ones, who would decide where it would go to.
Discrimination in the U.S. escalated at this point. Because to the prior lack of knowledge of blood-transmitted diseases, AIDS found its way into blood blanks due to blood donations. Hemophiliacs were stigmatized to have AID because due to the nature of their disease, they needed a constant supply of blood transfusions. In Tennessee, panicking parents forced twelve year old Dwane Mowlry to leave school because he was a hemophiliac infected with HIV. In Cocomo, Indiana, a 14 year old boy old hemophilic named Ryan White was forced to leave school due do suspicions of him having AIDS; someone even fired a bullet at his families home. There was a family in Florida whose house was burned down because their children were hemophiliacs with AIDS.
During this period of time, there has been a growing popularity of cocaine/drug shooting up galleries opening up in New York where people would rent a needle and syringe to shoot up drugs. This type of social system caused exploding cases of HIV in the injecting drug use community in New York and other places.
Later on in the U.S. the AIDS epidemic began to show up among minorities but more specifically black Americans. In parts of New York, up to twenty five percent of black men was HIV positive. In the black community, there was little to no response to AIDS. Black churches did not acknowledge AIDS and refused to acknowledge it was a reality in their community. The black community “whispered of it” like a secret but treated the epidemic like any other average disease. But when black churches did talk about AIDS, they stated that AIDS was a plague created by God to punish homosexuals. With the epidemic now shifting to minorities, there was a social question of race and class. Minorities felt that since people dying of AIDS were black and brown and those controlling the money were white that they were at a disadvantage.
As HIV/AIDS took notice in heterosexual men and women in Haiti, the CDC issued a warning on traveling to Haiti. This caused Haiti to take a big hit financially because of loss of tourism and countries refusing to import goods produced in Haiti. There was a growing discrimination toward Haitian people since the CDC labeled them as high-risk individuals.
In 1985 there was an estimated that among the two million infected by AIDS worldwide, most of the cases took place in Africa. By mid 1980’s, Uganda had the highest cases of AIDS in the world. In Uganda, AIDS traveled from the southeast and traveled with trade into the Rakia district, which is a more urban area. Prostitutes were known to solicit in these areas and it is believed that they were carriers that would infect men due to unprotected sex. Ironically, this caused more women to be infected by their husbands or boyfriends working in urban areas. Infected women would transmit HIV/AIDS to their children by childbirth or by breastfeeding.
In Africa, there was discrimination based upon HIV status. The topic of HIV/AIDS in Africa was controversial to the point where black townships met resistance. Africans felt that white people were accusing them of being irresponsible sexually, which has caused them to build walls towards communication. The AIDS epidemic in Africa caused a social stigma to Africans because it is a sexually transmitted disease. There, sex is a taboo subject and is not talked out openly. Also, do to the early knowledge on the disease; most thought the disease only occurred to white homosexual men in the gay community. Those infected with AIDS in Africa got poor treatment in hospitals.
There was one case where a woman’s husband named Christopher Kaliba was infected with AIDS from a blood transfusion. When he was in a hospital in Africa to receive treatment, the nurses and doctors avoided him. Also, African hospitals were denying AIDS infected children since it was a terminal disease and they needed to keep the beds open for those with a more promising prognosis. Doctors showed little interest in AIDS treatment because their views reflected those of their own government who was showing no concern for the epidemic.
In Thailand in the mountains north of Bangkok, there is a shrine to AIDS. Under the shrine, there is a pile of bones set to raise awareness that AIDS patients should not be forgotten. This shrine is referring to the social stigma of AIDS in Thailand. In this country, like others, there is a fear of HIV positive people. It caused discrimination against HIV/AIDS infected people to the point where they exiled these patients out of their community. HIV/AIDS spread in Thailand due to Bangkok’s sex tourism and drug problem. In Thailand’s prisons, needle-injecting drugs were popular to take the misery out of being in jail. This caused HIV spread among prisons. In 1987, Thailand’s king granted amnesty to prisoners and they were released to the general population. The released prisoners then infected others and contributed to the epidemic.
In Russia, the end of communism brought cheap heroine and AIDS. Movies influenced people to do drugs and they thought that it was a popular social activity. Drug users would sometimes become prostitutes to pay for their drug addiction. Men who used prostitutes would become infected with HIV/AIDS. Infected men would then carry the virus home to their wives and girlfriends. As a result, one million Russians became infected with HIV/AIDS. Personal stigma in Russia was to just ignore the disease.
From drug usage and sex workers, HIV traveled from Eastern Europe, Southeast Asia, India and China (the most populous places on the planet). In China, commercial blood plasma became contaminated and people became infected. Dr. Gui Xi’En M.D. brought rural patients infected with HIV/AIDS to the city for proper treatment and got arrested. China wanted to keep AIDS a secret. China’s social stigma about HIV/AIDS was the fact that they did not want to admit that the disease was in their country. Like Africa, it is a violation in their culture to talk about sex. Also, China was embarrassed that their blood transfusion equipment became contaminated. China was in a state of denial.
9) Aspects of public and personal denial that have slowed response to the pandemic; (give examples of public and personal denial affecting access/treatment/response)
In reference to question 7 and 10, public and personal denial go hand in hand in slowing the response of the pandemic. Leaders of countries hold influence on citizens and make the decision of whether or not AIDS is affecting their country. In the U.S., former President Reagan denied AIDS as an issue. His personal denial of the disease caused the American public to deny the disease. In Africa, former President Mbeki also had a personal denial towards the AIDS epidemic. His personal beliefs of AIDS being a conspiracy theory influenced the African public that AIDS was not an issue in their country. These examples of public and personal denial have affected access to treatment in both the U.S. and Africa. In the U.S., only individuals who could afford AIDS treatment could receive it. This alarmed AIDS patients in America because they felt that it was immoral to deny them access to a treatment that may potentially safe their life. In Africa, President Mbeki banned AIDS medications in government run hospitals because he thought that they were toxic. President Mbeki’s ignorance has caused African citizens to suffer. Africans had no access to treatment for extended period of time due to Mbeki not drawing national attention to the issue.
10) Aspects of societal discrimination that slowed response to the pandemic; give examples of public and personal discrimination affecting access/treatment/response)
In reference to question 7, the U.S. had a social stigma toward the gay community since they initially thought that AIDS was exclusive to their group of peoples. In the U.S. there was already a present discrimination toward the gay community do to their alternative lifestyle that goes against the hegemonic group of the conservative family model. Because the gay community was the first known groups to suffer from AIDS, the U.S. kept quiet about the new mysterious disease. The U.S. felt that the disease was not significant enough to get national attention because it only affected a small amount of the population. Former president Ronald Reagan and George H.W. Bush fed into this “silence” about AIDS which only caused a negative effect on Americans because the disease continued to spread.
Another case of societal discrimination in the U.S. occurred within the black community. In urban regions such as New York, black people were getting infected with HIV at a staggering rate. Instead of addressing the problem in the black community, they chose to ignore AIDS. Black people felt that AIDS was a disease that only happened to gay people. Perhaps the black community feared getting the same discrimination the gay community received. Because the black community failed to acknowledge AIDS, AIDS began to wipe out their community silently.
In countries such as Africa, AIDS spread like wildfire. Africa is thought to be the origin of AIDS due to humans contracting a similar disease from chimpanzees. President Mbeki of Africa felt that AIDS was a conspiracy theory and chose to ignore the epidemic occurring in his country. President Mbeki also banned AIDS medication in government hospitals because he felt that they were toxic. His personal discrimination against the disease caused the rest of the world to have a slowed response to Africa’s growing epidemic.
In Thailand, Buddhist monks raised awareness to AIDS by creating a shrine in their honor. Buddhist monks were also known to help AIDS patients in rural communities seek medical care in more urban areas. These actions upset Thai people as a society because they wanted to keep the disease out of their population. Their negligence as a population and the population of drugs and prostitution their country has caused a slow reaction to the dangers of AIDS.
In countries like Russia and China, drugs and prostitution became a growing problem. With activities such as drugs and prostitution, AIDS followed. Both Russian and Chinese officials denied that there was a problem due to pride in their country and not wanting to be stigmatized for the disease.
What all of these countries have in common is the fact that they all did not want to be the country responsible for the epidemic. Instead, these countries opted to ignore the disease in hopes that it would disappear. This slow type of reaction contributed to the AIDS epidemic escalading to a pandemic.
11) Medical barriers to assessment and treatment; (access to treatment, types of treatment available, health worker protocols)
There were many medical barriers to assessment and the treatment of HIV/AIDS. The first wave of treatment was developed at the National Cancer Institute. Scientists were looking for drugs that might slow or cure the disease. They began by testing compound that hand already been developed for other diseases. That is when they stumbled across the first effective AIDS treatment, named AZT. AZT was effective because it helped patients rebuild their immune system. The government gave the scientists permission to use a patent on the drug, making it one of the most expensive drugs in history at ten thousand dollars a year. Patients became impoverished by the disease and were unable to pay. Patients had to fight he bureaucracy to become eligible disability insurance. The patient community boycotted the FDA to lower the price and won. Unfortunately, AIDS became immune to AZT and quickly developed resistance.
Further research was halted until Dr. Robert Gallow, from the National Institute of Health had a scientific breakthrough in AIDS research. Dr. Gallow, like other scientists, speculated that AIDS was a virus. A virus is not active until it enters its host, where it is able to manifest itself and multiply. Dr. Gallow believed that AIDS was a type of retrovirus. Retroviruses are known to replicate sloppy, meaning that the virus is constantly mutating. To solve this problem, Dr. Gallow develops a “triple cocktail” of antiretroviral drugs to combat the mutations. In trials of the drugs, Dr. Gallows treatment was showing promising results.
Access to treatment of Dr. Gallow’s “triple cocktail” varied upon country to country. Due to its hefty price tag of $16,000 annually, some people deferred from the treatment because they were simply unable to afford it. In the U.S., only certain people were invited to participate in a clinical trial of the “triple cocktail”. This caused a controversy in the AIDS community in the U.S. In Brazil, their government built AIDS clinics in poor neighborhoods but didn’t have enough funding to provide patients with the “triple cocktail”. This changed in the case of Nair Brito who sued the government of Brazil in not honoring their constitution, where it states “health is the right to all.” Brito won the case and received treatment. Brazil took the case a step further by turning to their generic prescription drug labs to create a lower priced version of the triple cocktail (with consent from the global pharmaceutical company). Brazil was the first country in the world to guarantee antiretroviral medication to all of its citizens. In Africa, President Thabo Mbeki promised citizens a solution to AIDS. He later took back his promise by believing discredited theories of how HIV and AIDS are not real diseases. The president’s skepticism confused African citizens into believing that HIV/AIDS did not exist. On the advice of those who denied HIV/AIDS, President Mbeki banned the AZT and the “triple cocktail” from government hospitals by claiming that they were too toxic. President Mbeki had a traditional African response to the disease by believing that is was just a conspiracy theory.
The United Nations held a global meeting in order to resolve issues regarding AIDS. UN Ambassador Richard Holbrooke organized the meting because he believed AIDS was a security issue because it is destroying the stability of countries. In the meeting, there was a discussion about financing AIDS drugs so other countries could have access to treatment. The “triple cocktail” is $16,000 to administer for a year. Pharmaceutical companies claim that the high price goes toward creating the drug and the rest goes to future AIDS research. Another topic discussed included specific health care protocols that had to be followed in order to administer the drug. A medical barrier arose of how the drugs could be delivered to countries with little to no healthcare. Officials questioned how other countries could access AIDS drugs because it had to be administered by doctors and nurses so that they could monitor the drug dosage and effectiveness.
12) Involvement of various governmental agencies (US & Global); (what agencies were the lead agencies and what were their roles in the pandemic)
There were many governmental agencies involved in the pandemic that occurred during the time period of the 1980s-2000s:
1980- In the U.S., the Center for Disease Control (CDC) issues warnings to the general public about the disease. The CDC is responsible to naming the disease Acquired immunodeficiency syndrome (AIDS). The CDC also establishes the first International AIDS Conference in 1985
1983-Margaret Heckler was appointed Reagans secretary of Health and Human Services. She claimed that AIDS was her number one priority but did not put money towards public health organizations because she believed that it would be useless.
1986- The Surgeon General warned the public about the growing concern of AIDS. They also distributed an informational pamphlet on AIDS to American households.
1986- World Health Organization (WHO) created a global program on AIDS, which was led by Dr. Jonathan Mann who had the directed a CDC study in AIDS in Zaire. He grows the organization to nothing to a $100 million dollar program with a staff of 250 people. He travels the world and meets world leaders, grassroots activists, to sound the alarm and get governments attention. He is one of the first people to make humanitarian efforts directed at AIDS.
1990- President George H.W. Bush signs the Ryan White Care Act in honor of the hemophiliac who had campaigned against discrimination. The Ryan White Comprehensive AIDS Resources Emergency Kit authorizes 4.4 billion dollars over the next five hears to health care and support services to cities hit hardest by AIDS.
2003- The 3 x 5 initiative program was created by the WHO and UNAIDS. The goal is was to get 3 million people in developing countries on antiretroviral treatment by the end of 2005.
13) Development of issue specific NGOs and non-profits; (a number of NGOs and non-profit foundations/organizations were developed during the pandemic, note them and their significance)
There were many NGO’s and non-profit organizations created to address the pandemic:
1981- Gay activist Larry Kramer founded the Gay Men’s Health Crisis (GMHC), which is the first AIDS activist organization. In 1982, the city of San Francisco awards $450,000 to the Shanti Project, which is an AIDS clinic accessible to the public.
1984- Johnathan Mann studied AIDS in Zaire on behalf of the CDC. Mann was invited to be the leader of the WHO AIDS program.
1985- Martin Delany launched Project Inform in order to share information and accelerate advances in treatment in people living with HIV. HE formed the group after watching friends self-medicate with alternative therapies and black-market drugs from Mexico In 1985- The American Federation for AIDS Research (amfAR) is formed by Dr. Mathilde Krim and Dr. Michael Gottlieb to unify AIDS nonprofits of the East and West Coasts. Actress Elizabeth Taylor becomes a national chairman, and actor Rock Hudson gives the organization $250,000. In
1987- Activist Larry Kramer launched the AIDS Coalition to Unleash Power (ACT UP) to protest the high cost of AZT and other AIDS related drugs.
1997- Lead singer Bono of the band U2 announced how he was going to partner with Africa to raise money to alleviate the costs of the AIDS epidemic.
2001- Former president Bill Clinton launched the Clinton Foundation, whose aim is to raise money for AIDS research and to reduce the cost of AIDS medications for the public.
14) Development of public and private funding apparatus to support the science and those affected by the disease; (generally through foundations and governmental funding streams, name them)
There were many public and private funding groups crated to support science and those affected by the disease:
1983- The Aids Medical Foundation formed among the medical community, Dr. Mathilde Krim, a cancer researcher and New York’s Memorial Sloan-Keterling Cancer Center form the group.
1996- Dr. Peter Piot is asked to head the new agency, UNAIDS, which is designed to coordinate all of the U.N.’s AIDS efforts and fillt eh vacuum left by the WHO’s now defunct Global program on aids.
1998- congress authorizes the hemophilia fund. The Ricky Ray Hemophilia Relief Fund Act, named after one the three HIV-positive brothers in Arcadia, Florida home was burned down by arsonists in 1987. It authorizes payments to hemophiliacs who contracted HIV from the blood supply between 1982-1987. The fund pays out more than $559 million to 7,171 eligible individuals and survivors.
1998- Clinton administration creates the Minority AIDS initiative. At the urging of African American leaders and the Congressional Black Caucus, and alarmed by the rising proportion of AIDS cases in black and Latino communities, the Clinton administration authorizes $156 million for prevention, care and education campaigns targeting those communities.
2000- Accelerating Access Initiative formed. The AAI is formed by five pharmaceutical companies, UNAIDS, WHO, the World Bank, UNICEF and the U.N. Population Fund to provide deeply discounted drugs to the least developed countries. This program, however, is hampered by distribution problems and the companies negotiate separate rates for each country.
2001- President George W. Bush contributes $200 million to the Global Fund on Aids.
15) Social, cultural, political turning points in the disease and overall response to it; (available through the timeline, give an overview of those you found most significant, and give discuss your reasoning as to why you identified those key points)
The most significant social, cultural and political turning points in the disease begin when Dr. David Ho creates the “triple cocktail” medication for AIDS patients. At this point, AIDS is no longer considered a death sentence. Dr. Ho’s treatment opened doors for AIDS patients worldwide. Another significant turning point is when the country of Brazil allows all of its citizens to have access to AIDS medication. This action is a world-class example of how if a country intervenes in disease epidemics, then they may help control the situation. The last point that can be considered significant is former President Bill Clinton’s activism for AIDS. Clinton’s participation in campaigning for AIDS has drawn worldwide attention to the epidemic and it is no longer being ignored.
16) Social and cultural media messages regarding the pandemic within the United States (these have developed through the mass media, political/religious speeches, the use of bumper stickers, government reports, theatre, etc. Give several examples and note why you think they are significant).
The social and cultural media messages regarding the pandemic within the U.S. caused confusion among American citizens due to lack of knowledge about the AIDS virus. Former presidents played a role in creating a stir within the public about the AIDS epidemic. Former president Ronald Reagan initially downplayed the AIDS epidemic in the U.S. Reagan was later asked by celebrity Elizabeth Taylor to speak about AIDs at the American Foundation for AIDS Research. In Reagan’s speech, he discussed how education played an important role in understanding the disease. He then stated how he would like the CDC to list AIDS as a contagious disease and deny immigrants who are infected with the disease in the U.S. Former president Bill Clinton showed initiative in the AIDS epidemic and made bold political statements about the disease. At an AIDS conference, the president shook hands with an AIDS patient to prove that the disease could not be transmitted by handshakes. Clinton’s actions slightly eased the stigma on AIDS.
U.S. government run organizations was also contributing to the confusion. The CDC has often pointed fingers at minority groups for spreading the disease. The CDC initially thought that AIDS was a homosexual disease and caused a stigma within the gay community. Also, the CDC issued a warning to Americans not to travel to Haiti because they thought that Haitians were at high risk for AIDS. This caused discrimination toward Haitians not only in America but worldwide.
The U.S. had some more positive cultural messages about AIDS. In 1987 and AIDS quilt was displayed in Washington to represent the 40,000 people who died of AIDS. Cleave Jones who was an AIDS activist organized the quilt project. Jones wanted the quilt to represent a symbol for AIDS that would encourage people to talk and share memories of those who have died from the disease.
17) Who were the significant medical researchers/doctors along the AIDS pandemic? (e.g., Jim Curran, Don Francis, etc.);
Firstly, Dr. David Ho is a key researcher of the AIDS pandemic because he invented the “triple cocktail,” which is considered to be the first effective treatment toward AIDS. Secondly, Dr. Jim Curran is considered to be a notable researcher because he was the leader of the CDC’s research team on AIDS. Thirdly, Dr. Anthony Fauci is a memorable researcher because he directed the National Institute of Allergy and Infectious Diseases and made many contributions to AIDS research. Fourthly, Dr. Jim Curran of the CDC is the person who was responsible for submitting research on AIDS to the medicine magazine “Morbidity and Mortality Weekly Report,” which was distributed to those in the medical field worldwide. Fifthly, Dr. Peter Piot is a significant researcher in Africa who conducted the first groups of research in that country. Lastly, Dr. Don Francis made an important contribution to AIDS research because he performed the first tests on AIDS in a laboratory setting.
18) In addition: the final question should answer two elements: How has this exercise informed my understanding of how health issues are identified and responded to? And how will I use knowledge gained through this exercise in my career?
This exercise has informed me that public leaders, government run programs, and scientists are key players to addressing health related issues. This exercise has also informed me that it is important to respond to health issues immediately. From analyzing the AIDS pandemic, it can be concluded that it is important to notify the public of health issues because they are key players to the transmission of the disease. I learned that holding back knowledge only feeds into the problem because it is not addressing the health issue head on. Effective prevention, intervention and eradication techniques are vital to controlling health related issues.
I will use the knowledge learned from this exercise as a guideline on how to handle a health related issue as a social worker. If there was a new health related issue concerning the public, I would try to learn as much as I can about the issue. I would try to figure out how the disease is transmitted, what groups are at risk, what preventative measures can be taken, and what medications are effective in eradicating the disease. Knowledge is power because it is the public’s first line of defense against health related issues.
Simone, R. (Director). (2006). The Age of AIDS [Documentary]. U.S.: PBS Home Video.