UNAIDS: The First 10 Years

UNAIDS The First 10 Years8At about the same time, doctors working in various African countries were treating patientswith very similar symptoms. In 1983, a team from the Ugandan Ministry of Health investigateda new disease – known as ‘Slim’ because patients rapidly lost weight – in the Lake Victoriafishing village of Kasensero, and concluded that it was AIDS. Also in 1983, a team of Americanand European scientists, led by Peter Piot (now UNAIDS Executive Director and who hadbeen to the hospital years earlier, investigating the first outbreak of Ebola), visited the capitalof Zaire, Kinshasha, and, in a single hospital, found dozens of patients dying from AIDS.“In 1976, there were hardly any young adults there except for traffic accidents in orthopaedicwards”, Piot told a reporter. “Suddenly I walked in and saw all these young men and women,emaciated, dying” 3 . His colleague Joseph McCormick wrote: ‘Some developed suchexquisitely sore mouths and tongues that they were unable to eat. Those who could managea few bites of food were suddenly stricken by cramps and disgorged a copious amount ofdiarrhoea. Their skin would break out in massive, generalized eruptions. … When the infectiondidn’t consist of voracious yeast cells [as in cryptococcal meningitis], there were many otherparasites ready to eat the brain alive. None of the victims could comprehend in any waywhat was happening to them or why. And we? All we could do was watch in horror, our rolesas physicians reduced to scrupulous observers and accurate recorders of documentation.Our one hope was that if we could understand the processes we were observing, someone,somewhere, might find a solution’ 4 .The Human Immunodefi ciencyVirus was identifi ed in1983 as the cause of AIDS.UNAIDSSignificantly, as many women as men were among these Kinshasa patients; it was clear thattransmission was taking place through heterosexual as well as homosexual contact. Soon,AIDS cases were also identified in Congo, Rwanda, Tanzania and Zambia. The team quicklywrote a paper about the Zairian cases and submitted it to the prestigious Lancet, which initiallyrejected it but then published it in 1984 5 . In these early years of the epidemic, many scientistsrefused to believe that AIDS was a heterosexual problem; they also dismissed concerns aboutits potential to become a global pandemic as unnecessarily alarmist.Yet soon, cases were being reported in every region of the world, in most European countriesas well as Australia, New Zealand, and parts of Latin America.A slow responseFrom the beginning, people with AIDS were stigmatized. Many came from marginalizedpopulations – gay men, injecting drug users, sex workers, Haitians living in the USA andhaemophiliacs. Many religious groups believed the illness was God’s vengeance on anybodywho was sexually promiscuous or behaved in an ‘unnatural’ fashion. Famously, the Presidentof the USA, Ronald Reagan, made no pronouncement on AIDS until 1986. In most of Africa,3Malan R (2001). ‘AIDS in Africa: in search of the truth’. Rolling Stone, 22 November.4McCormick J, Fosher-Hoch S (1996). Level 4: Virus Hunters of the CDC. New York, Barnes and Noble Books.5Piot P, Quinn TC, Taelman H, Feinsod FM, Minlangu KB, Wobin O, Mbendi N, Mazebo P, Ndangi K, StevensW et al.(1984) ‘Acquired immunodeficiency syndrome in a heterosexual population in Zaire’. The Lancet,2(8394), 14 July.