The early years of the HIV epidemic were marked by relentless human loss. In the four years between 1993 and 1997, the number of people living with HIV more than doubled, from 14 million to 30 million. By the year 2000, an estimated 15 million people had lost their lives to AIDS. Funerals became an everyday part of life and the ranks of orphans swelled. The HIV epidemic was tearing at the fabric of communities around the world. HIV from a death sentence into a manageable chronic disease. People living with HIV who were fortunate enough to get their hands on these medicines were now able to live long and productive lives. In short order, death rates from AIDS began to plummet in the U.S., but the suffering continued unabated in Africa. By the year 2000, deaths in the U.S. had decreased by 60 percent, while in Africa an estimated 2.4 million people continued to die each year from the epidemic. As the global epidemic grew, the scientific community responded. In 1987, the first antiretroviral drug for treating HIV became available. Eight years later, a remarkable combination of HIV medicines transformed As a global crisis unfolded... Clinic for prevention of mother to child transmission of HIV. Namicopo, Mozambique HIV positive mother with her HIV negative baby. Côte d’Ivoire
...A vision of hope emerged Inspired by the availability of these miraculous treatment options, a group of visionary doctors in Harlem committed themselves to bringing these lifesaving treatments to their disenfranchised patients. Dr. Wafaa El-Sadr, then chief of the Division of Infectious Diseases at Harlem Hospital in New York City, pioneered an integrated model of care to address the medical, psychosocial, and other needs of her stigmatized patients and demonstrated the success of a novel family-focused approach. Meanwhile, her colleague, Dr. Elaine Abrams, a pediatrician who cared for some of the first HIV-infected infants at Harlem Hospital, was pioneering approaches to prevent transmission of the HIV virus from mother to child. Based on their success in Harlem, they became convinced that treatment could be—and must be— made a reality for those living in resource-limited settings. Together, and joining forces with Dr. Allan Rosenfield, then dean of Columbia’s Mailman School of Public Health and longtime global champion for the health of women, they challenged the prevailing thinking. Countering the many naysayers who believed it to be impossible and inadvisable to bring treatment to Africa, they brought a revolutionary new paradigm to a crisis that was causing incalculable suffering. In 2002 came the historic announcement that they would lead the world’s first-ever, multi-country HIV treatment program. With the goal of demonstrating to a disbelieving world that quality HIV care and treatment could be provided in resource-limited settings, the MTCT-Plus Initiative began enrolling pregnant women living with HIV at 13 demonstration sites in eight countries. The family-focused model that had proven so successful in Harlem made services to prevent mother-to-child transmission of HIV the entry point to lifelong HIV care and treatment for women and their families. Within four years, more than 14,000 women and their family members were accessing HIV care and treatment at these sites, establishing a shining precedent for the world and ushering in a new era of response to HIV.