Five patients had severely weakened immune systems, and many were suffering from an extremely rare form of pneumonia. Doctors couldn’t figure out how a cluster of previously healthy, young gay men had gotten so sick so quickly.
The warning from Los Angeles was soon followed by reports of similar cases in New York, San Francisco, and other cities.
By the end of that year, at least 121 people had died from the then-mysterious disease. By the end of the decade, the syndrome, which we now know as AIDS, had become a pandemic, taking more than 59,000 American lives. Worldwide, the World Health Organization (WHO) estimated, there were up to 400,000 cases.
Since the beginning of the epidemic, AIDS has claimed about 34 million lives. And there are an estimated 36.7 million people worldwide currently living with HIV, the virus that causes AIDS. It’s still the leading cause of death for women of reproductive age (15-44) worldwide.
But the tide is finally turning, and stopping a disease that once seemed unbeatable is now very much within our reach.
On June 8, almost exactly 35 years since the start of the AIDS crisis, the United Nations announced a new set of goals that would put the world on track to end the epidemic by 2030. That’s not only amazing, but entirely possible.
AIDS, or acquired immunodeficiency syndrome, is a disease caused by human immunodeficiency virus, or HIV. The virus attacks the immune system, specifically infection-fighting CD4 or T cells, until the body no longer can defend itself from opportunistic infections. Doctors diagnose a patient with AIDS, the final stage of HIV, when they develop opportunistic infections or the concentration of CD4 cells falls below a certain point. HIV is transmitted through blood and other bodily fluids — most people contract it through unprotected sex or intravenous drug use with contaminated needles. Mothers can also transmit the virus to their children during pregnancy or breastfeeding.
The targets set out in what’s called the UNAIDS Fast-Track plan are ambitious, but important. The first goal is the 90-90-90 target: By 2020, 90% of people with HIV will know they’re infected, 90% of those who know will have access to treatment, and 90% of people in treatment will be successfully suppressing the levels of the virus in their system. Also by 2020, the UN hopes to see 500,000 or fewer new infections among adults.
By 2030, the UN has set a goal to limit new infections among adults to 200,000, with treatment goals boosted to 95-95-95.
That may sounds like a tall order, but the strides made in the fight against AIDS in rich countries is tremendous. In the United States, deaths from AIDS-related illnesses peaked in the early 1990s and have fallen steadily ever since.
Globally, the most devastating year was 2005, when AIDS killed 2 million people, but that number’s been falling too — down to 1.1 million in 2015. New infections have declined by 6%, and among children, new cases are down 50%. On Monday, Australia announced that AIDS was “no longer a public health issue” in the country, according to Reuters.
With access to treatment, HIV is far from the death sentence it was at the height of the American epidemic — by blocking the growth of HIV cells with antiretroviral drugs, patients can live with HIV longer than ever and even avoid AIDS altogether. The risk of a pregnant mother transmitting HIV to her child can now be reduced to less than 5% with proper medical intervention.
As treatment has improved, so has prevention. A study released in the Journal of the American Medical Association (JAMA) on Tuesday tracking long-term, committed couples with different HIV statuses showed that antiretroviral therapy can also prevent an HIV-positive person from transmitting the virus to their uninfected partner.
Right now, the UN estimates that only 57% of people living with HIV know their status, and fewer than half have access to antiretroviral treatment. The rates of new infection are on the rise again — even in Australia, where HIV diagnoses actually rose by 13% over the past decade, despite the plummet in cases of full-blown AIDS.
And while treatment and prevention options have improved drastically, there are stark disparities in who has access to those options around the world.
“Today, we have multiple prevention options,” said Michel Sidibé, executive director the UN’s AIDS program, in a press release. “The issue is access — if people do not feel safe or have the means to access combination HIV prevention services we will not end this epidemic.”
Which is why one another important number in the plan the global AIDS epidemic is zero: Zero discrimination against people living with or vulnerable to HIV infection.