A person in the United States can live with AIDS for decades using a drug cocktail that effectively suppresses the virus that once meant almost certain death. But the same person, if they lived in sub-Saharan Africa, probably would not stand a chance.
Today is the 25th anniversary of first reported cases of AIDS. Nearly 1 million Americans and 40 million people around the world are living with the disease, according to the U.N. report on AIDS.
When the antiviral drug cocktail was unveiled in 1996, there was hope for those who could afford the medication. People got out of bed and began living their lives again. But AIDS continues to be a problem, and 40,000 new infections occur in America each year.
"It isn't an immediate death sentence," Dr. Anthony Fauci, immunologist and director of the Infectious Diseases Institute at the National Institute of Health, told "Good Morning America Weekend Edition." "The bad news is that … people think it's not a threat. But the drugs, the therapies that are available, they have changed this illness. People who get the drugs have a very good chance of living a very normal life for a very long time."
Every Day Is a Struggle
As a little girl, Hydeia Broadbent touched the world when she talked publicly about her battle with the AIDS virus. She became a child activist and trumpeted her cause on virtually every media outlet.
Broadbent contracted the disease through her biological mother, a drug-abuser. Doctors told her adoptive parents that she would not live past the age of five when she was diagnosed with AIDS at age three. Today, she is 21, a college student and has a good life, but it is not easy.
"I want people to know is that living with AIDS, every day is a struggle," she said. "You don't have a day off -- whether it's dealing with symptoms, or dealing with medications or how you're going to pay for medications. But you can't get stressed about it, because stress makes your symptoms worse. Still you have to try to live positive so you can be healthy. And that's all anyone with AIDS is trying to do."
Despite the progress, especially in affluent countries, AIDS continues to be a great divider between the haves and the have-nots; the rich and the poor. AIDS has infected people of every race, religion, age and sexual orientation.
Since it first appeared in five young homosexual men living in Los Angeles who contracted an unusual form of pneumonia because of their ravaged immune systems, half a million people have died in the United States and 25 million people have died worldwide, according to the World Health Organization. Last year alone, AIDS claimed the lives of 2.8 to 3.6 million people, over half a million of whom were children.
At first, the disease was a mystery considered the "gay plague." Its first technical name was GRID or gay-related immunodeficiency syndrome.
An Unimaginable Epidemic
"We never imagined that we were on the cusp of an epidemic, especially one of this proportion," said Dr. Michael Gottlieb, who treated the first AIDS patients.
The people who contracted the illness literally wasted away. They lost weight, developed lesions and many died a painful, lonely death.
"When I started treating AIDS patients, literally 100 percent of my patients died," said Fauci. "That was hard. We were the miracle workers. If you came to the NIH you got better. That's why we were there. But that wasn't the case back then. In 1981, no one got better."
No one understood what was happening and what it meant. It was only half-way through the 1980s that the syndrome got its official name, acquired immunodeficiency syndrome, or AIDS.
"I thought I was a pretty good looking guy -- average but happy," said AIDS patient Ken Ramsaur in an interview with "20/20" more than 20 years ago. "And now, I actually see myself fading away."
In 1985, actor Rock Hudson's death showed even movie stars were not immune -- and that star power could make a difference. Actress Elizabeth Taylor picked up the banner and made AIDS her primary cause.
"We will not be defeated by this illness, this disease," she said in 1985. "In the American tradition, we will fight the odds and win, because it is right to do so."
In the face of all the death and fear surrounding AIDS and HIV, the name for the virus before it begins to attack the body's immune system, public health officials were remarkably optimistic.
In 1984, President Reagan's health and human services secretary, Margaret Heckler, predicted that a vaccine was just around the corner.
"We hope to have such a vaccine ready for testing in approximately two years," she said.
There is still no vaccine, and Fauci said that because of the nature of the virus, a vaccine will be very difficult to develop.
"This virus has a unique ability to evade the body's natural defenses, and that's how we build vaccines -- by looking at how the body naturally defends itself from that virus," he said. "And what we have done with polio and smallpox vaccines are to look at how the body gets rid of those diseases on its own and mimic the body's own response -- putting that in a shot form. We can't do that with AIDS, because there is no natural biological response to mimic. So we have a scientific barrier. We have to somehow get around the body's lack of response to this disease and try to invent one ourselves. And we've never had to do that with a vaccine before."
Twenty years ago, researchers were not yet aware of how tenacious the virus was. It can mutate and become resistant to drugs, making it very difficult to cure.
"Thus far, it has been completely impossible to eliminate the virus from the body," Fauci said. "We can suppress it, but we can't eliminate it. And I don't know that we ever will be able to do that. There are no documented cases of eradication of the virus."
Fauci said that it is conceivable AIDS could be eradicated like polio because it is relatively hard to contract. It is not spread through casual contact, but only when bodily fluids are transferred.
"The bad news is that specific type of behavior is one that everyone does in life," he said. "So it would be hard to get rid of. And you'd have to do it through prevention. You would have to have a sustained educational prevention program for decades and decades and decades to get rid of it. And really, even then, I think AIDS will always be smoldering around."
Changing Face of AIDS
In 1987, President Ronald Reagan, who had been hesitant to discuss the topic, delivered his first and only speech about AIDS.
"AIDS affects all of us," he said. "We'll supply help and hope as quickly as we can."
Initially, AIDS was considered a disease for those with questionable lifestyles -- homosexual men and intravenous drug users. But when the disease contaminated the nation's blood supply and subsequently infected people like 13-year-old hemophilic Ryan White and the wife of actor Paul Glaser, Elizabeth Glaser, the face of the disease began to change.
In 1992, Elizabeth Glaser, the founder of the Pediatric AIDS Foundation, spoke at the Democratic National Convention.
"We are just real people wanting a more hopeful life," she said.
In 1991, basketball star Magic Johnson contracted the disease through unprotected sex.
"Because of my HIV virus I have attained, I will have to announce my retirement from the Lakers today," he said then, although he did return to play professional basketball once more.
Two years later, a prominent athlete was struck down with the disease. Tennis great Arthur Ashe announced that he had AIDS in 1992 and died the next year.
Johnson later appeared on a TV talk show for kids about AIDS. It featured a breakthrough moment when Broadbent, just seven at the time, made a desperate plea for acceptance.
"I want people to know we're just normal people," said Broadbent, who contracted the disease when she was four.
Today, much of the fear surrounding AIDS and HIV has dissipated in the United States due to the miracle drugs that allow patients to live relatively normal lives.
"I plan on finishing school, getting married, having kids and living my life," Broadbent said. "The same dreams as everyone else. And I just want to have the same opportunities as everyone else and not let AIDS get in the way."
But opportunities for normalcy are few and far between for people in Africa and Asia.
"When you think that there are 4 to 5 million infections a year and 3 million people dying, and the southern part of Africa still an apocalypse, and the virus moving around the world inexorably, it's just awful," said Stephen Lewis, the U.N. envoy for HIV/AIDS in Africa. "In the context of 25 years, I don't think there's been a historical precedent for working on a communicable disease for 25 years and making so little progress."
AIDS is the fourth-leading cause of death in the world, and there are countries in Africa where one third of the adults are HIV positive. Furthermore, those who do not have access to antiviral drugs usually survive less than 10 months after the HIV virus becomes AIDS.
President Bush has committed an unprecedented amount of money to fighting AIDS in the third world.
"I ask the Congress to commit $15 billion over the next five years," he said at the 2003 State of the Union.
Activists like U2 singer Bono -- who even convinced staunchly conservative former Sen. Jesse Helms to support AIDS funding -- are still pushing for more funding and more help to get drugs to the poorest and most vulnerable. More stars are picking up the mantle.
"It's not a cause, and to me it long ago surpassed being just a pandemic," said actress Ashley Judd. "All of this is preventable. Every single bit of it is preventable."
To learn more about the AIDS virus and what you can do to help fight it, visit these sites: aidsaction.org, aidsquilt.org, pedaids.org, aidsfund.org, the Office of AIDS Research at the National Institutes of Health and redribboncoalition.org
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