Slideshow: AIDS Retrospective - A Pictorial Timeline of the HIV/AIDS Pandemic
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AIDS-related illnesses have killed more than 30 million people since 1981. That's half as many deaths as in World War II. And it's not over. An estimated 1.1 million Americans are among the 33 million people worldwide who are now living with HIV, the virus that causes AIDS. How did we get here?
Circa 1900: From Monkeys to Humans
Between 1884 and 1924, somewhere near modern-day Kinshasa in West Central Africa, a hunter kills a chimpanzee. Some of the animal's blood enters the hunter's body, possibly through an open wound. The blood carries a virus harmless to the chimp, but lethal to humans: HIV. The virus spreads as colonial cities sprout up, but deaths are blamed on other causes.
1981: First Cases Recognized
In June, the CDC publishes a report from Los Angeles of five young homosexual men with fatal or life-threatening PCP pneumonia. Almost never seen in people with intact immune systems, PCP turns out to be one of the major "opportunistic infections" that kill people with AIDS. On the Fourth of July, the CDC reports that an unusual skin cancer -- Kaposi's sarcoma or KS -- is killing young, previously healthy men in New York City and California.
- The CDC calls the new disease acquired immune deficiency syndrome or AIDS. AIDS is seen in people with hemophilia, convincing scientists that the disease is spread by an infectious agent in contaminated blood.
- Gay men form the first AIDS advocacy organizations.
- The CDC warns that AIDS may spread by heterosexual sex and by mother-to-child transmission.
- The U.S. Public Health Service asks "members of groups at increased risk for AIDS" to stop donating blood.
- The Heterosexual spread of AIDS in Africa is confirmed.
- Public apprehension grows. False rumors of "household spread" abound. In New York, landlords are reported to evict AIDS patients.
Pasteur Institute researchers Luc Montagnier and Francoise Barre-Sinoussi isolate a virus from the swollen lymph gland of an AIDS patient. They called it lymphadenopathy-associated virus or LAV. Independently, UCSF researcher Jay Levy isolates ARV -- AIDS-related virus. Not until 1986 does everybody agree to call the virus HIV: human immunodeficiency virus.
National Cancer Institute (NCI) researcher Robert Gallo reports isolation of an AIDS virus he calls HTLV-III. Later, it turns out to be LAV from a sample sent by the Montagnier lab -- but not before HHS Secretary Margaret Heckler gives Gallo full credit. Heckler predicts a vaccine in two years, but does not specifically fund AIDS research.
- Rock Hudson dies of AIDS.
- As AIDS hysteria builds, Ryan White is barred from school in Indiana.
- AmFAR, the American Foundation for AIDS Research, is founded with Elizabeth Taylor as spokeswoman.
- First HIV test licensed; blood banks begin screening donations.
- First International AIDS Conference is held in Atlanta.
- A scathing government report blasts HHS for lack of AIDS funding.
- Larry Kramer's AIDS play, "The Normal Heart," shocks New York audiences.
- Lauren and Patrick Burk, and their son Dwight, show the impact of HIV/AIDS on the heterosexual community.
- Surgeon General Everett Koop urges parents to have a "frank and open conversation" about AIDS with their children and teens.
- The first panel of the AIDS quilt is created.
- For the first time, President Reagan publicly utters the word "AIDS."
- Princess Diana is photographed hugging people with AIDS.
- The AIDS quilt is displayed with 1,920 panels. By 1996, the quilt will cover the entire National Mall in Washington, D.C.
- ACT UP is formed to protest the $10,000 per year cost of AZT. It adopts the motto, SILENCE=DEATH.
- President Reagan makes his first speech on AIDS.
- The U.S. forbids immigration by people with HIV, a policy later signed into law by President Clinton.
- Liberace dies of AIDS.
- ACT UP protests shut down the FDA. Within a week, the FDA begins a "fast-track" policy allowing public access to lifesaving drugs still in clinical trials.
- The first World AIDS day is held on Dec. 1.
- Scientists find that even before AIDS symptoms develop, HIV replicates wildly in the blood. The goal of treatment shifts to keeping HIV at low levels.
- Robert Mapplethorpe dies of AIDS.
- The red ribbon is introduced as a symbol of AIDS solidarity.
- Magic Johnson announces he is HIV positive.
- Queen singer Freddy Mercury dies of AIDS.
- AIDS becomes the leading cause of death in U.S. men aged 25-44.
- FDA licenses the first rapid HIV test.
- ACT UP and Benetton put a giant condom on the Place de Concorde in Paris.
- The play “Angels in America” wins the Pulitzer Prize.
- The CDC launches condom ads on TV
Activist Pedro Zamora becomes a cast member on MTV's The Real World. One day after the season finale, he dies of AIDS at age 22.
A treatment breakthrough: The AIDS drug cocktail -- highly active anti-retroviral therapy or HAART -- can cut HIV viral load to undetectable levels. Hope surges when AIDS researcher David Ho, MD, suggests treatment could eliminate HIV from the body. He's wrong -- it's later found that HIV hides in dormant cells -- but U.S. AIDS deaths decline by more than 40%.
Awareness grows that HAART has serious side effects. Treatment failures underscore the need for newer, more powerful drugs. In the ensuing years, the FDA approves new classes of drugs that make HIV treatment safer, easier, and more effective. But the drugs still do not cure AIDS.
- UN Secretary General Kofi Annan proposes the Global Fund to Fight HIV/AIDS, TB and Malaria. The purpose of the Global Fund is to mobilize, manage, and distribute funds to fight HIV/AIDS.
- Treatment is still totally unavailable to the vast majority of people living with HIV. Only 1% of the 4.1 million sub-Saharan Africans with HIV receive anti-HIV drugs.
- AIDS becomes the leading cause of death worldwide for people aged 15 to 59.
- There is an HIV outbreak in the California porn industry.
- President Bush announces the $15 billion President's Emergency Plan for AIDS Relief. The prevention portion of the plan is criticized for over-emphasis on abstinence. But the plan provides much-needed HIV/AIDS-treatment funds to 15 nations.
- HIV treatment is shown to extend life by 24 years, at a cost of $618,900.
- Merck's HIV vaccine fails in clinical trials -- the latest in a long line of vaccine failures. However, new candidate vaccines continue to move through the development pipeline.
- UNAIDS recommends adult circumcision after it's found to halve HIV transmission from women to men in regions of high prevalence.
- The CDC says improved surveillance shows HIV in America is worse than we'd thought: 1.1 million infected, up 11% from 2003.
- New HIV infection rates soar among men who have sex with men.
- Luc Montagnier and Francoise Barre-Sinoussi awarded Nobel Prize in medicine for discovery of HIV.
- Of the 33 million people now living with HIV, 3 million are getting treatment. That's less than a third of those who need immediate treatment. Yet for the first time, global AIDS deaths decline.
UNAIDS calculates that the global spread of AIDS peaked in 1996 at 3.5 million new infections. Deaths peaked in 2004, at 2.2 million. Yet AIDS Day 2009 brings grim figures: 2.7 million new HIV infections and 2 million AIDS deaths in the previous year. More than half of those who need it get no treatment.
Polls show most Americans no longer consider AIDS a major problem. They're wrong. New infections continue to soar. Over half are in men who have sex with men, but 31% are in heterosexuals. African Americans -- 12% of the U.S. population -- get 45% of new HIV infections.
Hope for Tomorrow
Researchers have discovered more than a dozen antibodies that target the HIV virus. They hope that these discoveries will lead to a vaccine that offers long-term protection against AIDS. One antibody in particular, PGT 128, is considered among the most potent and promising -- preventing about 70% of viruses from infecting cells in laboratory tests.