AIDS at 35: A midlife crisis
This year marks the 35th since AIDS was first identified and the epidemic now faces a “mid-life” crisis. “It seems to us it is time to take stock of both the successes we have met and the challenges we face,” said social scientists, David Wilson and Alan Whiteside in their Editorial, “AIDS at 35: A midlife crisis”, African Journal of AIDS Research , Volume 15, Issue 4.
Both social scientists are from Southern Africa – Swaziland and South Africa in the case of Whiteside, and Zimbabwe for Wilson and both have been engaged with the epidemic since the late 1980’s. “We warned of the potential devastation AIDS would wreak across Africa, but this went unheard. We watched with dismay as colleagues and friends sickened and died, and the political leaders initially ignored what was to come.”
In this editorial, Wilson and Whiteside look at the best of times – where things went well, and the worst of times – where the challenges lie. In discussion around the best of times, one such eye-opener is treatment. In 1996, it became apparent that the most effective form of treatment was a combination of three different drugs. This breakthrough meant that patients could recover. Initially, patients had to take handfuls of tablets at specified times of the day, some with and some without food. “The cost was immense, initially over $10 000 per patient per year. In 2016, a person can take just one pill a day and treatment is delivered for less than $100 per patient per year in some parts of the developing world.”
In KwaZulu-Natal, South Africa, the global epicentre of the HIV epidemic, AIDS treatment has increased community life expectancy by a full 11 years, reversing decades of decline. Life expectancy in KwaZulu-Natal is higher today than before the HIV epidemic.
In noting the worst of times, where the challenges lie, Wilson and Whiteside mention prevention lags, no end to AIDS in sight and funding and political commitment. On funding and political commitment, the Editorial highlights that for the first 30 years of the epidemic money was not the binding constraint as the international community stepped forward and made billions of dollars available. HIV funding from the international community has fallen from $8.6 billion in 2014 to $7.5 billion in 2015. “We need to strengthen our focus on social and structural determinants of HIV transmissions. Secondary education, income, greater economic opportunity and shared, inclusive growth reinforce HIV prevention,” said Wilson and Whiteside in looking at the way forward.
In drawing a conclusion to the Editorial, the authors state that the African Journal of AIDS Research is undergoing changes. “Editorials give us the opportunity to identify key issues. We are planning to include book reviews and commentaries.” Read this thought-provoking and engaging Editorial at no cost until end of January 2017 here .