Our False Sense of Complacency about AIDS

By: Marc H. Morial
President and CEO
National Urban League

Two separate news items reported over the last month illustrate as much as anything can the present status of America's and the world's fight against the scourge of HIV/AIDS.
On the one hand, there was the good news. In late January public health officials said that AIDS among infants in the U.S., once the saddest tragedy of a disease that brings enormous suffering, is close to being eliminated.

In 1990, during the peak period of HIV infections in America, nearly 2,000 newborns were infected with HIV, the virus that causes AIDS. Now, that number has fallen to about 200, thanks to the mid-decade development of a drug called AZT and an aggressive education campaign aimed at pregnant women in low-income, high-risk communities.

On the other hand, however, it was reported that New York City's health department changed the name of one of its bureaus. What had been the department's Bureau of HIV/AIDS Services is now called the Bureau of HIV/AIDS Prevention and Control.

In that seemingly minor bureaucratic change was, health officials said, the sounding of an alarm, reflecting a sudden spike of concern among many American AIDS researchers and activists that the very success of treating the disease in this country—stabilizing those who have HIV/AIDS with carefully-calibrated regimens of medical drugs and diets—has produced growing complacency among some in the larger population about the dangers of unprotected sex or the sharing of drug needles.

What brought that alarm to the surface was New York City health officials' early February announcement of the discovery of a possibly new and virulent strain of HIV in a single patient.

It's still unclear if this one case does indeed represent a more ferocious variant of the virus. Some researchers and activists have expressed great skepticism that it does. Nonetheless, the announcement did get the AIDS community's attention for two reasons.

One is that experts have long believed that it's only a matter of time before a so-called HIV super virus—one impervious to all current treatments—emerges. The second stems from the fact that the number of Americans infected with HIV—estimated at 950,000—is relatively small compared to the total U.S. population, and that medical treatment for the disease here is the best in the world.

Dr. Thomas R. Frieden, New York City's health commissioner, worries this combination may have led many, including some who are most at risk for being infected with HIV, to think of the disease as merely another chronic health condition, which can be held at bay with medical treatment.

His concern was seconded in more graphic terms by an HIV-positive woman a New York Times reporter interviewed last month at a city community-based treatment center.

"The medications gave people a false sense of security," she said. "It gave them a sense that they could do things that before were a death sentence."

HIV/AIDS is not "just" another chronic health problem. It is a killer plague. In the rich nations of Europe and America, the medical community's mobilization and our ability to afford the drugs has shielded our societies from the killer's full power.

In other parts of the world, where that is not so, we can see AIDS' grim reaping.

In Black Africa more than 2 million people die from AIDS each year, devastating families, entire villages, and threatening to strangle the economies of numerous countries as it robs them of population. At least five million of South Africa's 44 million citizens have HIV; in 2002 at least 499,000 people there died from AIDS. Worldwide, 39 million people now have HIV/AIDS, and, with the disease reaching the epidemic stage in Russia, China and India, the worldwide annual death total is expected to reach at least five million by 2007.

In the United States HIV/AIDS continues to become concentrated among African Americans. Federal statistics indicate that black males make up nearly 36 percent of males with HIV/AIDS, and black females, reflecting a worldwide trend of the growing "feminization" of HIV infection, comprise 61 percent of females with it.

What this grim welter of statistics should underscore for us all is the world itself remains at risk of this devastating scourge—for which as yet there is no cure in sight. Abroad, the developed nations need to provide more funds for research and for HIV prevention and treatment programs, which have made a significant difference in many countries. Here at home, we need to re-start a vigorous public HIV/AIDS education and prevention program, especially in low-income African-American communities.

We must make the dangers of HIV/AIDS visible—and frightening—again, because the consequences are frightening. This is no time to be complacent. Our very lives are at stake.

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