Anniversaries compel us to reflect, to take stock, to inquire about how we can better carry out our missions. On the 30th anniversary of the first official report on what would be known as the HIV/AIDS epidemic—published by the U.S. Centers for Disease Control and Prevention on June 5, 1981—I would like to reflect on how far public health and HSPH have come to address the epidemic—and on what remains to be done.
A recent summary from UNAIDS states: “On the cusp of the fourth decade of the AIDS epidemic, the world has turned the corner—it has halted and begun to reverse the spread of HIV.” Our School and its faculty have helped catalyze this turnaround.
Since the early 1980s, HSPH researchers have made fundamental discoveries about the disease. In 1983, Max Essex provided key evidence that the infection is caused by a retrovirus; two years later, he co-discovered the gp-120 surface protein, which is now used worldwide for blood screening. In 1986, Essex, Phyllis Kanki, and Richard G. Marlink discovered a second AIDS virus, HIV-2, which causes most infections in West Africa.
The School has been a major presence at the frontlines of the epidemic. In 1988, HSPH helped launch what has become the Harvard School of Public Health AIDS Initiative. Through the Botswana Harvard AIDS Institute Partnership, the AIDS Prevention Initiative in Nigeria (APIN), the School’s vital work in the President’s Emergency Plan for AIDS Relief (PEPFAR), and through other international collaborations, HSPH has trained thousands of health care workers in some of the most tragically affected parts of the world. HSPH researchers have identified a treatment program that prevents 99 percent of mother-to-child HIV transmission via breastfeeding. Our scientists have helped slow illness in Africa through innovative nutrition interventions. Former Dean Harvey Fineberg staked out enlightened AIDS policy, both through his prolific writing in scientific journals and through campus-wide collaborations. Jonathan Mann, who was the first director of the François-Xavier Bagnoud Center for Health and Human Rights, showed the world that the AIDS epidemic was, at heart, a social justice issue. And the School continues to lead the way in testing, treatment, and vaccine research.
Yet, in many parts of Africa, Asia, and other developing nations, fewer than 30 percent of young men and women possess comprehensive and accurate knowledge about HIV. In resource-poor nations, drug treatment lags far behind the need. Here in the U.S., 3 percent of Washington, D.C. residents carry the AIDS virus, and African-Americans account for nearly half of all AIDS diagnoses nationwide—far disproportionate to their numbers in the population. Enormous disparities continue to mark who suffers from the infection and receives help, and who does not.
On December 1–2, 2011, the School’s AIDS@30 symposium will convene hundreds of global health leaders, elected officials, scientists, artists, and activists. Our goal: to discuss what we have learned from AIDS and how to use those lessons to halt the epidemic. If we can translate knowledge into action, by the next major milestone in time, the world may be on its way to ending this catastrophic epidemic.
— Julio Frenk is Dean of the Faculty and T & G Angelopoulos Professor of Public Health and International Development, Harvard School of Public Health
Read the Harvard Public Health Review special report: AIDS at 30: Hard Lessons and Hope.