12月1日星期日是世界艾滋病日，一个致力于提高艾滋病毒感染蔓延引起艾滋病大流行意识的国际日，以及记住那些死于该疾病的人的时间。自1988年以来已在全球范围内观察到。
奥伦科恩，MD，届，博士，博士首席医务人员，是在纽约市的流行病初期在纽约市的传染病医生，并享受这一纪念：
It was September of 1990 and my clinic schedule was packed. Like many of my patients, Mark was in the advanced stages of AIDS–multiple episodes of Pneumocystis pneumonia (PCP), cytomegalovirus retinitis, and innumerable Kaposi Sarcoma lesions which were painful and disfiguring. His CD4+ T cell count (a measure of the status of the immune system) was zero; his response to AZT had been brief. He was now blind, gaunt and pale with sunken cheeks. He was only 32 years old but, like many people with AIDS during this time, looked decades older. Mark, intense and quiet, had wanted to dedicate his career to public service, but we both realized at that appointment that he would unlikely survive another six months. He simply wanted to be comfortable so we selected home nursing and morphine as his treatment. He died a few days before Christmas.
NYC in 1990 was one of the AIDS capitals of the world, a designation shared with other major global urban centers. These cities, however, represented the proverbial ‘tip of the iceberg.’ In hindsight we know that by this time, HIV was already in smaller cities, towns, and villages worldwide, just not to the levels seen in NYC. The sterile diagnostic names belied the heartbreaking and crushing amount of human suffering. From disease. From loneliness. From abandonment, fear, hate, discrimination, and indignity.
Before it was called AIDS (acquired immunodeficiency syndrome) it was known as GRID (gay-related immunodeficiency syndrome), because it appeared that only gay men were developing these opportunistic infections and malignancies. The disease, however, was soon recognized also in blood transfusion recipients and hemophiliacs who had received infusions. The first reports of what we now call AIDS were published in 1981; by the mid-1980s, scientists would isolate and identify HIV as the virus that causes AIDS.
Although progress did not come soon enough for so many people like Mark, it was remarkably swift.
The most famous of the early AIDS drugs was AZT (azidothymidine). Under immense pressure from activists and others, the FDA review of AZT took only 4 months and it was approved 20 months after the investigational new drug application was filed. While AZT was terribly toxic for most patients and extremely expensive ($8,000/year), it was all we had at that time.
艾滋病激活主义在压制采取紧迫感的行动中的作用不能夸大。Groups including ACT UP, Gay Men’s Health Crisis, Treatment Action Group, Lambda Legal Defense and Education Fund and others integrated themselves into scientific meetings, communicated important findings to stakeholder communities, created crisis hotlines, and relentlessly pressured scientists, politicians, and policy makers to take action! The accelerated review of AZT was a real-time example of how AIDS activism influenced policy, and it eventually gave rise to the now-familiar “fast-track” designation within the FDA review process. It would be fair to say that the early advocacy of HIV-related organizations served as a model for the activism seen today around breast cancer, Alzheimer’s, and heart disease.
The subsequent history of anti-HIV drug development is remarkable in many ways. The therapeutic armamentarium now includes more than 30 drugs and many combination strategies that can be brought to bear as drug resistance emerges. Whereas life expectancy for AIDS patients early in the epidemic was measured in months, by 2011, the total life expectancy increased to about 70 years.
Recently, Covance has been involved in the development of a new drug candidate that represents a new class of drugs, HIV capsid inhibitors; this drug has been granted Breakthrough Therapy designation from the FDA.
In the West, HIV/AIDS began as an outbreak concentrated in gay men but we eventually began to unmask diversification of the epidemic, with increasing numbers of cases in injecting drug users and their partners – in both cases, disproportionately in people of color. On a global scale, sub-Saharan Africa has borne the greatest burden of the epidemic, as well as India and parts of southeast Asia. Of the approximately 40millionpeople living with HIV/AIDS around the world, nearly 30 million live in sub-Saharan Africa. Heterosexual transmission predominates in Africa, creating a huge number of “AIDS orphans.” Thanks to decades of improvements in public health and rising life expectancy in sub-Saharan Africa, the average life expectancy in Swaziland reached 62 years by 1990; however, in the face of an unchecked HIV epidemic, average life expectancy fell to 42.5 years by 2005.
在某些方面，我们是我们自己成功的受害者。我们很少听到新闻中的艾滋病毒/艾滋病。在西方，艾滋病毒致力于慢性，可管理的疾病。除了发展艾滋病毒感染治疗艾滋病毒感染的迅速进展外，该流行病刺激了大量的研究，这些研究有助于免疫学，肿瘤学，遗传学，寄生虫学和细菌学的进展。
我29年前去世的患者，我的患者将在所取得的进展中感到惊讶，但他将令人沮丧的是今天对艾滋病毒/艾滋病的关注程度较少，并且令人震惊的是，这么多年轻人几乎没有关于它的信息。因此，在纪念遇到的百万遇到的历史记录中，让我们让我们重新定位自己以结束流行病。我们找到有效的疫苗是必不可少的。我们需要教育和重新联系青年，以防止疫情再次在下一代再次捕捉火灾。对于艾滋病毒感染的数百万人来说，我们需要更多的研究来提高他们对抗病患者的长期后果的生活质量。最重要的是，我们需要同情和同情心。减轻痛苦。了解行动的持续紧迫性。
