AIDS at 30: Hard Lessons and Hope
Q:
HIV/AIDS has been one of the most catastrophic epidemics in all of history. Despite this tragic human toll, are there ways in which
HIV/AIDS changed public health for the better?
Fineberg: Yes, because it was the beginning of a new understanding of global
health—a commonality of risk and burden. The U.S. as a wealthy country and Uganda as a developing country: both faced the same disease problem, though in different ways. At the World Health Organization, Jonathan Mann, who would later join the School as founding director of the FXB Center, also helped define a new way of thinking about public health. He tried desperately to mobilize the world, awaken the world, to this looming disaster. He repeatedly described the inseparable nature of health and human rights. Marlink: The epidemic toppled myths in public health. People said we couldn’t do
anything about the epidemic in developing countries—we’ve shown that’s not true. People then said AIDS would pull resources away from malaria or childhood diseases and maternal health—we’ve shown that AIDS has dramatically increased total public health funding in Africa, including in these areas. AIDS has also brought about unprecedented international cooperation, such as the creation of UNAIDS and of the Global Fund to Fight AIDS, Tuberculosis and Malaria, among others. Walensky: Investments that have benefited HIV/AIDS patients have improved
health care in general. What is generally underestimated is what those resources have done for health care infrastructure, worker training, protocol development, clinical care sites, preventing children from being orphaned, preventing mother-to-child transmission, and making drinking water safe. Essex: I compare our response to HIV/AIDS to President Nixon’s war on can-
cer in 1972, which opened the floodgates for money on research. Rates of cancer deaths didn’t go down for a long time, but what did happen was a revolution in molecular biology. That revolution led to things that we wouldn’t have anticipated: biotechnology, the rejuvenation of pharmaceutical companies, a renewed emphasis on applied research. That’s where we are today with AIDS vaccines. Whatever knowledge is gained from a war on AIDS will help us make vaccines against cancer, heart disease, and other diseases.
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Harvard Public Health Review