Basic Course in HIV - History of HIV | Center for AIDS Research

and I hope you you find this interesting um I thought it was interesting compiling it so I hope you find it interesting listening to it um just wait a second until we're ready to record when I get the thumbs up I got the thumbs up okay all right so this lecture is about the history of HIV and I know a lot of lived through this era all of us lived through this era it started in 1981 when we first found out about HIV but we're still learning more and more and more about the very early period of actually how HIV came to infect humans and then I think a lot of us are still learning although we lived through it learning about why stigma is such a problem with HIV but I think when you go through this I think you might gain some understanding as to why stigma is what it is why it's so bad in some places like South Africa and why in other places stigma is coming down I can't say that it's gone everywhere HIV and stigma are intertwined but in some places stigma is coming down down down down places like Uganda like America like batswana you find that stigma is becoming less and less and less with HIV and I think you'll understand why when we get through to through this lecture okay so this lecture is a a compilation of of lots of things basically a timeline of HIV and when we first discovered it uh and then we go back a bit to see how it actually originated in the first place so some of its lectures and it's going to be interspaced with some videos the videos come from a series that was done in America uh from a channel called PBS or public broadcast system um a story called front line it's about a 4our documentary on the history of HIV I've taken a few I think four or five small little Snippets of it because I think they highlight a lot of what's happening with stigma in South Africa so these little Snippets from this front line documentary I think add tremendous amount to this lecture so I'm going to be talking a little bit we'll break for then I'll show a little bit of video and and come back and forth and we'll we'll see how this works okay so first a little bit about HIV itself and this is a a quick little summary that really tells you everything about HIV if I can get it to work the human imuno deficiency virus is not in the strictest sense a form of life until it is inside a host body it is no more alive than a rock or a stone it is a protein coated mass of genetic instructions 150 times smaller than the white blood cell it attacks after penetrating it multiplies until the cell bursts and dies this continues for years cell by cell the virus destroys its carrier's immune system untreated the person becomes ill from a series of infections that are progressively serious and rare and finally fatal this is [Music] Aids HIV in a few sentences but it really summed up what it is it's just a protein covered Mass it's not alive it's not a living thing but what it does is it gets in once somebody's infected it gets inside the cells particularly the tea cells causes a whole bunch of dysfunction and causes those cells to rupture by doing that it damages the immune system of the person by damaging the immune system it makes the person susceptible to becoming sick and then ultimately die and that's what HIV is and that's how it works well where did it come from well nobody knew what HIV was until 1981 that was the first description of HIV or Aids came in this journal called uh morbidity and mortality weeks reporter which is a CDC um Journal that comes out weekly uh and it's an epidemiology Journal often times they report outbreaks of things and uh different types of infections or or different types of things and this one this very first report came out of Los Angeles in California in the United States and what they noticed was these five cases that were strikingly similar five homosexual men all with devastatingly sick uh and very rare diseases particularly PCP pneumonia and some of them also had capaces saroma now these are very very very rare diseases and when they found out they found that these people these five individual had their immune system just shut down it wasn't working so they didn't know what this was they had no idea this was the first description this happened in June 1981 this uh article came out and this was the first description of what is HIV what was AIDS but at the time they didn't know what it was they just noticed that these there's this clustering of cases in certain individuals so where did it come from where's the beginning where's where do we start well actually the current research believes that HIV originally came uh from another type of virus called SIV or Simeon uh immune deficiency virus which infects primates like chimpanzees and monkeys and that's where it actually originated and it's thought somewhere between 1884 and 1924 the virus which was formerly SIV changed and when it changed somehow there was a mixing of blood between chimpanzees and humans and this is thought to have taken place in Cameroon and when that virus changed and it got into the human blood stream that's when HIV took place so they've scientists have actually pinpointed a very very very small area where they think it actually came from you could see a map of Africa and this is DRC uh Congo here and this is the Democratic Republic of the Congo and Cameroon is here on the coast you can see it blown up here this little circle is where a HIV originated that small small small little region is where SIV infected humans or the virus that was SIV had changed in chimpanzees became HIV and then infected humans so how did it spread How does it go how does it go from a chimpanzee to a human well it probably came into to humans through through trade at the time in the uh turn of the century there was population bursts and they needed people needed meat and food so one of them was the bush meat trade which was chimpan so probably either a hunter or a butcher in preparing meat or hunting of the animal or getting into a struggle with the animal during hunting then there was blood to blood mix most people believe that it was probably in the butchering process for but bush meat in Congo which was then transported uh often times to the DRC so in that process you know a butcher cuts his or the animal blood in preparing the meat or skinning it somehow the blood from the chimpanzee got into the human and did it only occur once no it probably happened over and over and over again I mean that did it spread quickly right away no it didn't it probably happened for long periods of time during that period of time in the 1880s uh to 1920s there were probably several humans that were infected through hunting through butchering through processing of bush meat so then how did it spread so quickly well it spread quickly because I have some pictures here this is uh kinasa in DRC uh in 1883 to 1885 that's the main Trading Post right there you can see it's just one small little building kinasa at the time was nothing it was a small little Trading Post but at the turn of the century with colonialism there was really an explosion of people in the in the 19 early 1900s and kinasa became a major trading center and why did it become a major trading center well look where it is this is the Congo River look where HIV first took hold in humanss look at the Rivers they all lead into the Congo and then the Congo comes down right by kinasa it was a trading route a trading route from boats people probably trading in bush meat trading in other Goods the those people brought the HIV into kinasa they brought it into kinasa at a time when it was exploding as a city transforming from a small little town into a city okay so SIV jumped species to HIV now people say how can a virus that only infects chimpanzees suddenly change itself and and turn into humans who's ever heard of such a thing well we've heard of swine flu right we've heard of bird flu right those the same things happened right those flu viruses like swine flu and like bird flu they used to only infect Birds but then something happened in that virus and it changed and now it can infect humans that same thing happened with the SIV virus and made it possible that the SIV virus can infect humans and then it became hi so it's not like the this is the only time this has ever happened many many many viruses can go from animals to humans what about rabies we all know that rabies is can be transferred from an animal to a human right as the current outbreak in Johannesburg has shown us so things can go from animals to humans quite easily and so that's how HIV happened and and kinasa was a major major point and major place where it took place because this was a place where people were all coming together together from far away because of trading it was a major trade route because it was using the rivers in the Congo River and at the at the early 19th Cent uh turn of the century this was the largest city in the area so people who want to go to trade and go for business and go for work this is where they came uh and then it got even bigger as the rise of the colonial cities in the 1960s so what's the very first known case of HIV well they went and looked back and they've tested lots and lots of of samples that were collected in this time and the very very first case of HIV ever known happened in 1959 of course at the time they didn't know that that was HIV but they found it in tissue samples of a person who was stored who had tissue samples stored and later researchers went back and looked at those tissues and found the earliest one uh was from a male in 1959 they also found another sample in a woman from a lymph node biopsy in 1960 so it shows simply from two samples in the late 50s early 60s that several people had it it was happening it was around it was passing at the time of the 60s and of course people didn't know what it was and they didn't even know um that HIV existed at the time and then there was transfer to Haiti lots and lots of infections were happening during this time in Haiti and people say well how did it get to Haiti Haiti is so far away well what language do they speak in the DRC they speak French what language do they speak in Haiti they speak Creole but it's sort of French as well so what actually happened in the DRC at the time of the 60s they were building up their new government and they said why don't we take the specialist from Haiti and bring them in to the DRC they took you know the professionals teachers loyers policemen all from Haiti came to DRC to work and to train and to to build up the little fledgling government in the DRC so these people then after their contracts were up they dispersed throughout the world most of them went back to Haiti some went to UK and the others dispersed throughout the world but that's how it's thought that many of the infections went which were starting in the DRC and pretty well localized and had been localized for a long time how did it start to spread well one way it spread to Haiti was through this time period people returning from work from the DRC the very first known case uh in the United States happened in the late 60s it was actually a teenage boy it was a case that was actually reported in in one of the medical journals of a strange case where the doctors didn't really know what was going on but they wanted to report that this is a very strange case and maybe somebody could figure it out it was a 16-year-old male in St Louis Missouri in the USA and he said that his symptoms began in 1966 he had weight loss sores genital warts swollen legs shortness of breath most of us now if a patient came in with these symptoms it' be highly suggestive of HIV wouldn't it but they didn't even hear of the HIV they didn't even know what that was at the time not for 20 more years did anyone ever hear of HIV they also noticed that his immune system had shut down of course they didn't know why he suddenly developed fever respiratory distress and died in 1969 he probably died of PCP pneumonia but again they didn't know that at the time autopsy diagnosed extensively extensive capaces saroma retrospectively they had save tissue samples and blood samples from from this because it was a very interesting case and in 1989 they went back and tested it and found out he had HIV so how did it spread from this small little area some localized infections happening in kinasa happening in the DRC happening in Haiti how did it spread so fast well travel is one big way that it's spread in the US in the late 70s and 80s there was also the homosexual Revolution lots of homosexuals were be openly gay there were gay bath houses where people openly had intercourse um then there was also sex tourism and one major place that people went for sex tourism was Haiti in Africa a lot of the spread is thought to be through Trucking routes throughout Africa again kinasa at the time was a major major city so everything being made there had and had to be exported it was exported through the roads through Trucking routes and what happens with long distance truck drivers they're away from home for a long period of time they make a lot of money and they like to spend it one way they can spend it you can figure it out in South Africa one of the major problems you'll see in one of the videos shortly is the minds so how can the minds amplify HIV again what's happening who works in the minds men they're underground for how long sometimes months at a time back then there wasn't much regulation sometimes 3 six months at a time they'd be living Underground so when they came out again they're making a good wage they're away from their families what happens prostitution also men living in in the mines themselves had male Partners they didn't consider themselves homosexuals but they were living in single seex blocks for months at a time so they had same-sex partners that amplifies it HIV and then what happens at the end of their contract they go home they go home and of course this was a major source of income for people not just in South Africa but throughout Africa working in a mine was a very very lucrative job so people worked in the mines Amplified the virus went back home and spread it other ways that it spread um at the time was the blood supply less so I think in South Africa than in America but what was happening in America is is people were being paid to donate blood so who needs money IV drug users right they would often sell their blood to get money to buy drugs and of course IV drug use spreads blood to- blood contact which spreads HIV so not only spreading among the IV drug users but then it gets into the blood supply it got into the blood supply and so hemophiliacs people who have a certain uh blood disease that requires frequent transfusions and at the time the main treatment for hemophilia was a blood product a pulled blood product so it wasn't a transfusion from one person to them it was pulled from hundreds and thousands of patients getting this one specific blood factor or clotting Factor giving it to to them so that their blood would clot but if you're pulling together hundreds and thousands of patients at the time when we have no idea what HIV is what's the chance that one of those units has HIV and that's all that it takes if one was infected then hemophiliacs were infected and at the time it's thought that by the late by the time the blood supply was screened it's thought that over 80% of hemophiliacs were infected with HIV so now a little bit we're going to go through a bit of a timeline so what was happening we've sort of gone through this chunk by chunk but in the 70s what was happening Well we'd never heard of HIV we didn't know what it was but it probably entered the the United States at about that time and it's thought to be from Haiti probably from sex tourists and how did it get to Haiti probably from the DRC um and at this time African doctors particularly in the see we're seeing patients dying young patients dying of a wasting disease they would lose weight suddenly they would get respiratory disease they would get swollen glands and they would die they started the very first description of this in Africa they called it Slim's disease because it made you slim it made you skinny the video that we saw before lunch was called living with slim that's what it meant living with HIV and in the United States in the early 80s it was called Grid or gay related immune deficiency because it was in the very early time was thought to only happen in homosexuals so that's what was happening in the 1970s we were just in Africa they were seeing a lot more uh in the United States it wasn't even recognized until 1981 and it was detected in California with that report that I showed you and at after that report came out other doctors particularly in New York and some in Florida were saying you know what we're seeing that too and so it started to spread and they said and people were starting to get scared what is this thing that's killing people it's killing young people particularly homosexuals and the first cases were among gay men and IV drug users but they didn't know how it was spread people thought there might be other ways to get it so in the early ' 80s 1982 more infections started coming out not just gays not just homosexuals not just IV drug users but also hemophiliacs the way that I described how did they get it from the blood supply then AIDS was described in several European countries France had several cases Belgium had some cases in 1982 uh they officially made the name aids for acquired immune deficiency syndrome again they didn't know what the cause was but they saw this constellation of symptoms and any constellation of symptoms we call a syndrome and so that's what AIDS AIDS means and then in 1983 it started to be described in women because at the time it was mostly men and then children they thought then they were most confident that age was infectious but at the time people were panicking they thought maybe it was infectious like the flu maybe you could get it from coughing on somebody maybe you could get it from shaking hands with somebody from kissing from being in the same room using the same toilet using the same utensils didn't know how it was spread so that caused a lot a lot of fear at this time is when Ryan White became infected with HIV does anyone know who Ryan White is Ryan White was a at the time he was a 13-year-old boy with hemophilia and he got very very sick with a very bad pneumonia and at that time they found out that he had HIV they actually when he was diagnosed at age 13 they said he only had 16 or six months to live I believe his CD4 count was something like 25 he said he has six months to live but he didn't live six months he lived several years after that but he went through a lot once it was found out that he had HIV he was kicked out of school his family received death threats people they actually had to move because people had shot at his house trying to kill him people in the schools thought that if he was in the same school he would infect all the children this was starting to come later and more and more was being learned about HIV but it actually went to court and he had to go to court to fight to go into school and finally he was allowed to go back to school but the school made him sit by himself he had to eat with plastic utensils was very very very difficult for him but a lot of people a lot of famous people actually got behind Ryan White um Michael Jackson did Elton John they all a lot of lot of famous people um so supported him and tried to decrease the stigma and he was actually very very instrumental he lived for five more years he actually died just before graduating high school but he accomplished a lot in that time because he battled stigma that was his main cause he and with the power and money of lots of other people he actually helped decrease the stigma in the United States so this was happening in the in the late 80s um in 1984 they they actually first um identified HIV is when scientists found it and saw that this is the virus that causes AIDS they found it in the laboratory um in the Netherlands they actually began the first needle exchange program to decrease HIV transmission among IV drug users in 1985 the first HIV test became available before that we couldn't even test for it you couldn't diagnose somebody with HIV from a blood test you would have to do it clinically because of their symptoms um AIDS is starting to spread and be found in more and more places it was found in China um and then 19 I want to to to highlight this this point here in 1986 very very very early on in the infection very very early on in the in the pandemic and epidemic Uganda began promoting sexual behavior changes in AIDS 1986 it was spearheaded by their president president musar he spearheaded the campaign in 1986 to stop the spread of AIDS in his country 1987 the very first drug for HIV became available and that was a a was the very first drug that became available for HIV and it happened in 1987 in 1991 Thailand La launches uh a preventative and HIV prevention program again this is still pretty early on in the epidemic in 1983 or 1993 a was shown to benefit uh those in early HIV infection so earlier before they got very sick if you gave people a they actually did better 1994 is found that a reduces motherto child transmission and then something else happened in the United States to decrease stigma Magic Johnson you may or may not know of him but he's everybody in the United States would know who Magic Johnson is very very very famous basketball player at the time he was diagnosed HIV positive he was at the top of his game he was one of the probably one or two or three best basketball players in the world but he was HIV positive he actually when he found out he was positive he didn't hide from it he actually went on national television and announced it at the time in the early 90s HIV was in Ivy drug users and homosexuals that's what the public thought so they said oh he must be homosexual and he said no I'm not so he what he did also decreased the stigma he actually retired from basketball for about a year and then he came back to play being HIV positive not only did he just play he made the allstar game he played in the Olympics he won a gold medal so he showed people that you can be HIV positive and do well and be healthy and that you can get it through other ways than IV drug use and from being homosexual so that's what was happening in the 90s in the United States what was happening in the 90s in South Africa well lots of things okay we had the early 90s lots of violence the fall of apartate a new government thec takes over Nelson Mandela is elected president but what was happening with HIV in the 9s so we'll watch a video hopefully the sound is a bit better this [Music] time Africa in the 1980s men leave their homes and their country for a chance to work they head south to a nation where they have no rights to the gold mines near Johannesburg the economic backbone of South Africa's white apartate [Music] regime until now South Africa has largely been free from AIDS but many of the foreign miners come from countries where the epidemic is already out of control and they work together with miners drawn from within South Africa [Music] itself they all live side by side in crowded hosts cut off from their families outside each mine is a small settlement just a company store and women for hire this is the P that's basically being used by m workers from the hostel to go and buy their booies from the concession store where we're going it's the bushes where the women actually have their business of sex we they have an area where they sit Within These bushes and they wait for their clients to come from the hostel walking through to the shop these women were sex workers but didn't have a clue about HIV and didn't even use condoms and they they they had different partners there was no knowledge at [Music] all away from the mines apartate was crumbling as black South Africans struggle for Freedom AIDS was someone else's problem and at that time it was something for him you see people in television dying of AIDS it was as if it's happening overseas in America you know not year in 1990 Nelson Mandela was released from prison by then nearly 1% of South African adults were HIV positive wel welcome Milla was released and a few months later I discovered I had HIV I'd been very active in politics and our slogan was Freedom In Our Lifetime and here the possibility of Freedom was beckoning and what happened was in fact a a at that time a death sentence as in the west gay activists were among the first to warn that aids was coming I got infected as hundreds of thousands of comfortable gay men in Sydney and San Francisco and elsewhere but it was already plain at that stage that it was a heterosexual African epidemic which was going to surpass the epidemic amongst people like myself we started an HIV prevention program trying to speak to people about it trying to say to people use condoms and so on in the black townships the activists met resistance if you come outside coming to your community telling you how to behave especially if they are whites and they black and you can easily look at it as if they think that you are irresponsible sexual and once you reach that feeling you start to build walls in Pockets Across the Nation like rural quisa Nal people began to die from AIDS increasingly they were women infected by their husbands and lovers who'd worked in the mines we used to get more males than females but eventually there was a change then we we got more female patients than males such a change that we actually had to change the accommodation at some stage use the big award for females and use the the the the other word for males for 4 years after Mandela's release the apartate leaders and thec were consumed with a transfer of power in that political vacuum an opportunity to stem the epidemic was slipping away in a way the complex political transition the lack of credibility of their party government at that time which was disintegrating in effect and and the new government was yet to be installed and the new government had all kinds of challenges not least HIV in poor crowded townships like Soto the epidemic accelerated doctors at the nation's largest hospital were soon overwhelmed it was just hemorrhaging and we just watched this this thing expired in our face babies were being infected by their mothers through childbirth and breastfeeding as HIV became more frequent and more common place in children and as they needed more and more uh uh care um the the icus in the country also made decisions not to admit children with HIV into their IUS because it was terminal and we needed to keep the beds open for children who had B prognosis is HIV became the new apartate in South Africa you know we discriminated not on Race anymore but on on HIV status nurses were burnt out doctors didn't care as well you know uh why should I care when when the government doesn't [Applause] care in May 1994 when Nelson Mandela became South Africa's president he saw his job as reconciliation holding his fractured Nation together activists hoped he would also make time for AIDS at the time I chaed a National Convention on AIDS my co-chair and I made every effort we could to get an audience with President Mandela and we didn't succeed we got an audience instead with Deputy president Clerk and Deputy president eki joined the meeting Mandela delegated aids to his Deputy tab Becky our efforts which were sustained and determined and insistent to get president Mandela to involve himself personally in the epidemic were unsuccessful 8 years before another African president had taken a very different approach uganda's ueri mevy personally led a nationwide prevention campaign AES is a dangerous disease because it has no cure but on the other hand it is not so dangerous because it does not infect easily Uganda was one of the first countries to bring AIDS under control if the president has sent out a call if you see working on the issue it is politically correct you know on the contrary there were other countries where if you were seen to be working on HIV and AIDS you are immediately a subject of Suspicion are you saying that we have Aids in this country so it was a very very interesting contrast that I saw very early this was a campaign South African experts wished they could emulate it was largely a function of the credibility of the messages it was largely a function of the way in which the state was willing to intervene not just to posters and pamphlets and billboard but intervene in structural ways to try impact on this epidemic we just did not have that in this [Music] country in his 5 years as South Africa's president Nelson Mandela barely mentioned AIDS the fact is that President Mandela had a huge job he saved our country he didn't do what we would have wanted in AIDS whether history will fault him I'm not clear infections were doubling every year South Africa's epidemic was on its way to becoming the world's largest I felt that the window available to us to try and change the course of this epidemic was rapidly closing you know what what did we really have available to us I mean when you think about it if you're going to fight this kind of battle you want to be better armed and we just w't by now stigma in the United States was coming down in Uganda stigma was coming down because the president himself wanted to fight against in 1986 5 years after anyone ever heard of HIV they started battling in 1990s 94 up to 99 the president hadn't mentioned it had infections were doubling every year so that's what was happening in the '90s so in the late 9s what we call heart or we call Art here or the medicines became available it was found that taking not just one like a that was available but taking several of them like three of them at the same time had the most benefit so combination anti retroviral therapy was shown to be highly effective against HIV and that was in 1996 in developed countries many people uh began taking the new treatment but it was extremely expensive one year of treatment at the time would have cost about 100,000 Rand most people could not afford that most people could not at the time it was very difficult to take some of the medicines like a had to be taken five or six times a day people had to wake up in the middle of the night to take their treatment so it was difficult but it was available and it was saving lives in other countries like Brazil started the first developed country to begin providing free anti-retroviral therapy for their citizens in 1997 so that was even ahead of a lot of the other developed countries this was the first country to do it in Brazil but that was not happening in South Africa there was still a struggle the president even Mandela didn't even mention HIV and then as drugs were becoming available in other places overseas people were saying why can't we have the drugs if it's saving their lives why can't it save our lives so let's watch this video in South Africa the historic presidency of Nelson Mandela came to an end his successor was his longtime Deputy tabon Becky who finally emerged from his mentor's shadow on his lapel Becky wore an AIDS ribbon and Becky came into Power with a different message a message of we got a job to do and we're going to deliver and so I was quite hopeful Becky promised African solutions to African problems including AIDS the real crisis event 6 months after president Andi took office when he rose to give a speech in the Upper House of sou Afric po see when you ask a question does HIV cause AIDS the question is does a virus cause a syndrome how does a virus cause a syndrome it can't it really truly it's necessary I've been saying to The Honorable members to the people in this country it's necessary for people to study this question it was clear from his speech that he'd had access to denialist literature on AES denialist literature that queried whether HIV was in fact a virally caused condition and that queried most significantly whether the anti retroviral drugs were of any use in treating what the nists claim is an environmental and social condition not a viral condition Becky had made contact with Peter duberg a University of California biologist who claimed HIV had nothing to do with AIDS it's just a harmless retrovirus there are hundreds of those around hundreds everywhere in there's no animal around that doesn't have it no it's not an infectious disease it's not that virus newberg's theories have been discredited for years if HIV doesn't cause AIDS then how would anti-hiv drugs lead to such dramatic Improvement in one's uh well-being and that's only one example there are plenty of examples to do away with this ridiculous Theory across South Africa the president skepticism reinforced local doubts about AIDS I used to hear about it from the TVs and the newspapers the radios but then I wasn't interested in the in in it because of I didn't believe that it existed I just made up just just made up one day as she came home from work Dorothy maala was attacked by four men and raped I was get rap by four men there was blood well unfortunately most viruses cause syndromes who's heard of chickenpox it's a syndrome right measles syndrome rabies syndrome all of them caused by viruses A syndrome simply means a constellation of symptoms that all cluster together well almost every single virus causes a syndrome the flu causes a viral syndrome I mean the flu is a syndrome influenza is the virus that causes it a common cold is a syndrome caused by many different viruses so unfortunately at the time Tabo Becky did not have a minister of Health that was had really any guts to stand up to him and to teach him about the science and medical knowledge that was known at the time so I'll show you another clip uh and things were thought to possibly change in 2000 by now it was clear Beyond any doubt that HIV caused AIDs that the medicines clearly prevented children from getting the infections through pmtct and it saved lives so the national the uh International Aid Society held its annual meeting in Durban in 2000 and it was thought that maybe now in South Africa things will [Music] change AIDS researchers decided to hold their banial meeting in South Africa up to then no AIDS conference had happened in the developing world and uh we really wanted to have it in in Africa it was a very difficult conference but also I think a historic conference the turning point for me was the Durban meeting 2000 that was um a life-changing event I think I think for many people it's my first trip to Africa and it put a face onto the problem and it was deeply disturbing and even though you read about it and heard about it and thought about it it didn't resonate as much as actually seeing it and you go bed after bed after bed to actually be there and make rounds on patients in which you can't do anything that triggered in me this not only frustration but absolute resolve that we can't accept this this is just something that as human beings we can't [Applause] accept as arrived South African activists launched a new campaign to force their government out of its denial comrades today is a sad zachi ammot who could afford the drugs himself had stopped taking them until they were available to everyone do away with poverty Injustice we decided to embark on a civil disobedience campaign to get government to treat people it was critical for me that we win it was critical for everyone that we [Music] win activists hoped that with the world watching president mcki would respond I want to believe that even mey if he actually visited people dying of of it and saw what was happening even Becky would be willing to just Becky agreed to give the opening speech he even asked for more time so I was very hopeful I mean I thought he needed 25 minutes because he needed to to explain what had happened and that he needed to Mark out A New Path there is no substance to the allegation that there is any hesitation on the part of our government to confront the challenge of HIV AIDS however we remain convinced of the need for it was only when he actually was 10 minutes into his speech that I realized he was not going to make any drastic new announcement overall Becky repeated the denialists claim that aids in Africa was caused by poverty not HIV as I listened and heard the whole story told about our own country it seemed to me that we could not blame everything on a single violence his speech was met with stunned silence if only he said un causes AIDS and he made an announc on using mother to child transission he he would have seized the moral High Ground he didn't and you you look around so again contrast to other countries like Uganda where the president spearheaded the campaign against AES in 2000 Becky says it doesn't exist so what does that do to stigma and country so in 2002 something again remarkable happened batswana our neighbor to the west their president at the time fesus migh saw what was happening in his country and he actually got up and said if I don't do something about HIV in our country our people can become extinct he actually used those words so in 2002 he partnered with anyone he could with NOS with other governments it became the first country in Africa to provide anti-retroviral therapy for its citizens in 2004 the United States launched pepar which is President's emergency plan for AIDS relief to send billions of dollars to countries that want to start AIDS program programs South Africa finally begins to provide anti-retroviral therapy but it's only because it was taken to court to do it compared to batswana where the president led the charge and so I call that a reluctant Victory it was a victory we got AIDS drugs into the country people started to be on them but it was reluctant on the part of the government govern they had to be forced through the courts to to Pro to provide them so I think this is our last video South Africa was to be one of the biggest recipients of the global treatment programs but president Tabo and Becky had banned the triple cocktail activists sued the government forcing Becky's Health minister to appear before the high court the money had been allocated the science was clear the health profession was ready the country was ready the only obstacle was the minister of Health in the president the Court ruled unanimously that the government could not deny AIDS treatment to its citizens it broke the damn War it broke the damn war in the sense that the country realized a that government's denialism is not invincible and that people Unified in action can achieve things reluctantly the government began to cooperate with the treatment programs in late 2004 drugs from the bush fund arrived at this Catholic hospice where one of the patients was Dorothy [Music] maxela okay [Music] e 1 in the morning one at night okay then I begin taking the drugs and then I saw some improvement on my face on my feet and I was gaining weight I've gained a lot of weight the wishes and the hopes started being realized and I can just tell you from my own experience working in a little poor Community I mean when we first started working there our patients were dying and we just there was nothing we could do we just couldn't afford anything and we now have all these patients on treatment and now all you hear about is the patients are suddenly gaining weight going back to work and encouraging others to get tested it's changed the whole nature of the discourse but the vast majority of patients had to rely on state-run hospitals where although the global fund paid for the cocktail the health Ministry set priorities this country only has 40,000 people on treatment we have almost 5 million people that are HIV infected in South Africa 40,000 it's like a A Drop in the Ocean you know if we really are going to turn this epidemic around we have to um March out into retrial therapy you know we need a military operation we need a state of emergency in this country so a recent research study done about I think it was about three years ago now said that tab Becki and Manu shabalala through their actions of denialism at the time three years ago I think it was about 3 years ago cost 300,000 lives in South Africa 300,000 lives I if you went out and killed 300,000 people that would be genocide but now we have the drugs after 2004 so what has happened now what is happening now well part of that you'll see in my lecture on the DVDs um the epidemiology of HIV in South Africa this sort of goes back to the history and what was happening then and that takes us forward uh from here once we got treatment what was what's happening okay so that's the lecture that you're going to watch for next week but things are happening in South Africa now lots of change particularly what you're going to see next week with the new National guidelines The New National guidelines have changed things tremendously making it more Avail treatment is easier for infants to become available saves many many many lives of infants pregnant women much easier to get them onto treatment and lots more interventions we can do to prevent motherto child transmission to decrease the amount of transmission to Children another story that I'm going to tell you again later on you'll hear me say this but in other countries like in batswana before the president program in 2002 the anti-natal clinic prevalence rate and transmission of mother to child at the time was about 35% so about 35% of women who were pregnant transferred HIV to their children in the past year they came out with a study in batswana so it's now eight years after the treatment programs the mother to Childhood transmission rate is less than 4% the antinal up uptake for pregnant women so the women who go to the clinic when they're pregnant and test and get an intervention to prevent pregnancy is 98% in bwan recently it's been between 30 and 50% in South Africa so we have a ways to go but lot lot is happening we have newer drugs we have drugs with less side effects drugs that you don't have to take as frequently so a lot is happening in South Africa so I'll leave you with that for the history of HIV the next is to be continued in several lectures ahead for

Channel: Harvard University

Views: 29,366

Keywords: hiv, aids, hiv/aids, harvard, aids research, center for aids research, cfar, aids education, hiv education

Id: 8D0fxPupD78

Length: 61min 3sec (3663 seconds)

Published: Tue Apr 30 2013