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THE HISTORY OF AIDS: HEROES AND VILLAINS

Friday, 10th of June 2011

The history of AIDS : Heroes and villains

The story of AIDS involves many larger-than-life characters, good and bad

The Economist, Jun 2nd 2011 | from the print edition

http://www.economist.com/node/18772268

ANNIVERSARIES are times for reflection, and this one should be no exception, for the 30-year history of AIDS is a mirror in which humanity can examine itself. From questionable scientists to philanthropic billionaires, people’s actions against AIDS, and reactions to it, have shown up the best and worst that humans have to offer.

Such dualism was there from the beginning, in the question of who discovered the AIDS-causing virus. There were two claimants. One, Robert Gallo, is American. The other, Luc Montagnier, is French. Dr Gallo called his discovery HTLV-3. Dr Montagnier called his LAV. They were in fact the same thing. It turned out, however, that Dr Gallo’s virus had come from Dr Montagnier’s laboratory. It was never conclusively proved how, though a contaminated sample may have been to blame. And Dr Gallo was exonerated of any wrongdoing by an official investigation and is universally recognised to have done important work on AIDS. But only Dr Montagnier won the Nobel prize—eloquent testimony to some people’s opinion of the whole affair.

Another source of conflict was whether HIV, as the virus eventually came to be known, was truly the cause of AIDS. At the beginning of the epidemic, that might have been debatable. Perhaps HIV was merely a passenger that took advantage of an immune system weakened by another cause? One once-respected scientist, Peter Duesberg, who did early research on viral causes of cancer, would not drop the idea. He insisted—and still insists—that the weakening of the immune system characteristic of AIDS is caused by drug-taking (he blames both recreational drugs and AZT, one of the early anti-AIDS drugs), and that HIV is, indeed, a passenger.

This theory would not have mattered much except that Thabo Mbeki, a former president of South Africa, latched on to it. Since South Africa has the world’s largest number of AIDS cases, and one of its highest infection rates, this was bad news, as was Mr Mbeki’s health minister, Manto Tshabalala-Msimang, who was appointed mainly because she agreed with him, and recommended beetroot and garlic as treatment for the disease. Only with the election of Jacob Zuma, who has himself been publicly tested for HIV (he did not have it), did South Africa return to sensible anti-AIDS policies.

Among the heroes, Bill Gates looms large. The foundation into which he poured much of his Microsoft fortune took AIDS seriously from the beginning, forming a particularly fruitful partnership with the government of Botswana, one of the worst-affected countries. And Nelson Mandela, the heroes’ hero, also cleaved eventually to the path of righteousness, even while admitting he had not done enough to combat AIDS during his own presidency of South Africa.

Mr Gates and Mr Mandela are easy to admire. One hero that many AIDS activists have difficulty accepting, though, is George Bush junior. Activists do not much like born-again Christians, who take a dim view of the sort of sex lives that help to spread HIV. But Mr Bush was responsible for setting up the President’s Emergency Plan For AIDS Relief (PEPFAR) and for making sure it had plenty of money. PEPFAR is one of the two main organisations, along with the Global Fund, that dish out the cash that rich countries give poor ones to combat AIDS. Last year, it spent almost $7 billion on AIDS and the tuberculosis that often accompanies it, and it is responsible for helping half of the 6.6m people now on anti-retroviral drugs. Many activists may be reluctant to give Mr Bush credit. But handsome is as handsome does.