Before SARS there was AIDS. There still is. The cover of the May 12 issue of The New Yorker pays tribute to the SARS outbreak, as did the previous week's Newsweek cover story. Yet to date, fewer than 400 people worldwide have been confirmed to have died of SARS, which has a mortality rate of 15 percent (50 percent in people over 60).
The near-hysteria over the newly discovered SARS virus (which ironically may be best treated with AIDS drugs, according to data released very recently) provides striking contrast to the current response to AIDS, one of the world's deadliest viruses, for which there is still no cure.
According to the World Health Organization, in 2002 the number of men, women and children infected with AIDS worldwide was 45 million, which represents only a quarter of the worldwide rate of HIV infection. About 2 million of those with AIDS live in the United States; an additional 4 1 / 2 million cases have been reported in Central and South America and Canada. In Africa, 28 million are infected. What SARS has taught us in recent weeks is that no true quarantine exists within the global village. Today's SARS outbreak in Hunan province, China, can be Baltimore's outbreak a few weeks later.
Within the past few years both the Clinton and Bush administrations have deemed the HIV / AIDS pandemic a threat to the United States on a scale with terrorism. In their just-released book Global AIDS: Myths and Facts: Tools for Fighting the AIDS Pandemic (South End Press, 267 pages, $19), infectious-disease specialists Alexander Irwin, Joyce Millen and Dorothy Fallows discuss in well-researched and highly accessible detail both the current course of the pandemic and the means for combating it. Irwin and Millen are research associates at Harvard Medical School, Fallows a molecular biologist with a concentration in infectious diseases.
The trio estimate that by 2010 there will be triple the number of worldwide HIV / AIDS cases if greater efforts are not made to curtail the spread and treat those already infected, plans which demand immense efforts from the West.
Nations with newly exploding HIV / AIDS epidemics like Thailand, China, India and Mexico are ill-prepared to address the crises, according to Global AIDS. If Western nations with access to health care and AIDS treatments do not staunch the pandemic, the impact will be felt worldwide. The authors are clear: Neglect the global AIDS crisis at our peril.
Many now believe AIDS is over in the United States. Statistics can be misleading, making it appear the disease is being eradicated. No explosion of new cases of HIV / AIDS exists in the U.S. heartland, but according to the Centers for Disease Control, New Jersey has the highest rate of new infections among teen-agers in the entire nation, while in Washington, D.C., one in 20 African-American men is infected with HIV and other cities in the West, Southwest and Northeast have similar escalations. As Irwin, Millen and Fallows report, infection rates decreased in the United States in the late 1980s and early 1990s, but new infections have risen in the United States since 1997, particularly among teen-agers and people of color.
Johnnetta B. Cole and Beverly Guy-Sheftall explore some reasons for this increase among African-Americans in their provocative book Gender Talk: The Struggle for Women's Equality in African American Communities (One World, 298 pages, $24.95). Cole, former president of Spelman College, and Guy-Sheftall, a professor of women's studies at Spelman, address gender and AIDS, elaborating on the secrecy surrounding HIV / AIDS within the African-American community. They cite new HIV-infections even among middle-class blacks while declines continue in affluent white communities, and they attribute the effects to race and gender bias.
The initial labeling of AIDS as a gay disease when it was first discovered in 1981 (AIDS was originally called GRID -- Gay-Related Immune Dysfunction) has made an often homophobic black community view discussion of the disease as shameful. Secrecy about male sexual activities puts wives and girlfriends at risk for HIV infection, currently on the increase among African-American women and girls in the United States.
Polls indicate a majority of Americans believe there's a cure for AIDS in the form of a pill or vaccine. As veteran reporter Patricia Thomas, former editor of the Harvard Health Letter and a Knight Science Journalism Fellow at the Massachussetts Institute of Technology, asserts in Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine (PublicAffairs, 416 pages, $27.50), nothing could be further from the truth. The reasons why a vaccine doesn't yet exist range from a frustratingly elusive virus in continual mutation to political decisions that an AIDS vaccine is unattainable, and perhaps should be.