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Victoria A. Harden - AIDS at 30: A History

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A history of the most insidious epidemic of our time

Society was not prepared in 1981 for the appearance of a new infectious disease, but we have since learned that emerging and reemerging diseases will continue to challenge humanity. AIDS at 30 is the first history of HIV/AIDS written for a general audience that emphasizes the medical response to the epidemic.

Award-winning medical historian Victoria A. Harden approaches the AIDS virus from philosophical and intellectual perspectives in the history of medical science, discussing the process of scientific discovery, scientific evidence, and how laboratories found the cause of AIDS and developed therapeutic interventions. Similarly, her book places AIDS as the first infectious disease to be recognized simultaneously worldwide as a single phenomenon.

After years of believing that vaccines and antibiotics would keep deadly epidemics away, researchers, doctors, patients, and the public were forced to abandon the arrogant assumption that they had conquered infectious diseases. By presenting an accessible discussion of the history of HIV/AIDS and analyzing how aspects of society advanced or hindered the response to the disease, AIDS at 30 illustrates for both medical professionals and general readers how medicine identifies and evaluates new infectious diseases quickly and what political and cultural factors limit the medical communitys response.

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AIDS at 30

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AIDS at 30

A History

Victoria A. Harden

Copyright 2012 by Victoria A Harden Published in the United States by Potomac - photo 1

Copyright 2012 by Victoria A. Harden

Published in the United States by Potomac Books, Inc. All rights reserved. No part of this book may be reproduced in any manner whatsoever without written permission from the publisher, except in the case of brief quotations embodied in critical articles and reviews.

Library of Congress Cataloging-in-Publication Data

Harden, Victoria Angela.

AIDS at 30: a history / Victoria A. Harden.1st ed.

p. cm.

Includes bibliographical references and index.

ISBN 978-1-59797-294-9 (hardcover: alk. paper)

ISBN 978-1-61234-516-1 (electronic edition)

1. AIDS (disease)History. I. Title. II. Title: AIDS at thirty.

RA643.8.H37 2012

616.9792dc23

2011028331

Printed in the United States of America on acid-free paper that meets the American National Standards Institute Z39-48 Standard.

Potomac Books
22841 Quicksilver Drive
Dulles, Virginia 20166

First Edition

10 9 8 7 6 5 4 3 2 1

forSibyl Victoria McDonell-Leslie

Illustrations

Abbreviations

ACT UP

AIDS Coalition to Unleash Power

amfAR

American Foundation for AIDS Research

ANC

African National Congress

APHA

American Public Health Association

ASH

assistant secretary for health, DHHS

BBC

British Broadcasting Corporation

CDC

U.S. Centers for Disease Control and Prevention

CIA

U.S. Central Intelligence Agency

DHHS

U.S. Department of Health and Human Services

DOH

Department of Health (New York City)

EIS

Epidemic Intelligence Service (CDC)

FDA

U.S. Food and Drug Administration

FOIA

U.S. Freedom of Information Act

FWG

French Working Group

GHESKIO

Haitian Group for the Study of Kaposis Sarcoma and Opportunistic Infections

GLAAD

Gay and Lesbian Alliance against Defamation

GMHC

Gay Mens Health Crisis

GPA

Global Programme on AIDS (WHO)

IAVI

International AIDS Vaccine Initiative

ICD

International Classification of Diseases (WHO document)

ICMR

Indian Council of Medical Research

INRB

National Institute of Biomedical Research (Zaire)

INSERM

National Institute for Health and Medical Research (France)

ITM

Institute of Tropical Medicine (Belgium)

MAP

Multicountry AIDS Program (World Bank)

MCC

Medicines Control Council (South Africa)

NAT

National AIDS Trust (United Kingdom)

NCI

U.S. National Cancer Institute

NEI

U.S. National Eye Institute

NIAID

U.S. National Institute of Allergy and Infectious Diseases

NIDR

U.S. National Institute of Dental Research

NIH

U.S. National Institutes of Health

NINCDS

U.S. National Institute of Neurological and Communicative Disorders and Stroke

OAR

Office of AIDS Research, NIH

PAHO

Pan American Health Organization (Western Hemisphere branch of WHO)

PEPFAR

U.S. Presidents Emergency Plan for AIDS Relief

PHS

U.S. Public Health Service

SABC

South African Broadcasting Corporation

SVCP

Special Virus Cancer Program

TAC

Treatment Action Campaign (South Africa)

TAG

Treatment Action Group (United States)

TASO

The AIDS Support Organization (Uganda)

UCLA

University of CaliforniaLos Angeles

UCSF

University of CaliforniaSan Francisco

UN

United Nations

UNAIDS

Joint United Nations Programme on HIV/AIDS

UNDP

United Nations Development Programme

UNGASS

United Nations General Assembly Special Session

UNICEF

United Nations International Childrens Emergency Relief Fund

USAID

U.S. Agency for International Development

VRC

Vaccine Research Center, NIH

WHO

World Health Organization

Preface

This book had its origin in September 1984, when I arrived at the U.S. National Institutes of Health (NIH) to write about another infectious disease for the National Institute of Allergy and Infectious Diseases (NIAID) and found myself housed in an office with Ruth Guyer, an immunologist turned science writer who was producing a newsletter called the AIDS Memorandum. Talk around the NIH campus was intense with regard to the new disease AIDS, and a number of NIAID scientists working on AIDS were next door or downstairs from our office. Confessing that I had never heard of T cells and B cells, which seemed to be involved somehow with AIDS, I asked Guyer to enlighten me, and so began my education into molecular immunology and virology. As a historian, I wondered who was collecting materials such as the AIDS Memorandum and conducting interviews with scientists working on AIDS, and I found out that no formal historical process existed at NIH. Here was a new disease, key investigators working around me, important discoveries going on, and no one was capturing this? It seemed a dereliction of duty for a historian not to make some sort of attempt to document what was occurring.

In 1986 I had the good fortune to become the founding director of the Office of NIH History and Stetten Museum, a position from which I was able to include what by then was beginning to be called HIV/AIDS documentation efforts alongside other initiatives to document biomedical research history at the United States foremost medical research institution. Because my research on HIV/AIDS was conducted over more than a quarter century, however, I have incurred more debts to more people than I can possibly acknowledge. The number of NIH staff who went out of their way to assist me at various times is far too large for me to name every person, but to them all I am most grateful. My colleagues in the Office of Communications at NIH, mostly trained as journalists, were welcoming to a historian and taught me much about excellence in writing and thinking about a public audience. Don Ralbovsky collected ephemera for the Stetten Museum during the 1990 Storm the NIH ACT UP protest. Dennis Rodrigues worked with me for some years on the AIDS oral history project, bringing his expertise as a former staff member of the NIH AIDS Executive Committee. The communications staff in the NIAID and the National Cancer Institute (NCI) worked intensely with me in 2001 to prepare the website In Their Own Words: NIH Scientists Recall the Early Years of AIDS, which was launched to mark the twentieth anniversary of the AIDS epidemic.

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