Isn't AIDS a fairly unique disease? It has a long incubation period and it adapts quickly to drugs (hence the need for combo treatments) and seems to be resistant to our standard methods for creating vaccines......
HIV-AIDS is unique for several reasons.
One it is a modern pandemic. Unless you were around in 1918, you haven't experienced a pandemic. Measles, smallpox, TB and other major infectious disease killers are endemic so they don't have the same epidemiological patterns as a pandemic. (They were involved in their own pandemics when they were spread around the world in the past by European explorers.)
Two, HIV-AIDS has spread quickly enough to have infected tens of millions of people in 30 years but slowly enough so as to have only caused temporary panic and outrage among people. Right now it is almost under the radar screen altogether for many people. While it is indeed a pandemic, it is perceived as endemic which generates a different psychological response with different consequences.
And three, on the molecular level, the HIV virus hides itself in a coating of simple sugars rather than proteins which surround most other viruses. The sugars allow HIV to not only avoid the immune system which targets foreign proteins, but also, the unique viral coating is the reason a vaccine has not been developed. While HIV's ability to rapidly mutate also makes it difficult to develop a vaccine, the fact that antibodies are not effective is the larger reason.
Some criticisim of And the Band Played on is at the AVERT site of aids history.
http://www.avert.org/his87_92.htm
history starts here:
http://www.avert.org/his81_86.htm
I didn't find the AVERT site above to be complete. Just as with the opening post, it begins with the HIV pandemic when it reached the USA as if the rest of the world's disease burden barely existed.
HIV and AIDS in relation to other pandemics
HIV has readily exploited various niches provided by our lifestyle in the developed world, including air travel, narcotic dependence and steamy, promiscuous bath houses (Shilts, 1987). However, it is wreaking the most havoc among the world's poorest and most underprivileged communities, in which life expectancy has dropped by 20 years on average....
...'Slim' disease in Uganda and the aggressive Kaposi's sarcoma in Zambia were found to be manifestations of AIDS, as 10% of young adults were already HIV positive in sub-Saharan Africa (Serwadda et al., 1985). It became clear that AIDS was not merely a curiosity among gay men in the developed world, but would become a worldwide problem.
We now know that there are two types of HIV virus, HIV-1 and HIV-2, that crossed into humans from quite distinct primate species (Hahn et al., 2000). HIV-1 is closely related to SIVcpz of chimpanzees. It is classed phylogenetically into three groups—M, N and O—which differ from each other in genetic sequence as much as each does from SIVcpz, indicating that each group represents a separate chimpanzee-to-human transfer. HIV-2, in contrast, resembles SIVsm of the sooty mangabey monkey, with at least six separate transfers of this virus to humans. Whereas HIV-1 groups N and O remain localized in Gabon and Cameroon, close to their former reservoir species, and HIV-2 is present mainly in West Africa (with some spread to Europe and India), HIV-1 group M has given rise to the worldwide pandemic, diverging into various clades or subtypes, known as A−K. It is not yet clear what has made HIV-1 M fitter for pandemic spread. Furthermore, recombinant forms of HIV-1 are becoming increasingly evident in regions where more than one group or subtype circulates. HIV-1/HIV-2 recombinants have not yet been recorded, but now that both are prevalent in West Africa, novel hybrid viruses might emerge....
...from detailed phylogenetic studies of extant strains, a date for the species jump can be estimated as 1931 plusminus 12 years (Korber et al., 2000). The widespread use of non-sterile injecting equipment in Africa in the second half of the twentieth century might have helped HIV-1 to establish a reservoir before its sexual transmission became common (Drucker et al., 2001).
HIV's Origins Traced to 1930s; Joan Stephenson, PhD; JAMA. 2000;283:1279.
Using one of the world's most powerful supercomputers, a machine typically used to crunch numbers for physicists and astronomers, Bette Korber, PhD, and colleagues from the Los Alamos National Laboratory in New Mexico analyzed a global database of the genetic sequences of variants of HIV-1. By applying mathematical modeling techniques used to study evolution on the molecular level, the team extrapolated from some 160 HIV variants to predict when such variants converged back to a common origin.
A study headed by Dr Beatrice Hahn further refined the point of origin to the Democratic Republic of the Congo.
A revealing new subtype of the simian form of HIV has been found in 19 greater spot-nose monkeys in Cameroon. ...
In 1999, a team led by Beatrice Hahn at the University of Alabama pinpointed one particular subspecies of chimpanzee in west central Africa as the source of the SIV strain that gave rise to HIV-1, one of the two strains that causes AIDS.
The new SIV - dubbed SIVgsn, after the monkeys - is the closest yet found to the strain that infects these chimpanzees, and is similar to HIV-1.
"Chimpanzees eat these little white-nosed monkeys," notes Eric Delaporte, of the Research Institute for Development in Montpellier, who led the new research. ...
Paul Sharp at Nottingham University, UK, who was part of Hahn's team, agrees: "The west central African chimps are the original natural reservoir of the virus. But our own work suggests the chimps must have originally acquired the virus from a species of monkey in Africa."
AIDSin Africa website has a useful epidemic map. Click on "Display AIDS over time". The Democratic Republic of the Congo and Uganda are the first hit then later have better control over the pandemic than Botswana, Zimbabwe, Namibia, Zambia, and South Africa which have higher rates of infection currently.
The AIDS epidemic spreads through channels such as truck routes which greatly facilitate population movement, thus increasing the risks of AIDS infection in villages along such routes.
REVIEW LITERATURE GUIDE FOR HIV/AIDS AND TRANSPORT
This link, (html of a Word doc), reports on about 20 studies showing differing relationships between the African Trucking industry and HIV such as the following:
Major Findings:
This article indicates that trading villages along main roads represent obvious reservoir of infection outside the main urban areas; their importance as focuses of infection, related in part to commercial sex between local women and long distance truck drivers.
There are a slew of websites promoting all sorts of false information about the origin of HIV. The most credible yet still completely discredited was the claim that Dr. Hilary Koprowski, an American scientist who developed a live polio vaccine at the same time as Dr. Albert Sabin developed his, used primate kidneys to grow the vaccine virus thus spreading HIV inadvertently. The original hypothesis was described in a book and later made into a documentary.
News summary
The Origins of AIDS, directed by Peter Chappell and Catherine Peix, follows the evidence laid out by British journalist Edward Hooper in his 1999 book, The River. In it, Hooper proposed (based on nearly two decades of research) that one man's part in the race to create the polio vaccine launched the AIDS epidemic.
However, the film was criticized
Hooper's conclusion, described by one biologist in the film as "medical science's worst-hated hypothesis" directly challenges the findings of other investigators who were interviewed for the documentary, but whose diverging opinions ended up on the cutting-room floor.
"The public doesn't hear my view, nor does it hear the view of anybody else who has doubts about this theory," said Beatrice Hahn, a professor of medicine at the University of Alabama at Birmingham.
Despite the hypothesis being
ruled out by the evidence, people's willingness to believe in conspiracy theories continues to promote these ideas. Edward Hooper, the author of the book, The River, which outlined the hypothesis rebuts the WHO statement
here. However, the timing of the pandemic's origin and the early pattern of spread is not as consistent with Hooper's hypothesis as he claims. Those are
just a few of the problems with the hypothesis.
Hepatitis B vaccine was also claimed to be the source of HIV pandemic. Some people in the first cohort of study of the Hepatitis B vaccine had a high rate of HIV. Not surprising since high risk behavior was one of the criteria for being included in the cohort. Despite what the last sentence in the link states, Hep B vaccine has been thoroughly investigated and ruled out as having anything to do with HIV.
There are many interesting parallels with the H5N1 bird flu pandemic occurring today. There is a big divide over whether the virus is being spread by wild birds or the movement of domestic birds. While it may seem like two different hypotheses and so what, there is actually incredible tempers flaring over the topic.
Gays and IVDUs were blamed for the HIV pandemic. Certainly multiple partners and dirty needles were contributing factors.
But so was the outlawing of needle exchange programs and refusal to fund promotion of condom use and sex education.
See
Frontline, The age of AIDS for an excellent examination of all the factors contributing to the pandemic in the USA from the gay communities' denial at first to the stupidity of the Reagan response. BTW, I found John Robert's (aka new Supreme Court Justice), warning letter to Reagan to go against the CDC's position and claim we weren't sure of how you could or couldn't get HIV most disturbing. Intelligence and education are no guarantee of science literacy.
