JUDY WOODRUFF: Four decades ago this past week, the first ever cases of the HIV/AIDS
epidemic were publicly noted and hardly noticed.
The Centers for Disease Control published a weekly report then, noting that five gay
men in Los Angeles were sick with an unusual pneumonia-like infection. Two had died. By
the end of that year, the CDC counted 270 confirmed cases of -- quote -- "severe immune
deficiency," the disease that later became known as AIDS, caused by the infection of
HIV.
Cases exploded around the world. It's estimated that about 35 million people have died from
AIDS in the years since.
William Brangham looks now at the progress made against this virus and the major problems
that remain.
WILLIAM BRANGHAM: In the 1980s and early '90s, the AIDS epidemic was marked by two kinds
of images. One, we saw in public, activists taking to the streets demanding not only action,
but basic recognition that AIDS was real. President Reagan's administration often ignored
the crisis. Reagan himself didn't publicly mention it for years.
But the other was in private, in homes and in hospitals, patients, many of them gay men,
wasting away from AIDS. The LGBTQ community lost a staggering number of friends and loved
ones to the virus. With no medications or vaccine, contracting HIV back then was often
a death sentence, a sentence shrouded with a thick blanket of stigma and denial.
By the late '80s and early '90s, some small improvements. As well-known Americans tested
positive and came forward, attitudes began to shift. And then in the late 1980s came
the first antiretroviral drugs to treat HIV infection. A decade later, combination of
drugs proved the virus could not just be slowed, but suppressed.
This huge shift meant people could survive, with HIV becoming a chronic, but not fatal
condition. But, for years, those drugs were expensive and not available to people in sub-Saharan
Africa. Millions died before new programs were launched to make those drugs more affordable
and more widely available.
Salim Abdool Karim runs one of South Africa's leading HIV research centers.
SALIM ABDOOL KARIM, Director, CAPRISA: It is not that we don't know what to do. It is
a challenge of trying to do what we know works and to do it at a scale where it can really
make a difference.
WILLIAM BRANGHAM: HIV treatment has undoubtedly saved millions. Nearly 38 million around the
world today, more than 1.2 million in the U.S., are living with HIV; 27 million of them
get that treatment.
But AIDS still takes its toll. Nearly 700,000 people died last year, and millions still
don't get the lifesaving access they need.
So, for a look back at this epidemic and a look at the best way forward, we turn to two
people deeply immersed in all of this.
Chris Collins is the president and CEO of Friends of the Global Fight Against AIDS,
Tuberculosis and Malaria. And the Reverend Robert Newells is director of national programs
at the Black AIDS Institute, an African American-led research and advocacy group focused on ending
HIV in Black communities.
Gentlemen, thank you both very much for being here on this anniversary.
Chris Collins, to you first.
I grew up in San Francisco in the '80s. I lived in New York in the '90s. I have very
distinct memories of this epidemic. For people who don't remember, can you just give us a
snapshot of what it was like back then?
CHRIS COLLINS, President and CEO, Friends of the Global Fight Against AIDS, Tuberculosis
and Malaria: It was absolutely terrifying and tragic.
I mean, I came out as gay a year before the MMWR was released. And as soon as that happened,
all of the...
WILLIAM BRANGHAM: This was when the CDC first signaled that HIV was here.
CHRIS COLLINS: That's right.
And, pretty soon, everybody I knew was scared, worried for themselves, worried for all of
their friends. It was a mystery then of what was going on. And we saw our government not
responding adequately to it. So it was a time of a great deal of fear, but also frustration
and anger.
WILLIAM BRANGHAM: And, Reverend Newells, the same question to you.
Do you have an early memory of this epidemic that you could share with us?
REV. ROB NEWELLS, Director of National Programs, Black AIDS Institute: Sure.
I grew up in Oakland just across the bay from San Francisco. But I was 10 years old 40 years
ago. And what I remember was seeing white gay men on television suffering from this
new disease, but, in my community, it was really a secret. We didn't die of AIDS in
those days. We died of pneumonia or cancer, so it was that stigma that kept people quiet
about it.
So I really didn't see it as a Black disease at that time.
WILLIAM BRANGHAM: And we certainly now how that has changed since then.
Chris Collins, as I mentioned in the introduction, so much progress has been made. We have drugs
that treat HIV. We have drugs that prevent HIV, so great success on one hand, and yet
still a lot of faltering going on globally.
CHRIS COLLINS: Well, that's right. I mean, the progress has been incredible, in terms
of where the science has taken us, and just the mobilization that has been global to demand
equity and scale up of things that work for people.
But we're falling short in a lot of ways, as you say. There's about a 10 million-person
treatment gap right now between the number of people living with HIV and those that are
on treatment. And we're seeing increases in HIV infections in some parts of the world.
And now, also, because of neglect all over the world of marginalized people, people who
are marginalized in their own societies, such as gay men and other men who have sex with
men,sex workers, people who inject drugs, trans people, others, you're seeing now an
increasing share of infections are among those key population groups, those marginalized
groups.
And governments all over the world are criminalizing their behavior. Societies are -- make them
outcast, and that makes them more vulnerable and makes it very tough for them to access
services. So we have got to turn that around if we're going to begin to end this epidemic.
WILLIAM BRANGHAM: And, Reverend Newells, we know that, here in the United States, that
once HIV/AIDS sort of dropped off the front page, a lot of Americans thought, OK, we're
done with that.
But as your work certainly is a testament to, there is still a pocket where we have
not figured out how to solve this in the U.S. Can you tell us a little bit about where HIV
is still prevalent in America?
REV. ROB NEWELLS: Sure.
In Black and brown communities, much like everyone has talked about with the COVID pandemic,
HIV and AIDS is still really prevalent among Black same-gender-loving men, Latino same-gender-loving
men, and Black trans women specifically, and cisgender black women.
So, I think -- and in the Deep South, because that's where most Black people in this country
live, the HIV epidemic seems to be center in big urban areas. There is a big problem
in rural areas as well that looks like it looks in sub-Saharan Africa.
WILLIAM BRANGHAM: And, Chris Collins, with regards to those particular populations, you
often hear this term that they're hard to reach.
But I have heard many activists say it's not about hard to reach. It's that we know what
works. It's just a function of finding the political will to do better. Do you agree
with that assessment?
CHRIS COLLINS: Absolutely.
I mean, it is not easy to bring down HIV infection mortality rates, but we do know what to do.
It's not rocket science. Communities around the world have actually dramatically driven
down HIV incidence and mortality when they have gone to scale and reached everybody at
risk.
But what we have got in the United States now, really, if you look at the map of HIV
incidence, it's a map of policy failure and the impact of racism in our in our society.
It doesn't have to be that way. Line up the states with some of the highest HIV incidents
against states that didn't take the Medicaid waiver for Obamacare, for example, you will
see the impact of policy, failure of health systems to be scaled so that they can reach
everybody.
That plays out in more severe HIV epidemics. We can turn this around, but it's going to
take political commitment and the investment.
WILLIAM BRANGHAM: Reverend Newells, you touched on this earlier, but I wonder if you could
talk a bit more about the issue of stigma, because that seems to be still such a big
impediment to getting people to care and getting good care to people.
REV. ROB NEWELLS: Sure, stigma, both individualized stigma, community stigma, family stigma, faith-based
stigma, can prevent folks from, A, getting tested to even find out what your status is,
and then, B,getting treatment.
It's not always all about access. Access is a big deal. But access doesn't mean uptake.
And so, if you feel stigmatized by going to get treatment or services, then the access
doesn't really matter. You're not going to uptake those services.
WILLIAM BRANGHAM: So, Chris Collins, the COVID pandemic has certainly shown us how a virus
loose anywhere in the world can be a threat to everybody.
Going forward, with regards to the fight against HIV, what do you think we ought to be doing?
What are the next most important steps to take?
CHRIS COLLINS: Well, we need to make sure we're reaching everybody.
One of the priorities that came out of the high-level meeting that the United Nations
just had was to say, we have really got to work with governments around the world and
get rid of negative laws that criminalize people's behavior and that marginalize them
in communities. Doing that and getting tailored services to those populations is going to
be essential.
We have got to increase investment. This is another thing the U.N. called for this week.
We're underinvesting in ending HIV. We could bring this epidemic to near an end, but we
have been underinvesting for decades now.
WILLIAM BRANGHAM: Reverend Newells, same question to you.
What do you -- do you think we have it within our power to end the HIV epidemic?
REV. ROB NEWELLS: We absolutely have it within our power.
I think some of the lessons we take from the COVID experience that we have all shared is
that the messenger really does matter. If you're trying to reach folks that you're not
used to reaching, you're not going to be successful.
So, we have to invest in Black leadership, Black folks reaching Black folks. The messenger
matters when addressing medical mistrust, the history of that, and the lived present-day
experience that folks have with medical racism. Like, those are things that contribute to
this pandemic. And those are the things that we have to hit head on if we're going to end
it for everyone by 2030, as the U.N. would like to do.
WILLIAM BRANGHAM: All right, Reverend Robert Newells and Chris Collins, thank you both
for joining us on this anniversary. Good to talk with you.
CHRIS COLLINS: Thank you.
REV. ROB NEWELLS: Thank you.