I’m a baby of the 80’s. In the early days of the epidemic I wasn’t old enough to remember the ravages of HIV. The invention of triple-drug therapy in 1996 and free access to treatment via Medicare has undeniably saved my life, a luxury many diagnosed before me did not have. As a member of a younger generation effected by HIV in Australia I believe it’s important to have insight into the history of HIV and recognition of the challenges and successes other countries face, often amongst differing political ethos and limited resources.
This month the BBC World Service, Health Check has put together 5 podcasts on the global response to HIV called “The Truth About AIDS”. It explores the history of the HIV epidemic and the varied global response. You can download and listen to the podcast below.
Episode 1: The Fight Against AIDS (27 mins) explores the medical breakthroughs which have transformed HIV from a death sentence to a chronic manageable disease. In June 1981 the first documented cases were recorded in the US yet it wasn’t until four years later a blood test became widely available. Dozens of potential anti-HIV drugs were tested unsuccessful, until finally, dramatic results were seen in the first zidovudine (AZT) trials. Community activisms in the US lead to the AIDS Coalition to Unleash Power (ACT UP) demanding quicker access to experimental drugs. The development of new drug classes in the early 1990’s further reduced HIV viral loads in clinical studies. This lead to a historical announcement that treating HIV with a combination of drugs from different drug classes significantly reduced AIDS deaths. However international trade agreements prevented the sale of cheap generic HIV medication to the continent where it was most needed, Africa.
Episode 2: Britain and America (27 mins) discusses the biggest health campaign in the UK since World War II with the 1980’s Minister for Health, Lord Norman Fowler. This is starkly contrasted against the US’s slow political response and continual ban on funding for public health prevention strategies that work.
Episode 3: Russia and Australia (27 mins) describes HIV preventative strategies that are known to work at reducing new HIV rates. Australia is considered a world leader in its quick response to implementing clean needle exchange, decriminalisation of sex work and strong political leadership which drove through prejudice and out dated attitudes. In comparison, Russia continues to deny its burgeoning HIV epidemic, spurred on by intravenous drug use. Clean need exchange and methadone programs are not legalised and people living with HIV struggle to access treatment.
Episode 4: The Truth About AIDS in Uganda (27 mins) acknowledges Uganda was the first African country to discover HIV and by 1994 18% of the population was HIV+. Since then the country has made significant headway reducing new infection, with a 70% reduction in mother-to-child transmission. This is been possible with funding from international donors, including PEPFAR and the Global Fund. Most clinics are provided in urban areas and there are continual gaps in rural service delivery. Community initiatives, such as the Stigmaless band are vital in reducing stigma and teaching HIV education using the medium of song “adherence is the key to success, take your drugs and victory will be yours”.
Episode 5: Manilla (27 mins) is the capital of the Philippines, a conservative Roman Catholic country. The key themes of this podcast explore the stigma of being homosexual and the ‘loss of face’, shame and denial of being HIV+. Dr Margarita Holmes examines ethical and personal dilemmas, including the taboo of talking about sex.
Interestingly, this episode also explores the ban on PLHIV travelling and working the UAE. A mandatory HIV test for a work permit, followed by a HIV+ result sees a Pilipino man detained for a month in a ‘quarantine area’ described as a prison cell, with people kept in handcuffs and chains while waiting for deportation.