The AIDS epidemic for a doctor in his sixties reads like a book in the history of medicine, in time-lapse. Obviously, the fight is far from won, but doctors have in a very short period of time – less than forty years – identified a deadly new disease, found its cure, made it bearable, identified a simple way. protection and developed simple screening tests. At the same time, civil society was carrying out a global communications operation on a scale that will arguably never be matched again. There are still major gray areas: the inadmissible spread in our country, uncontrollable in poor countries and the absence of a vaccine.
Victories
The virus responsible
It is probably a very old virus, ultra sophisticated, which explains why, although unknown, and therefore supposedly boorish and young, it has known how to challenge the world of virology. There remains a certain threat, but with controlled virulence. Humans have made more progress in 40 years against this virus than itself in millions of years of evolution.
The treatment
We all remember the death notices of this disease … So many blows to a research which, however, was working hard. And then came the antiretrovirals, the famous “triple therapy” since a single molecule was not enough. A real lifeline at the start, since the patients would no longer die – or rather less -, but very imperfect because of too important side effects. The pharmaceutical industry has continued to work since to make the effective treatment as bearable as possible and, strongly criticized by associations, to manufacture drugs at a price bearable by most of the poor countries decimated by the epidemic.
Protection
The most effective means had been at hand since the start of the epidemic! Our parents’ condom, which had been gradually abandoned due to the decrease in sexually transmitted diseases in the 1970s, and above all, access to the pill for women.
Now, it is no longer the job of doctors to make its use systematic during unprotected sex. Can do better.
A screening
The word “positive” is initially a misnomer and misinterpretation, as doctors are often responsible for. It took a long time for people to realize that being positive was not… Screening is an area where progress is constant: speed, cost, availability, anonymity. In theory almost perfect … provided you do it. There are still too many new cases to be satisfied.
Communication
It was exemplary and regardless of the lawsuits against those who sometimes confuse promotion and prevention, the work carried out was colossal and effective, both in prevention and in the recovery of significant funds for research.
Defeats
Escape and therapeutic failure
It is now estimated that the current life expectancy, under treatment, in young infected subjects may exceed 35 years. It is insufficient. This is due to two phenomena: virological escape, that is to say that the treatment does not manage to completely control the development of the virus, and especially the therapeutic failure which means threat of imminent death. It concerns less than 4% of patients treated, but we still die too much of AIDS in France, today, detected and treated …
Communication
Even if it may seem very important, there are still too many new AIDS cases each year to let our guard down; especially among adolescents and young people. We will have to review the hum of certain operations that have become institutions and even more use social networks.
The vaccine
This is the most resounding failure … Not a week without an announcement effect … All questioned. But some researchers are starting to evoke other reasons than the resistance of the virus… In question, the real desire of governments and the pharmaceutical industry to spend large sums for a market less profitable than other infectious diseases…
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