Maybe you don’t remember it that often anymore. Maybe it’s been long enough ago that the AIDS epidemic, and its effect on friends and family, has faded into the past.
Combinations of antiretroviral drugs took HIV, the human immunodeficiency virus, off the list of diseases causing near-certain early death, to the point that the United Nations said in 2016 that the end of danger from the virus was near.
But experts now warn HIV may be coming back, and coming back bigger, nastier and more dangerous than ever.
The problem, as outlined at the 22nd International AIDS Conference in late July, is that diminished resources to fight the disease, problems with public health delivery and rapid demographic change are combining to increase the spread of the disease. Along with that, new strains of the virus are appearing that are resistant to the current HIV-controlling medications.
Millions of people carry the virus, which is held in check by treatment — but interruption of that treatment, whether by conflict or by something as simple as a diversion of public health funds to other uses, can cause a rapid increase in virus load in individuals.
Last year, 940,000 people died of HIV, while more than 1.8 million were newly infected.
And some of the research is particularly ominous. In all, 22 million people are being treated for the disease. It’s estimated that another 15 million are carrying it, untreated.
Think about this, from Foreign Policy.com’s reporting on the conference: “A 63-nation survey funded by (the World Health Organization and the Bill & Melinda Gates Foundation) found anywhere from six to 11 per cent of new infections involved drug-resistant forms of HIV, and the trend was dire, with resistance increasing as high as 23 per cent annually.”
That’s not a case of the statistics working in anyone’s favour.
And it’s not all far away, either. In Saskatchewan, researchers have noted newly mutated HIV strains are moving much more quickly.
“Instead of it taking years, sometimes it just takes a month or a year and it’s much more aggressive than we would otherwise see,” Dr. Alex Wong, an infectious disease physician with the Saskatchewan Health Authority, told the Canadian Press.
And even in a country like Canada, there are clear concerns about the health system’s ability to keep people on antiretrovirals, so that they can live healthier lives, and also not spread their infection.
“The drugs work extremely well,” Wong said. “The challenge oftentimes is getting people linked to care and keeping them linked to care.”
The message? There’s no winning yet. HIV is still a serious health concern, and we forget about that at our peril. It’s is not, right now, the clear scourge it once was. But keeping the disease in check is everyone’s concern.