TIME health

How the Mystery of AIDS Created Dangerous Myths

SIDA
Microscope view of HIV, 1985 Michel Setboun—Gamma-Rapho / Getty Images

Dec. 10, 1981: The New England Journal of Medicine publishes a series of articles about a new disease that appears to target gay men

The early days of the AIDS epidemic were dangerous not just because a killer virus was sweeping across America, but because the mysterious syndrome spawned its own damaging myths.

On this day, Dec. 10, in 1981, the New England Journal of Medicine published three landmark articles and an editorial attempting to make sense of the deadly immune deficiency, which had been identified a scant six months earlier. By December, according to the BBC, the condition had been found in 180 Americans and killed 75, nearly all of them gay men.

Doctor Michael Gottlieb was among the first to recognize the chilling threat the crisis posed. When the epidemic began, 33 years ago, Gottlieb himself was 33 and an assistant professor of immunology at the UCLA Medical Center, eagerly searching for interesting “teaching cases,” according to a profile in the American Journal of Public Health.

One case that caught his attention was a harbinger of the devastation to come: a young gay man with an array of serious health problems more common to organ transplant patients than otherwise robust young people. Gottlieb and his fellow immunologists found that the man had virtually none of the “helper” cells that fight infection. After coming across several similar cases, the doctor suspected that some new, unknown virus was responsible. He told the editor of the New England Journal of Medicine that it might be “a bigger story than Legionnaire’s disease.”

To warn the medical community, Gottlieb put out his preliminary findings in the weekly report issued by the U.S. Centers for Disease Control and Prevention. By the time the journal article came out in December, other doctors from around the country had reported similar cases and were hunting for a cause.

One early theory pegged the spread of the disease — which the CDC named AIDS — to a club drug called “poppers,” although the correlation quickly broke down. New evidence that the virus was transmitted through bodily fluids emerged when heterosexual drug users began reporting symptoms, apparently after sharing dirty needles.

By then, however, hysteria over the agonizing illness had led to a proliferation of myths about its transmission. Those myths lingered long after they were disproved, adding another layer of stigma for the syndrome’s victims.

For example, in 1988 — by which time AIDS was well enough understood to make such claims preposterous — a sensationalistic book, Crisis: Heterosexual Behavior in the Age of AIDS, stirred new panic with old assertions about how the syndrome was spread. According to TIME’s review of the book, the authors suggested that contracting AIDS was as easy as using the toilet after someone with the virus, being bitten by the same mosquito or even getting to second base. This last was meant as a literal warning to baseball players, not a metaphor for heavy petting: a player could catch the virus by sliding onto the base “if, by chance, an infected player has bled onto it,” the book warned.

When confused — and terrified — callers jammed AIDS hotlines, one epidemiologist fumed, “This is the AIDS equivalent of shouting ‘Fire!’ in a crowded theater.”

Read more about the early search for the HIV virus, here in TIME’s archives: Hunting for the Hidden Killers

TIME portfolio

The Best Pictures of the Week: Nov. 28 – Dec. 5.

From ousted Egyptian President Hosni Mubarak’s acquittal to protests over Eric Garner’s chokehold death verdict and the launch of NASA’s unmanned exploration spacecraft Orion to the White House’s Christmas decorations, TIME presents the best pictures of the week.

TIME Parenting

Feds Say Circumcision Best for Boys

The ruling came as part of the first federal guidelines to address the procedure.

The benefits of male circumcision outweigh the risks of the procedure, U.S. health officials said Tuesday, in the first federal guidelines about circumcision.

“Male circumcision is a proven effective prevention intervention with known medical benefits,” the Centers for Disease Control and Prevention (CDC) said. “Financial and other barriers to access to male circumcision should be reduced or eliminated.”

The CDC stopped short of explicitly telling parents to have their children circumcised, nothing that “other considerations, such as religion, societal norms and social customs, hygiene, aesthetic preference, and ethical considerations also influence decisions about male circumcision. Ultimately, whether to circumcise a male neonate is a decision made by parents or guardians on behalf of their newborn son.”

The guidelines specifically target adolescents and young men, populations who are more likely to be infected by sexually-transmitted diseases. The guidelines say that circumcision reduces the likelihood of infection with sexually transmitted diseases, and also reduces the risk of developing penile cancer. Overall, men who are circumcised are 44% less likely to be infected with HIV, the CDC said.

 

TIME Infectious Disease

NYC HIV Diagnoses Reach Historic Low

On World AIDS Day, the city announced a 40% decline in known cases since 2003

New York City’s HIV diagnoses have hit a historic low, a new report revealed on Monday, World AIDS Day.

The New York City Health Department report shows that 2,832 people were diagnosed with HIV in 2013 (the most recent data available), which represents an all-time low and a more than 40% decline in known cases since 2003. New AIDS cases also dropped to 1,784 in 2013 from 5,422 in 2003.

Still, more than three quarters of the city’s new diagnoses were among blacks and Hispanics, and men who have sex with men also represent a disproportionate number of new cases. “But, 2,800 individuals newly infected with HIV are still too many people. We must strive harder to reach communities of color, which bear the highest burden of HIV,” NYC Health Commissioner Dr. Mary Bassett said in a statement.

New York City, one of the most populous urban areas in the world, was one of the hardest hit at the beginning of the AIDS epidemic. During a World AIDS Day event, the Health Department recognized local organizations and individuals for their outstanding contributions in the city’s fight against the disease.

Other cities, like San Francisco, have made even greater strides in cutting their new diagnoses. As TIME recently reported, San Francisco is trying to get down to zero new diagnoses. The California city, which was also an epicenter for the AIDS epidemic, had only 359 new HIV diagnoses in 2013. Not only that, but 94% of HIV-positive people in San Francisco are aware of their status.

MORE: The End of AIDS

TIME health

World AIDS Day: The History of a Virus in 7 Stories

Track the history of the disease through the pages of TIME

Dec. 1 has been World AIDS Day since 1988 — but though the awareness and activism around the diseases has changed drastically during the years between then and now.

To see just how much our understanding and attitudes have evolved, take a look back at TIME’s coverage of AIDS through these seven essential stories:

Hunting for the Hidden Killers by Walter Isaacson, Jul. 4, 1983

This 1983 cover story wasn’t the first time AIDS appeared in the pages of TIME — in 1982, an article had explained the new “plague” to readers — but the tale of the “disease detectives” at the Centers for Disease Control and the National Institutes of Health highlights just how little was known about the disease:

Based on what is known so far, two theories have emerged. One is that AIDS is caused by a specific agent, most probably a virus. “The infectious-agent hypothesis is much stronger than it was months ago,” says Curran, reflecting the prevailing opinion at CDC. NIH Researcher Fauci, who staunchly believes that the culprit is a virus, has been collecting helper T-cells from AIDS victims to look for bits of viruses within their genetic codes. So far, however, this and other complex methods of detecting viruses have yielded nothing conclusive. Suspicion focuses on two viruses: one is a member of the herpes family called CMV; the other, called human T-cell leukemia virus, or HTLV, is linked to leukemia and lymphoma.

The other theory is that the immune system of AIDS victims is simply overpowered by the assault of a variety of infections. Both drug users and active homosexuals are continually bombarded by a gallery of illnesses. Repeated exposure to the herpes virus, or to sperm entering the blood after anal intercourse, can lead to elevated levels of suppressor Tcells. The immune system eventually is so badly altered that, as one researcher puts it, “the whole thing explodes.” Other experts combine the two theories, speculating that a new virus may indeed be involved, but that it only takes hold when a combination of factors affects the potential victim, such as an imbalanced immune system or certain genetic characteristics.

AIDS: A Growing Threat by Claudia Wallis, Aug. 12, 1985

As AIDS spread, so did awareness and knowledge — as well as paranoia:

Despite their physical ordeal, many AIDS sufferers say that the worst aspect of their condition is the sense of isolation and personal rejection. “It’s like wearing the scarlet letter,” says a 35-year-old Harvard-educated lawyer who was forced out of a job at a top Texas law firm. “When people do find out,” he says, “there is a shading, a variation in how they treat me. There is less familiarity. A lot less.” Sometimes the changes are far from subtle, according to Mark Senak, a lawyer at the Gay Men’s Health Crisis, a volunteer organization that helps AIDS patients in New York. “They’ll come out of the hospital, and their roommate has thrown them out–I mean literally,” he says. “Their clothes will be on the street.” Rejection of this sort is not unique to gay men. Senak cites the case of a heterosexual woman with AIDS whose husband and family refused to take her back home from the hospital.

Invincible AIDS by Christine Gorman, Aug. 3, 1992

As the ’90s began, the hope that modern science could quickly conquer AIDS began to fade:

Wars are usually launched with the promise of a quick victory, with trumpets primed never to sound retreat. And the campaign against AIDS was no exception. Soon after researchers announced in the mid-1980s that they had discovered the virus that causes AIDS, U.S. health officials confidently crowed that a vaccine would be ready in two years. The most frightening scourge of the late 20th century would succumb to a swift counterattack of human ingenuity and high technology.

But no one was making any victory speeches last week in Amsterdam, where more than 11,000 scientists and other experts gathered for the Eighth International AIDS Conference. The mood was somber, reflecting a decade of frustration, failure and mounting tragedy. After billions of dollars of scattershot albeit intensive research and halfhearted prevention efforts, humanity may not be any closer to conquering AIDS than when the quest began.

As if by Magic by Steve Wulf, Feb. 12, 1996

For more than a decade, AIDS had been a death sentence — but suddenly survival had a celebrity face. The NBA’s Magic Johnson was back in action:

If there was a bittersweet feeling to Johnson’s return last week, it came from the realization that his exile from the game had been largely unnecessary. When Magic announced to the world on Nov. 7, 1991, that he had contracted the AIDS virus, it seemed to many that he was pronouncing his own death sentence. Michael Cooper, a teammate at the time, left the press conference crying. Johnson had to quit basketball then, supposedly for the sake of his own health and definitely for the peace of mind of his peers. He made cameo appearances, first at the 1992 N.B.A. All-Star Game and then as a member of the USA’s Dream Team in the Barcelona Olympics, but when he tried to make a comeback in the fall of ’92, the fears of some outspoken N.B.A. players forced him to call it off.

But so much has happened in four years, in both AIDS research and AIDS education.

Hope With an Asterisk by Richard Lacayo, Dec. 30, 1996

In 1996, TIME named Dr. David Ho, an AIDS researcher, the Man of the Year — and, in a series of accompanying stories, explained why. That year, a cocktail of three drugs had changed what it meant to be an HIV patient:

In the history of the epidemic, there has never been a moment as intricate as this one. AIDS once again, as in the first years after it appeared, presents a predicament so new that no one is sure how to talk about it. When we say protease inhibitors work, what do we mean? Whom do they work for, how well and for how long? The only thing we know with certainty is that the conventions of language and sentiment that fit an earlier moment of AIDS, meaning all the years when death was at the end of every struggle, are unsuited to this one, when nothing is a foregone conclusion. Something powerful is happening. The new prospects for effective treatment insist that despair is an outmoded psychological reflex. Yet among people who live with AIDS, optimism is a suspicious character. Too many bright hopes of the past didn’t pan out. So this is a moment in which, for anyone with feeling and judgment, feeling and judgment are unsettled.

Death Stalks a Continent by Johanna McGeary, Feb. 12, 2001

In the U.S., the possibility was on the horizon: AIDS could be perhaps become a manageable chronic illness, or at least a rare disease rather than a plague. But that hopeful attitude was not a worldwide phenomenon, as a lengthy and moving cover story about African patients made clear:

AIDS in Africa bears little resemblance to the American epidemic, limited to specific high-risk groups and brought under control through intensive education, vigorous political action and expensive drug therapy. Here the disease has bred a Darwinian perversion. Society’s fittest, not its frailest, are the ones who die–adults spirited away, leaving the old and the children behind. You cannot define risk groups: everyone who is sexually active is at risk. Babies too, unwittingly infected by mothers. Barely a single family remains untouched. Most do not know how or when they caught the virus, many never know they have it, many who do know don’t tell anyone as they lie dying. Africa can provide no treatment for those with AIDS.

The End of AIDS by Alice Park, Dec. 1, 2014

The current issue of TIME presents pretty much the opposite picture from the one seen a mere three decades earlier. Whereas the syndrome’s first mentions were full of confusion and fear, today’s AIDS story — the tale of a program in San Francisco that aims to get everyone who’s positive onto medication — is about control and opportunity:

More than three decades later, the disease has killed over 650,000 Americans, and the HIV/AIDS landscape, thankfully, has changed. At its peak, there were 50,000 deaths from the virus per year; now the number is 15,000. Lately, the rate of new HIV infections has stabilized at about 50,000 annually, and more than 1 million people in the U.S. are now living with an HIV diagnosis.

Those trends are making it possible for public-health experts to shift the conversation toward reducing, and even eliminating, HIV infections. More people are living with the virus–successfully controlling it with medication–and far fewer have the immune-system crashes, cancers and infections that can come with full-blown AIDS.

And the face of HIV today is a world away from the gaunt faces and wasted spirits brought to life in Tony Kushner’s Angels in America and by Tom Hanks in Philadelphia. The reality is that it’s now possible to live, for nearly an average lifetime, without any obvious physical evidence of an HIV infection.

Read more: The Photo That Changed the Face of AIDS

TIME Cancer

Scientists Develop New Way to Treat HPV-Related Cancer

hpv image
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A drug already off-patent may provide better treatment for cervical cancer

A drug called cidofovir that’s already used to target viruses could also be used as part of a novel way to treat cervical cancer.

In new research presented at an annual Symposium on Molecular Targets and Cancer Therapeutics in Barcelona, Spain, researchers tested cidofovir in tandem with chemotherapy and found that the drug caused shrinkage of cervical cancer tumors in all of the trial participants, and in 80% of the patients the tumors disappeared completely. The combination also showed no toxic side effects.

The clinical trial was small with only 15 women, who received doses of the drug weekly for two weeks, and then every two weeks after chemoradiation started.

One of the side effects of cidofovir can be kidney damage, but there was no damage observed in the participants, suggesting the dosage was safe. The researchers hope to move on to a phase II and phase III trial to look at how the drug impacts overall survival.

In the U.S. alone, about 12,000 women get cervical cancer each year. Human papillomavirus (HPV) is a very common STD, and it’s also the most common cause of cervical cancer. But cervical cancer is a common disease worldwide, and the researchers, lead by Eric Deutsch, a professor of radiation oncology at the Institut Gustave Roussy, Villejuif, France, say they see their drug treatment being very cost effective for low-income countries since it’s now available off patent.

That’s another reason it’s hard to get the support for the research. “This is also why it has taken us more than ten years to move from the first preclinical data to a phase I trial,” said Deutsch in a statement. “Due to lack of interest and support from the pharmaceutical industry, the trial had to be performed with 100% academic funding.”

TIME ebola

The Psychology Behind Our Collective Ebola Freak-Out

Airlines and the CDC Oppose Ebola Flight Bans
A protester stands outside the White House asking President Barack Obama to ban flights in effort to stop Ebola on Oct. 17, 2014 in Washington, DC. Olivier Douliery—dpa/Corbis

The almost-zero probability of acquiring Ebola in the U.S. often doesn’t register at a time of mass fear. It’s human nature

In Hazlehurst, Miss., parents pulled their children out of middle school last week after learning that the principal had recently visited southern Africa.

At Syracuse University, a Pulitzer Prize–winning photojournalist who had planned to speak about public health crises was banned from campus after working in Liberia.

An office building in Brecksville, Ohio, closed where almost 1,000 people work over fears that an employee had been exposed to Ebola.

A high school in Oregon canceled a visit from nine students from Africa — even though none of them hailed from countries containing the deadly disease.

All over the U.S., fear of contracting Ebola has prompted a collective, nationwide freak-out. Schools have emptied; businesses have temporarily shuttered; Americans who have merely traveled to Africa are being blackballed.

As the federal government works to contain the deadly disease’s spread under a newly appointed “Ebola czar,” and as others remain quarantined, the actual number of confirmed cases in the U.S. can still be counted on one hand: three. And they’ve all centered on the case of Thomas Eric Duncan, who died Oct. 8 in a Dallas hospital after traveling to Liberia; two nurses who treated him are the only other CDC-confirmed cases in the U.S.

The almost-zero probability of acquiring something like Ebola, given the virus’s very real and terrifying symptoms, often doesn’t register at a time of mass paranoia. Rationality disappears; irrational inclinations take over. It’s human nature, and we’ve been acting this way basically since we found out there were mysterious things out there that could kill us.

“There are documented cases of people misunderstanding and fearing infectious diseases going back through history,” says Andrew Noymer, an associate professor of public health at the University of California at Irvine. “Stigmatization is an old game.”

While there was widespread stigma surrounding diseases like the Black Death in Europe in the 1300s (which killed tens of millions) and more recently tuberculosis in the U.S. (patients’ family members often couldn’t get life-insurance policies, for example), our current overreaction seems more akin to collective responses in the last half of the 20th century to two other diseases: polio and HIV/AIDS.

Concern over polio in the 1950s led to widespread bans on children swimming in lakes and pools after it was discovered that they could catch the virus in the water. Thirty years later, the scare over HIV and AIDS led to many refusing to even get near those believed to have the disease. (Think of the hostile reaction from fellow players over Magic Johnson deciding to play in the 1992 NBA All-Star Game.)

Like the first cases of polio and HIV/AIDS, Ebola is something novel in the U.S. It is uncommon, unknown, its foreign origins alone often leading to fearful reactions. The fatality rate for those who do contract it is incredibly high, and the often gruesome symptoms — including bleeding from the eyes and possible bleeding from the ears, nose and rectum — provoke incredibly strong and often instinctual responses in attempts to avoid it or contain it.

“It hits all the risk-perception hot buttons,” says University of Oregon psychology professor Paul Slovic.

Humans essentially respond to risk in two ways: either through gut feeling or longer gestating, more reflective decisionmaking based on information and analysis. Before the era of Big Data, or data at all, we had to use our gut. Does that look like it’s going to kill us? Then stay away. Is that person ill? Well, probably best to avoid them.

“We didn’t have science and analysis to guide us,” Slovic says. “We just went with our gut feelings, and we survived.”

But even though we know today that things like the flu will likely kill tens of thousands of people this year, or that heart disease is the leading cause of death in the U.S. every year, we’re more likely to spend time worrying about the infinitesimal chances that we’re going to contract a disease that has only affected a handful of people, thanks in part to its frightening outcomes.

“When the consequences are perceived as dreadful, probability goes out the window,” Slovic says. “Our feelings aren’t moderated by the fact that it’s unlikely.”

Slovic compares it to the threat from terrorism, something that is also unlikely to kill us yet its consequences lead to massive amounts of government resources and calls for continued vigilance from the American people.

“Statistics are human beings with the tears dried off,” he says. “We often tend to react much less to the big picture.”

And that overreaction is often counterproductive. Gene Beresin, a Harvard Medical School psychiatry professor, says that fear is causing unnecessary reactions, oftentimes by parents and school officials, and a social rejection of those who in no way could have caught Ebola.

“It’s totally ridiculous to close these schools,” Beresin says. “It’s very difficult to catch. People need to step back, calm down and look at the actual facts, because we do have the capacity to use our rationality to prevent hysterical reactions.”

Read next: Nigeria Is Ebola-Free: Here’s What They Did Right

TIME Innovation

Five Best Ideas of the Day: October 17

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Bill Gates has some notes for Thomas Piketty: Tackle income inequality by taxing consumption, not capital.

By Bill Gates in Gates Notes

2. Thousands have died as Central African Republic slides toward civil war, but media coverage is scant. Is there an empathy gap?

By Jared Malsin in the Columbia Journalism Review

3. Europe’s apprentice model isn’t a perfect fit for U.S. manufacturing, but it could change the way we train a new generation of blue-collar workers.

By Tamar Jacoby in the New America Foundation Weekly Wonk

4. Ebola may be gruesome but it’s not the biggest threat to Africa.

By Fraser Nelson in the Guardian

5. In dry California, regulators are using an innovative pricing scheme to push conservation.

By Sarah Gardner at Marketplace

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME health

How Lessons From the AIDS Crisis Can Help Us Beat Ebola

Health officials counsel guests on the p
Health officials counsel guests on the prevention of HIV/AIDS transmission at the Argungu fishing festival in Kebbi State, northwestern Nigeria on March 13, 2008. Hundreds of fishermen from different parts of Nigeria and neighbouring West African countries have started arriving in Argungu fishing Town to participate in the fishing festival. AFP PHOTO / PIUS UTOMI EKPEI (Photo credit should read PIUS UTOMI EKPEI/AFP/Getty Images) PIUS UTOMI EKPEI—AFP/Getty Images

Ruth Katz is the director of the Health, Medicine and Society program at the Aspen Institute, a nonpartisan educational and policy studies institute based in Washington, D.C.

For too long, the history of infectious diseases has been that of ignoring a threat until it nears disaster

Without urgent action, Ebola could become “the world’s next AIDS,” said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention (CDC). HIV/AIDS has killed some 36 million people since the epidemic began, and another 35 million are living with the virus. Is history really about to repeat itself?

It doesn’t have to, if we have the wisdom to learn from past experiences. The tools we need immediately are swift international action, strong leadership, respect for science and broad-based compassion. But once we contain Ebola – and we will – we need new resource commitments and global health strategies to bring the next deadly epidemic under control much more quickly.

We’ve already done some things right. President Obama traveled to CDC headquarters in Atlanta, a rare presidential action, to detail an aggressive offensive against Ebola that includes sending troops and supplies to build health care facilities in Africa. Contrast that with the response to AIDS under President Reagan, who did not mention the epidemic publicly until 1987, six years after people started dying from it. This time around, we’re seeing leadership at the top.

Health officials have also put out a unified message about how Ebola can be transmitted – only through direct contact with bodily fluids. That, too, stands in welcome contrast with HIV, where irresponsible rumors quickly took hold and people worried about sharing toilets seats and touching doorknobs. The importance of educating health care workers and keeping them safe represents a commonality between Ebola and HIV, and must be among our highest priorities. Following the science is the only way we’re going to stop this thing.

Another lesson from HIV is that adequate resources can transform disease outcomes. The President’s Emergency Plan for AIDS Relief (PEPFAR), a $15 billion, five-year commitment under President George W. Bush saved millions of lives around the world. But by contrast, even though the CDC is attacking Ebola with the largest global response in its history, the effort doesn’t come close to having the budget necessary to do all the field work needed to really beat back Ebola. Bipartisan funding support is crucial to enable public health officials to act aggressively.

One lesson that has not been well learned is that we stigmatize people at our own peril. During the AIDS epidemic, we saw an American teenager, Ryan White, expelled from school after he contracted HIV through a blood transfusion. In Dallas, where the first known Ebola victim in the U.S. has died, we hear reports that people of African origin have been turned away from restaurants and parents are pulling their children out of school. Cries to ban flights from Ebola-affected countries — an ineffective strategy reminiscent of the 22-year ban on the entry of HIV-positive people into the U.S. — are growing louder.

Experience tells us that when we are driven by fear, we tend to push infected people underground, further from the reach of the health-care system and perhaps closer to harming others. There was a time when many people assumed every gay man could spread AIDS; now some are suspicious that anyone from West Africa could harbor a deadly virus. Acting on ignorance is the best way to disrupt an optimal public health response.

We should look to other infectious diseases for lessons as well. After severe acute respiratory syndrome (SARS) surfaced in China in 2002 and spread to more than 30 countries in just a few months, an aggressive, well-coordinated global response averted a potential catastrophe. We saw how much could be done when political and cultural differences were set aside in favor of cooperation. SARS also spurred the World Health Organization (WHO) to update its International Health Regulations for the first time in 35 years, and prompted many countries to strengthen their surveillance and response infrastructure, including establishing new national public health agencies.

But glaring gaps remain in the health care and public health systems of many nations, despite years of warnings from almost anyone who has taken a careful look at them. With a population of 4 million, Liberia has only 250 doctors left in the country. That’s more than just Liberia’s problem, because if we can’t contain the Ebola epidemic there, we’re at much higher risk here. And within our own borders, we have a public health system that the Institute of Medicine termed “neglected” back in 2002. That assessment was largely unchanged a decade later when the IOM said that “public health is not funded commensurate with its mission” in the U.S.

The international community dragged its feet far too long on Ebola, and as a result, the virus still has the upper hand, outpacing the steps finally being taken to defeat it. Sierra Leone has just 304 beds for Ebola patients and needs almost 1,500 right now; by next week, it will need more. When it comes to control and prevention, speed is paramount. With the epidemic doubling every three weeks, the actions we take today will have a much greater impact than if we take those actions a month from now.

When we finally subdue this epidemic, we also need to shed our complacency towards the infectious diseases that plague us still, and the new ones likely to arrive with little warning. In a globalized world, they remain an immense threat. Almost 50,000 new HIV infections occur in the United States every year, as do 2 million worldwide. Influenza kills thousands of people annually, and more virulent strains can be much more dire. Yet we shrug most of this off, rarely paying attention until blaring headlines announce an impending cataclysm.

To get ahead of the curve, we need a renewed commitment to research and action, and enough resources to put more public health boots on the ground, both at home and abroad. Greater support for the Global Health Security Agenda, designed to close gaps in the world’s ability to quell infectious disease, should be a priority. The agenda, launched earlier this year, is a partnership involving the U.S. government, WHO, other international agencies and some 30 partner countries.

For too long, the history of infectious diseases has been that of ignoring a threat until it nears disaster, and then stepping in to prevent it from getting even worse. We can’t afford to keep repeating that pattern, and squandering blood and treasure in the process.

Ebola is a humanitarian crisis, but it does not belong to West Africa alone. We are all in this together.

 

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Ruth Katz is the director of the Health, Medicine and Society program at the Aspen Institute, a nonpartisan educational and policy studies institute based in Washington, DC. She served from 2009 to 2013 as Chief Public Health Counsel with the Committee on Energy and Commerce in the U.S. House of Representatives. Ms. Katz was the lead Democratic committee staff on the public health components of the health reform initiative passed by the House of Representatives in November 2009. Prior to her work with the Committee, Ms. Katz was the Walter G. Ross Professor of Health Policy of the School of Public Health and Health Services at The George Washington University. She served as the dean of the school from 2003 to 2008. This article also appears in the Aspen Journal of ideas.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Infectious Disease

Origins of AIDS Traced Back to Central African City of Kinshasa

Archived samples of HIV’s genetic code allow researchers to pinpoint its beginnings to the 1920s

HIV/AIDS originated in Kinshasa in 1920, long before it was officially recognized in the 1980s, according to a study published on Friday in the journal Science.

The authors of the study traced the origin of the disease to Kinshasa, which is now part of the Democratic Republic of Congo, using archived samples of HIV’s genetic code. HIV is a mutation of simian immunodeficiency virus, a virus found in chimpanzees, and the researchers think it probably entered the human species through infected blood from bush meat.

The report then attributes the spread of the disease to a rapid population expansion, a booming sex trade and unsterilized needles used in health clinics. “The second really interesting aspect is the transport networks that enabled people to move around a huge country,” Oliver Pybus, one of the authors of the study, told the BBC, which reports that over 1 million people were using Kinshasa’s railways by the end of 1940, allowing the disease to spread even more rapidly.

HIV first came to global attention around 1980, and has since affected over 75 million people.

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