We begin with an overview of the AIDS pandemic. This is an outline, a snapshot. The details will be filled in as our course progresses. Since the early 1980s, when AIDS was noticed globally, 36 million people have died. How do we understand a number like that? The Tokyo metropolitan area has about 37 million people, so the world has lost about a Tokyo-sized population to AIDS. If you have seen a person die of the opportunistic infections associated with AIDS, you know how much suffering is involved in that number. If you have not, it will take an act of imagination which may be beyond our reach. Today, 35 million people are infected, most of them in Africa and the Caribbean. Of the 35 million people in the world today who are HIV positive, 19 million do not know that they are infected. Those people are unknowingly progressing towards AIDS, and many of them are unknowingly transmitting the infection to others. This means that expanding the reach of HIV testing is one of the most critical issues in controlling the pandemic. Of the 35 million people infected with HIV, 49% are women. In the most hard hit areas of the world, in parts of Africa and the Caribbean, about 60% of the HIV people are women. Poverty and gender inequality are major factors that contribute to the increasing prevalence of HIV among women. AIDS is not a gay men's disease, it arises from a sexually transmitted infection. In some part of the world, HIV infection have become established in the gay male community. In other parts of the world, HIV infections are more prominent among heterosexual couples. 3.4 million children are infected with HIV, almost 10% of all infections. They acquired HIV in utero, during birth, or from breast milk. Globally, children have less access to treatment than adults. Since AIDS effects people during the periods of their lives when they are most sexually active, many parents of young children have died of AIDS. The pandemic has produced 17.8 million AIDS orphans. These children are sometimes infected themselves. They are often poor, unprotected, and vulnerable to exploitation. Another result of the AIDS deaths among people in their 20s and 30s is that the economic productivity of their societies is badly damaged. Commerce, industry, agriculture and the military are all deprived of some of their most productive citizens. Currently, 1.5 million people die of AIDS per year, which is down 35% from the worst year, which was 2005. There is no cure for HIV in the sense that there is no way to eliminate it from the body of an infected person. There are effective drug treatments for HIV infections that often allow people to lead lives that are very close to normal. The treatments involve taking three drugs simultaneously, although the three drugs may be combined into one pill. People receiving treatment must continue taking the medicines for the rest of their lives. The triple drug therapy was devised in 1996, so it has existed for less than 20 years. This therapy has prevented 7.6 million deaths since it was instituted. Of the 35 million people infected with HIV, 38% have access to treatment. The majority, 62%, do not have access to treatment, and until they do, they will progress towards AIDS, many will die, and many will spread the infections to others. The cost of anti-retroviral drugs, AIDS drugs, varies widely around the world. In rich country a year's supply may cost more than $15,000. In poor countries with various programs in place, a year's supply may cost less than $100. I've thrown a lot of information at you and a lot of numbers. There's bad news. Many people are getting infected, getting sick, spreading the infection, suffering, and dying. There's good news. We're making progress. Through testing, treatment, and prevention, we can see a path towards ending the disaster. Fear and hope. In this course, we will study the details.
