HIV/Aids is the world’s deadliest infectious disease. It now takes more than three million lives each year and its impact is particularly devastating in poor nations.
In the rich and developed West, however, the virus is no longer regarded as a death sentence. The success of anti-retroviral drugs such as AZT means that it is increasingly regarded as a chronic but manageable illness. In countries where therapy is available and affordable, there are more and more patients out there like Chris Smith, the former Cabinet minister who recently announced that he has been HIV-positive for 17 years.
The result has been a growing mood of complacency about the disease in Britain and the United States. Almost a third of 18 to 24-year-olds think there is a cure for the virus, according to research by the Terence Higgins Trust. A perception that HIV infection is not necessarily something to be terrified of is contributing to a more cavalier attitude to safe sex borth among homosexuals and heterosexuals. And this worries health experts who rightly consider prevention rather than therapy the key to controlling Aids.
It is against this background that this week’s scare about a new “superstrain” of the virus is best understood. It began when officials in New York announced the detection of a form of HIV that was resistant to three of the four classes of anti-retroviral drugs, and which progressed rapidly to cause full-blown Aids. Both characteristics had been seen before but never together.
Thomas Friedman, the city’s Health Commissioner, issued a grave public warning: this new type of virus is “extremely concerning and a wake-up call”, he said.
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The problem, however, had arisen in just one patient. HIV is known to affect different patients in different ways — one sexual partner infected with exactly the same strain might live for years, while the other dies within months. While a single case is well worth monitoring, it is hardly cause for panic. As Robert Gallo, one of the first scientists to link HIV to Aids, explained, the patient, not the virus, was more likely to be unusual. “From the science,
I would say the probability is very high that you won’t see this virus again,” he said. “It’s irresponsible and outrageous.”
It is easy to understand the temptation for health officials to make the most of a case like this. The patient in question was a methamphetamine abuser who may have had unprotected sex with upwards of 200 homosexual partners. Here was a cautionary tale that could illustrate the message that HIV had not been beaten.
“We have first and foremost a responsibility to educate the public as to what they can do to save their lives,” said Michael Bloomberg, the Mayor of New York. If a scare brought a return to safer sex practices among high-risk groups, who could possibly lose? This, though, ignores the charged history of HIV/Aids. This disease has spawned too many damaging myths for anyone to be comfortable about adding another. The misconception that HIV can be cured is certainly one of these, which risks feeding the epidemic. Panicking people on the back of paltry evidence, however, is not going to address this in the long run.
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It might encourage more cautious behaviour at first, amid worry about the lurid headlines.
But what happens when the threat fails to materialise, as the experts currently think is probable? The “superstrain” will be held up as another example of Aids as a weapon in a moral crusade. It will become one more reason to mistrust official advice and to ignore more considered warnings based on stronger grounds for concern. When a disease is as dangerous and politicised as Aids, evidence and balance become more essential than ever. Scaremongering might be tempting — but it will not ultimately save lives.
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Mark Henderson is the Times science correspondent