For the first of the College of Human Ecology’s Global Health Lecture Series, Prof. Roy M. Gulick, medicine, Weill Medical College, presented his lecture “HIV/Aids 2007: Where are we?”
Dr. Gulick researches clinical trials of antiretroviral therapies (ART), the drugs currently used to treat HIV. The lecture marks the beginning of a series of lectures that explores issues of global health with the ultimate goal to “create an innovative university-wide research and training program,” encompassing a number of different fields and studies according to Prof. Rebecca Stoltzfus, nutritional science, who both introduced and organized the lecture series.
This particular lecture explored the history of the HIV/AIDS pandemic, treatment and where the global health community now stands in dealing with the dire effects of this virus. According to Gulick, the term “AIDS,” or Acquired Immune Deficiency Syndrome, was first coined in 1982 and referred to a number of diseases that weakened the immune system. In 1985 the definition was changed to include HIV and in 1993 it was changed to include a limited number of CD4 cells, white blood cells that aid the immune system in fighting illness.
As of now, a total of 40.3 million people worldwide are infected with HIV; this includes 1.2 million in North America and as many as five million in South Africa, according to Gulick. Further statistics presented by Gulick include the four million new infections per year and the three million deaths as a result of HIV/AIDS per year. Each day there are 14,000 new infections, 2,000 of which occur in people under 15 years old and 12,000 of which occur in people in the 15 to 24 age bracket, according to Gulick.
Although the numbers may be discouraging, there has been success over the past 15 years in treating HIV and preventing the onset of AIDS, which tends to occur in 10 years without treatment after the initial HIV infection and usually results in death, according to Gulick. His particular research is on ART, which is a number of drugs that have been successful in slowing down the effects of HIV and its ability to multiply and infect cells.
According to Gulick, ART can “interfere with one or more steps in the life cycle of HIV.”
The first ART, called AZT, was available in 1987 and since then 22 forms have been introduced to treat HIV.
There have been “really profound effects from HIV therapy in the U.S.” as evident by the three million “life-years” saved here, Gulick said.
But a number of problems still remain; only 1.6 million people in the developing world have access to ART and less than five percent of those receiving such treatment are children. About $25 billion is needed to sustain the treatment and the drugs often have side effects.
“Side effects may be profoundly disturbing and very challenging,” Gulick said.
Although there is research currently being done to create an HIV vaccine, in Gulick’s view, the creation of a vaccine within the next 10 years is unlikely, or “daunting” at best.
For current Cornell students, HIV can seem distant, but anyone is at risk. Gulick stressed that college students “have lived in a world that has always had AIDS,” and always need to use protection when engaging in sexual behavior.
“Don’t think you’re not at risk. It can happen to you,” he said.
So, where are we in 2007? Gulick believes that prevention has “always been the most powerful tool we’ve had.” The ABC program, which encourages abstinence, fidelity and the use of condoms, has been implemented in Africa; Gulick feels this has been extremely successful.
Although “our treatments today are road blocks thrown up in the course of its lifetime,” Gulick strongly believes that in order to fight HIV and AIDS, “you can’t just ship ART to clinics in Africa, you need support, monitoring and training for the staff.”
As for the future, “Cure, prevention [and] better treatment” are the three keys in conquering this global health issue.
Ariela Rutkin-Becker ’09, who attended the lecture, left with optimism.
“I think that there is so much left to do in the world but I think that he definitely left the audience feeling lifted because of the research that the drug companies are doing,” she said.