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New York Times
Huge Gains, and Huge Worries, on AIDS

October 9, 1998
The medical accomplishment has been astonishing. Not many years ago infection with the virus that causes AIDS was considered a death sentence. Virtually everyone infected, except for rare individuals with a peculiar natural resistance, would inexorably develop symptoms, become progressively sicker, and die. It might take 10 years or more for the virus to destroy the body's immune system, leaving it vulnerable to attack by a host of opportunistic infections, but the end was invariably the same -- premature death for individuals who were mostly in the prime of life.

Then came the advent of drugs to attack the virus itself and to treat the pneumonias and other infections that typically administer the coup de grace. Most important was the development in recent years of powerful new cocktails of drugs that provided the most effective treatment yet for neutralizing the virus. Suddenly people who thought they were doomed had a new hold on life. The number of deaths from AIDS in the United States fell by 29 percent in 1996 and by a spectacular 47 percent last year, the largest single-year decline ever recorded for any major disease.

That is cause for jubilation, but not for a declaration of victory. As many as 900,000 Americans remain infected with the AIDS virus, and the rate of new infections is holding steady in the United States at some 40,000 a year. Now that infected individuals are living longer and healthier lives, there is an increasing danger that they will pass the virus on to others.

Worse, the virus is spreading at a frightening rate in Africa and other parts of the developing world, where large parts of the population are infected and there is neither money nor medical capacity to provide lifesaving drugs. The world will not be rid of this scourge until breakthroughs in vaccines or prevention strategies can stop the spread of infection before any curative treatment is needed.

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