In the beginning.

• Author: Conant, Marc
• Position: AIDS epidemic

In the beginning, the AIDS epidemic struck like a thief in the night--suddenly, terrify-ingly, and deadly. At first, there were a few cases of a rare malignancy, Kaposi's sarcoma, then came the appearance of Pneumocystis pneumonia; and finally a plethora of opportunistic infections including systemic candidiasis, cryptococcal meningitis, and Mycobacterium avium-intracellulare--all rare diseases associated with this new mysterious, unknown, and unnamed spectre.

Infectious disease doctors had been predicting that mankind would completely conquer all infectious diseases, and that these ancient plagues would be eliminated at the end of the twentieth century. In just one generation from Alexander Fleming's discovery of penicillin, the scientific community was able to develop antibiotics and antiviral medication to treat most of the world's known infectious agents. Suddenly, out of Africa, came a new infectious disease heretofore unknown and deadly. Society had just experienced and conquered Legionnaire's disease and toxic shock syndrome, and most of us felt that the identification and elimination of this new scourge would occur quickly and decisively. None of us anticipated that 30 years later we would still be battling one of the most lethal infectious agents known to man.

As with every epidemic, this one went through the four seminal stages of societal response:

First, as always, was denial. Some countries, such as South Africa, denied that AIDS was even happening. Most countries, such as Saudi Arabia and Japan, felt it was something only happening to other people, and would not happen to them. But, of course, with every epidemic, it did happen to them.

Then came blame: it was the fault of gay men; it was the fault of promiscuity; it was God's punishment for immoral behaviour. Some people thought that it would never happen to them because they did not have "those kinds of people" in their society. To their surprise, they did have those kinds of people, and it did happen to them.

Inappropriate legislation always follows a new epidemic. As one of the countries first and hardest hit by the epidemic, the United States passed laws to exclude HIV-positive individuals from entering the country--a classic case of closing the barn door after the horse has bolted. United States Senator Jesse Helms championed legislation which prohibited American scientists, paid for by the United States Government, from attending international meetings dedicated to...