Michael Harbour, US and Global Medical Director HIV and Endocrinology at EMD Serono, Inc., Chief Medical Officer at ConnectWell, shared a post on LinkedIn:
“Every year on December 1 since 1988, the United States has recognized World AIDS Day. Not this year. For the first time, the US government will not commemorate World AIDS Day. It occurs amid broader concerns about the future of the President’s Emergency Plan for AIDS Relief (PEPFAR), America’s flagship global HIV/AIDS program, which has faced recent funding restrictions and delays. It represents a retreat from America’s global leadership in the fight against HIV/AIDS and the de-prioritization of traditional public health priorities. World AIDS Day has historically been a crucial platform for raising public awareness, reducing stigma, and mourning lives lost. Without this public messaging, the government may be perceived as undermining decades of progress in these areas. For this reason, commemorating World AIDS Day this year is more critical than ever to prevent decades of success from unraveling and slipping backwards.
World AIDS Day is time of remembrance, thankfulness, and hope. First, we first remember those who have passed away including family members, friends, patients, pioneers and those who struggled silently around us while we were not even aware. We also remember those that are currently living with the illness and battling the many obstacles that they face including aging with HIV. Second, we give thanks for the many advances in disease understanding, prevention and treatments that have been accomplished over the decades since the disease was discovered. This includes the many collateral benefits that humanity has gained from a greater understanding of HIV and infectious diseases. These byproducts include advancements in immunology (organ transplant, inflammatory diseases and vaccines), antiviral drug development (Hepatitis B, C, RSV and Covid-19) and cancer therapies (immunotherapies for many tumor types including lung and breast). Finally, we hope for a future with even better treatments, therapies to prevent new infections, and the discovery of a vaccine and eventual cure. World AIDS Day inspires each of us to remember in our unique way.
According to the WHO, approximately 44.1 million people worldwide have died of AIDS since the epidemic began and 40.8 million are currently living with HIV/AIDS including 1.5 million children under age 15. In the US, the CDC estimates that there are 1.2 million people living with HIV/AIDS today and approximately 13% do not even know their HIV status thereby being able to pass on the virus to others. Nearly 38,000 new HIV infections occurred in 2022 despite our prevention efforts including effective pre-exposure prophylaxis (PrEP). Finally, slightly over 50% of all persons living in the US are over the age of 50 which presents many challenges to care for this aging population. In summary, a lot of work remains to be done.
On this World AIDS day, some will don a red ribbon to recognize the disease as one of the many we acknowledge in our modern society. Some will visit a portion of the AIDS Memorial Quilt and experience the vast patchwork of lives spread out among open fields or school gymnasiums. Others may visit gravesites, and some may just quietly remember those with HIV that have touched their lives. For me, World AIDS Day is a profound day that not only evokes remembrance, thanks and hope, but also a day of career affirmation and rededication to the profession of medicine. The beginning of the HIV/AIDS epidemic was an era that inspired me to ‘do something.‘ It was a calling that came at a unique time in my medical education and career development. There wasn’t a known pathway to become an HIV/AIDS specialist when I entered medical school in 1988. I had planned on becoming a plastic and reconstructive surgeon. I pursued this goal and even matched to a six-year combined plastic surgery residency and fellowship early in my fourth year of medical school. It wasn’t until the end of my medical school education when I cared for a young gay man around my age who had AIDS-related pneumonia that I was moved to make a career change. I was heartbroken by the severity of his illness and how little was known about the underlying cause. I was also astonished by the fear of some hospital staff and hurtful comments that a few medical professionals made about the patient in the private confines of the medical charting area. It was at that time that I chose to become a physician, researcher and advocate for those affected by HIV/AIDS. I withdrew my slot from the plastic surgery program, and humbly scrambled to find an internal medicine program that would take me at the 11th hour. To my great satisfaction, I found a home at Boston City Hospital and began my new career path. Since then, I haven’t looked backwards.
Taking care of HIV/AIDS patients has made me a better physician and person. It has afforded me journeys and experiences beyond what I would have imagined. I’ve lived and worked in Tanzania taking care of AIDS patients with no access to antiviral treatment where death and funerals were a daily occurrence in the villages where I lived. With the trust of patients, I’ve participated in clinical trials that have brought new hope and medications to thousands of infected patients. I ran the City of Boston’s only AIDS hospice until I was laid off when the effective treatments reduced the number of admissions that it didn’t justify its existence. I’ve led clinical programs at Harvard and Stanford and advocated for new laws in California to allow HIV infected persons to have children through IVF. I was even an invited guest of President Obama to the White House for recognition of work that I had been all too happy to do even without any accolades.
To me, HIV and AIDS has been the defining disease of my generation and career. I am grateful to have had the opportunity to be just one person among many in the world-wide effort to alleviate suffering, treat illness, reduce stigma and strive for improvement. On this World AIDS Day, even if the US government has officially chosen not to commemorate it, I’m reminiscent, thankful, and eternally hopeful for new therapies and a future without the disease and its ongoing stigma.”
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