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These are some of the most important events that occurred in the history of AIDS from 2007 onwards.

2007 History

A large-scale international microbicide study was halted in January after preliminary results found that the product was not achieving its aims of preventing HIV infection in women. In fact, trials of the drug in some sites found that there was a higher infection rate amongst women who used the cellulose sulphate vaginal gel, compared to the placebo group.¹ UNAIDS regarded the news as “a disappointing and unexpected setback” as “[t]he need to continue research to find a user-controlled means of preventing HIV infection in women is urgent.”²

Also in January came the dramatic announcement by President Jammeh of The Gambia that he had found a cure for AIDS.

“I can treat asthma and HIV/AIDS and the cure is a day’s treatment. Within three days the person should be tested again and I can tell you that he/she will be negative...”³

Although results released by the president’s office three weeks later were reported as positive, further scrutiny found Jammeh’s claim to be unfounded. In fact, a scientist who conducted the tests rebutted the study’s findings, saying that none of the trial patients “could be described as cured.”⁴ Yet, despite the negative outcomes of the trial, the president continued in his belief of his treatment plan, which was also endorsed by the Gambian health ministry and administered in state hospitals. The President of the International AIDS Society Dr. Pedro Cahn called the Gambian president’s claims “shocking and irresponsible”⁵, not only for providing false hope, but also for risking people’s lives by taking them off potent combination antiretroviral therapy.

Good news came to South Africa in March when the government finally developed an ambitious and comprehensive plan to try and tackle the epidemic after years of inaction. Headed up by the deputy president, Phumzile Mlambo-Ngcuka, and the deputy health minister Nozizwe Madlala-Routledge, the plan aimed to try and reduce the number of new infections by fifty percent, and bring treatment care and support to at least eighty percent of all HIV-positive people and their families.⁶ The new plan was welcomed by national and international health experts, although it was made clear that in order for the new goals to be realised there needed to be a fast track restructuring of the health care system.

Also that month came the first publication by the World Health Organisation (WHO) and the Joint UN Programme on HIV/AIDS (UNAIDS) regarding recommendations on circumcision and HIV. The guidance came three months after trials in Uganda and Kenya provided conclusive evidence that circumcision reduces the risk of transmission from women to men by around 50-60%. The publication stressed that men should be taught that circumcision provides only partial protection against HIV, to prevent them developing a false sense of security, and should only be provided as part of a comprehensive HIV prevention package. It also stressed that well-trained practitioners working in sanitary conditions should perform the procedure only after obtaining informed consent.⁷

The following week, the Institute of Medicine (IOM) issued a major review of America's global AIDS initiative, known as PEPFAR (the President's Emergency Plan For AIDS Relief). Although the report praised the multi-billion dollar programme for providing treatment, care, testing and prevention services to millions of people in the developing world, the report obliged President Bush to consider its recommendations to change a number of policies that were judged to have hampered effectiveness.⁸

In April, it was revealed by the WHO that at the end of 2006 two million HIV-positive people in low- and middle-income countries were accessing antiretroviral treatment. This means that around 28% of those in need of the life-saving drugs were receiving them. The speed of expansion remained too slow to meet the global targets agreed by the G8 summit.⁹

Further to the IOM’s March report, at the end of May US President George Bush announced that he would be renewing the PEPFAR initiative for another 5 years, and would also be doubling the amount of money that the fund will distribute, taking the figure to $30 billion. During this time, the fund would move away from its original focus on emergency action, to concentrate on the expansion and sustainability of the programmes.¹⁰ Although Bush’s announcement was widely welcomed, there were criticisms regarding PEPFAR’s regulation committing 33% of prevention funding to abstinence-only programmes.¹¹

As one pledge was made, another was retracted, and just one week after Bush’s PEPFAR budget announcement, the G8 appeared to renege its universal treatment pledge to give every person in need of HIV treatment access by 2010. Instead, it proposed a new weaker target stating that the G8 would, “over the next few years” aim to ensure access for “approximately five million people”.¹² The weakening of the original G8 pledge caused anger, as it was felt that a commitment had been broken which had been at the very heart of the fight against AIDS for the past two years.¹³ Although it was acknowledged that universal treatment by 2010 was more idealistic than feasible, many people believed that having such a demanding target put pressure on country governments to get as many people as possible into treatment programmes and highlighted the scale and urgency of the task.

In July, it was revealed that new methods of sampling led to a massive reduction in the estimated number of people living with HIV in India. Previous estimates had suggested that there were around 5.7 million people living with HIV in India, giving it the largest HIV caseload in the world. The new figures suggested that the actual total was somewhere between 2 and 3.1 million people - around 60% lower than the original estimate - and placed India third after South Africa and Nigeria for countries with the highest HIV infected populations. The previously inflated HIV numbers for India were due to figures being obtained in areas of particularly high HIV prevalence and taken from samples from surveillance sites visited mainly by pregnant women, injecting drug users and prostitutes.¹⁴

“Today we have a far more reliable estimate of the burden of HIV in India,” said the Indian Health Minister, Anbumani Ramadoss. He did however warn of complacency, as “in terms of human lives affected, the numbers are still large, in fact very large.”¹⁵

In July, there were reports of counterfeit antiretroviral drugs (ARVs) flooding the market in Zimbabwe, potentially putting many lives at risk. The adverse economic and political conditions in Zimbabwe meant that supplies of government-funded ARVs dried up in many parts of the country, leaving those with HIV at serious risk of developing AIDS. This left the door open for dealers to sell fake or illegally obtained pills to HIV positive people desperate to maintain their health. A spokesperson for the Medicines Control Authority of Zimbabwe (MCAZ) said “Such medicines may be counterfeited, adulterated and contaminated, thus rendering them ineffective and sometimes dangerous.”¹⁶

As July drew to a close so to did the eight-year ordeal of the six Bulgarian medics facing the death sentence in Libya for allegedly infecting hundreds of children with HIV. They had always denied the claim, saying their confessions were extracted under torture. Expert evidence from various scientists claimed that the infections began long before the medics had arrived in the country, and that they were due to poor hygiene and the reuse of equipment and needles.¹⁷ Bulgaria had been negotiating with Libya to secure the return of the medics for several years. The Libyan authorities finally agreed to release the medics to spend the rest of their sentences in Bulgaria, but on arrival, they were pardoned by the Bulgarian President and returned home to their friends and families.¹⁸

Optimism regarding South Africa’s response to the AIDS crisis was short lived after it was announced in August that the Deputy Health Minister Nozizwe Madlala-Routledge had been fired. After years of denial and inaction in the country it was felt that Madlala-Routledge was a government member who finally recognised the seriousness of the epidemic and was determined to take effective action. The official reason for Madlala-Routledge’s dismissal was cited as her inappropriate labelling of infant deaths at Frere Hospital as ‘a national emergency’ and accusations of her attendance at an AIDS conference in Spain without the President’s permission. But it was felt that the underlying motive for her dismissal was her ongoing conflict with Tshabalala-Msimang, the Health Minister, and in particular their contrasting opinions on how to confront AIDS.¹⁹

It was revealed that the African nation of Botswana had managed to dramatically reduce rates of mother-to-child HIV transmission. Botswana, with one of the highest HIV prevalence rates in the world, set up a comprehensive treatment and care programme, to ensure that all women were being tested for HIV in pregnancy and offered appropriate drugs to prevent HIV being passed to their babies. Without intervention, around one in three babies born to HIV positive mothers will become infected with HIV themselves; but by implementing this programme, Botswana successfully cut the mother-to-child transmission rate to under 4%.²⁰

In August, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the new HIV drugs maraviroc (Selzentry) and raltegravir (Isentress). These two new drugs offered hope to patients infected with virus strains resistant to almost all other classes of drugs designed to fight AIDS.²¹

The following month, a major HIV vaccine trial being carried out in the USA and South Africa had to be halted, after initial results showed the vaccine to be ineffective. The vaccine hoped to stimulate the production of specific anti-HIV immune cells that could neutralise HIV before it had a chance to take hold in the body. Although it was promisingly effective in animal trials, early results from the US study clearly showed that in humans the vaccine was no more effective than a placebo. Leading vaccine researcher Dr. Gary Nabel described the results of the Merck vaccine trial as “a big blow to the field.”²²

In October, it was revealed that the hundreds of South Africans who were involved in the above AIDS vaccine trial may have an increased their risk of HIV infection as a result. It was revealed that the infection rate was higher among people who received the vaccine than among those given a placebo. Experts said the vaccine itself could not have caused HIV infection, but it may have increased the risk of transmission by affecting immune responses.²³

The biographer of Thabo Mbeki revealed in November that the South African President remained unconvinced that HIV caused AIDS. Mbeki had previously stepped back from the AIDS debate in South Africa in 2000 after causing much controversy.²⁴

Towards the end of 2007 UNAIDS released dramatically revised figures of the number of people living with HIV globally. According to the new statistics, there were thought to be 33.2 million people living with HIV globally, down from the 39.5 million estimate made at the end of 2006. Although much of the reduction was attributed to better surveillance techniques in many countries, it also reflected the drop in HIV prevalence in certain areas, including Sub- Saharan Africa.²⁵

“For the first time, we are seeing a decline in global AIDS deaths,” - Dr. Kevin De Cock, director of the AIDS department at the World Health Organization²⁶

An estimated 2.1 million people died of AIDS in 2007, down from around 2.3 million in 2005. UNAIDS urged for the new statistics not be taken as an excuse to become complacent, or cut funding for AIDS.

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• AIDS & HIV history up to 1986
• AIDS & HIV history: 1987-1992
• AIDS & HIV history: 1993-1997
• AIDS & HIV history: 1998-2002
• AIDS & HIV history: 2003- 2006