The city Health Department last week announced one of the most important news stories of the 21st century: AIDS is no longer one of the top 10 causes of death in New York City, for the first time since 1983.
It says a lot about how far we’ve come that this was barely news. In 1990, when I graduated from college, such a headline would’ve been seen as a cruel joke.
Give thanks to American medical innovation — and hope that innovation doesn’t come to a halt.
In the five boroughs, only 609 people died of AIDS-related illness in 2012, down from 766 in 2011. More than 16,000 city residents died of heart disease in 2012, and just over 13,000 died of cancer.
To put this in context, turn the clock back to 1994 — the peak year of AIDS mortality in the city, with close to 9,000 deaths reported due to the disease. Back then, AIDS was an epidemic with no end in sight and only a glimmer of hope that the disease could be “controlled” in some manner in my lifetime.
First reported in 1981, Acquired Immune Deficiency Syndrome was seen as some sort of “gay cancer.” As a young man coming out in the late 1980s, I was terrified to come to grips with my sexual identity precisely because I saw “being gay” as a literal death sentence. There were no effective diagnostic measures or treatments until 1987 — and both were rudimentary.
Even now, we haven’t beaten HIV. HIV infections have remained relatively stable since the mid ’90s, with about 50,000 Americans a year newly testing positive. (New diagnoses in New York City in 2012 totalled just over 3,100.)
So why the dramatic drop in AIDS deaths? Innovation.
Gay activist groups helped force the Food and Drug Administration to get serious on fast-tracking drug treatments for emerging diseases like HIV/AIDS. This led to the fastest-ever FDA approval for AZT, the first real AIDS treatment.
But then the virus began to mutate and develop resistance to that treatment, known as monotherapy. The AIDS “death sentence” continued until the mid-1990s.
So those living with HIV had to count on innovation by the US biotech and pharmaceutical industry to come up with the practical, life-saving solutions.
The medical community turned the corner only after intensive government and private-sector investment in basic research, comprehensive clinical trials and safe manufacturing of innovative and breakthrough products. That innovation cost US taxpayers and private capital billions of dollars since the 1980s — but it was well worth the investment.
The era of HAART (Highly Active Antiretroviral Therapy) began in the mid-1990s with the so-called “cocktail” of drugs that attacked the virus in a variety of ways. Antiretroviral-therapy options for HIV patients were further expanded with fusion inhibitors in 2003 and entry inhibitors in 2007.
In the past five years, many of these antiretroviral drugs became available generically, dramatically reducing US patients’ out-of-pocket costs.
Beyond our shores, thanks to former President George W. Bush, the United States exported its HIV-prevention technology and its goodwill to stop AIDS in its tracks in the developing nations of Africa. American taxpayers have provided antiretroviral treatment for more than 5 million men, women and children worldwide, mainly in Africa. A 2009 study showed that this effort directly led to the saving of more than 1.1 million lives.
Here at home, medical treatments have effectively “cured” AIDS for most new patients. But the government is now threatening to ration care and take our progress back 30 years.
Under ObamaCare, those infected with HIV may have their access to life-saving medicines restricted, as many recipients of the Federal AIDS Drug Assistance Program have been dumped into the new exchanges.
In the rollout of the Affordable Care Act, countless Americans have already lost their doctors, seen their coverage options shrink and their premiums increase. This poses extra risks to an HIV-infected patient, as any interruption of treatment can destroy years of effective disease management and lead to the virus “breaking out,” resulting in serious complications including death.
With its other taxes and efforts to contain the price of new medicines, ObamaCare may well slow pharmaceutical advances like those that have so dramatically reduced AIDS-related deaths.
It is perhaps another positive sign of our times that gay activists seem more preoccupied with bullying cake bakers and photographers rather than reducing future HIV infections. America’s medical innovators have provided the gay community the luxury to move on to more trivial concerns than the fight over life and death.
Bruce Carroll, an original co-founder of GOPROUD and creator of the GayPatriot blog, is also a health-care-policy and corporate-communications consultant.