SPH Researcher Says AIDS Prevention Strategy Is Failing

A School of Public Health professor this week said at the 10th International AIDS Conference that efforts to halt the spread of the disease through education and preventive measures have failed.

The declaration came despite a recent experimental trial--in which several Harvard doctors participated--showing that the antiviral drug AZT is associated with the delayed onset of AIDS in HIV-positive people.

Professor of Epidemiology and International Health Jonathan M. Mann, who served as the first director of the World Health Organization's (WHO) AIDS program, said Tuesday that little can be done to prevent the disease from spreading to vulnerable countries.

"It is now evident to all that while the first global AIDS strategy--and all our work based on it--was courageous, extremely important and necessary, it is also manifestly insufficient to bring the pandemic under control," Mann said, as reported in the Boston Globe.

The strategy to which he refers, originally drafted by the WHO, discourages discrimination against sufferers so that they will not infect unwilling partners, targets health services at high-risk groups and works on providing education about AIDS.

"Pilot projects are not being sustained, the lessons learned from past global experiences are being ignored, community and political commitment to AIDS is plateauing or even declining," Mann said this week.

In order to contain the disease, he said, deep social problems--barriers to open discussions of sexuality, economic inequity and sexual inequality--will have to be addressed.

But, while many in attendance at the conference professed support for Mann's view, there was encouraging news on the medical front of the anti-AIDS movement.

An article in the August 10 Journal of the American Medical Association titled "The Duration of Zidovudine Benefit in Persons With Asymptomativ HIV Infection" concluded that AZT, when administered at 500 milligram doses "caused a significant delay in progression to AIDS or death [in asymptomatic individuals]."

But the article also said that the negative effect that AZT has on the progression of the disease appears to be nonpermanent, lasting about 2 years for most individuals in the trial.

Three of the article's many authors are affiliated with Harvard: Janet M. Grimes, a biostatistician at the School of Public Health, Martin S. Hirsch, professor of medicine, and Stephen W. Lagakos, professor of biostatistics.

A total of 1565 HIV-positive subjects participated in the study.