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The Anatomy of an Epidemic


through the DARDAR Project, as director of a course to train Tanzanian researchers and as coinvestigator of a clinical trial in Tanzania to test a new vaccine aimed at preventing TB in HIV/AIDS patients.

John Mellors, DMS '78, is a member of the faculty at the University of Pittsburgh. He studies antiretroviral therapy for HIV/AIDS, viral variants that are resistant to antiretroviral drugs, viral load as a predictor of disease outcomes, and salvage treatment regimens. He also conducts clinical trials of new antiretroviral combinations.

Richard Zuckerman studies the interactions between HIV and herpes simplex virus (HSV) because over half
of persons with HIV are also infected with HSV. He also does research to clarify clinically important interventions that may prevent HIV transmission and/or progression.

Victoria Johnson, housestaff (HS) '82-86, is on the faculty at the University of Alabama. She studies HIV resistance and coauthored a 2003 New England Journal of Medicine study on the effectiveness of a specific combination of anti-HIV drugs.

J. Brooks Jackson, DMS '82, is on the faculty at Johns Hopkins. He ran a large AIDS clinical trial in Uganda in the 1990s which found that oral nevirapine significantly reduces the transmission of HIV from mother to infant.

Mary-Margaret Andrews (also HS '91-'97) is the director of Dartmouth-Hitchcock Medical Center's Family HIV Program, a federally funded program that provides care to women and children who are HIV-positive.

In 1987, DMS alumna Hein opened the world's first comprehensive AIDS program for adolescents. Even by then, some of her colleagues in New York City were skeptical. "They called us the 'emperor's new clothes clinic,' " she says. "Then, lo and behold, people in their twenties started getting sick" with AIDS.

Peter Wright, DMS '65, is on the faculty at Vanderbilt University. In 1987, he created Vanderbilt's HIV vaccine program, which is part of an international HIV trials network. He also established a research and development unit within WHO's Expanded Program on Immunization.

Timothy Lahey is both a clinician and a researcher. He does studies in the fields of immunology—tuning immune responses to HIV—and epidemiology— looking at the impact of living in rural areas on HIV outcomes. He recently received a five-year Mentored Clinical Scientist Development Award from the NIH.

Joyce Sackey-Acheampong, DMS '89, is a member of the faculty at Harvard Medical School. She founded a nonprofit organization called Foundation for African Relief that trains African health workers who care for people with HIV/AIDS and runs an HIV/AIDS clinic in Ghana.

Bryan Marsh (also HS '90-'96) is medical director of DHMC's Regional HIV/AIDS Program. Alan Rozycki (also DMS '63) and Jeffrey Parsonnet have also provided care for many years for AIDS patients from all over northern New England.

2003

  • WHO announces 3 by 5 Initiative, to bring treatment to 3 million people by 2005.
  • Vaxgen announces that its AIDS vaccine failed to reduce infection rates among clinical trial subjects who had been vaccinated.
  • Belgian researchers conclude that HIV-2 probably jumped from sooty mangabeys to humans in Guinea-Bissau in the 1940s.

2004

  • FDA approves the first rapid oral HIV test.
  • HIV prevalence in Uganda has been reduced by 70% since the early 1990s. The drop is believed to be due to people limiting their number of sexual partners and to community-based prevention efforts.
  • A survey of U.S. media shows that the number of AIDS stories peaked in 1987, increased slightly in 1991 when Magic Johnson spoke about his HIV status, and rose again in 1996-97 upon the introduction of combination therapy.

2005

  • It is clear that WHO's 3 by 5 Initiative will not achieve its goal. The head of the organization's HIV/AIDS program expresses regret for the failure of the ambitious plan.
  • The FDA approves the first generic AIDS drug made by a foreign company.
  • AZT's U.S. patent ends. The FDA immediately approves four generic forms of the antiretroviral for sale in the U.S.

2006

  • UNAIDS estimates that worldwide, 25 million people have died from AIDS and 40 million people are living with HIV.
  • This year's International AIDS Conference is scheduled to be held from August 13 to 18 in Toronto, Canada.

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Laura Carter is Dartmouth Medicine's associate editor. Sources for the timeline below include The AIDS Reader, March 2006, Vol. 16, No. 3; American Medical News, July 2, 2001; Newsweek, May 15, 2006; www.avert.org; www.aegis.com/topics/timeline/; and aidshistory.nih.gov.

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