Some today view AIDS only as a chronic disease.
Seth Berkley: It’s interesting. The AIDS epidemic, there’s been some perception that it’s just a chronic disease now. You can just take some medicines and that’s it. Well, thank God there are a lot of reasonably good medicines now to treat it. There’s lots of first-line and second-line drugs and so in essence, people can treat the infection, but people who get treated don’t have a normal life expectancy and some people can’t tolerate the medicines. The other thing is, because the virus is always mutating, you end up with resistance, so there’s a lot of problems with the existing paradigm. On top of that, most people still today don’t know they’re infected who are infected, so the epidemic continues to spread. Right now, for every person that is put on treatment, we have four new infections and so the epidemic is continuing to outpace that effort to go ahead and treat it. In the developed world, places like the United States, it hasn’t gone away; it’s been pretty steady and fairly significant. There’s been somewhere around 40,000 new infections a year; actually, the number’s probably closer to 60, not that it leaped up, but just because probably some problems with measurement. But in the rest of the world, there’s something like two and a half million new infections a year so it’s still growing and still a big problem.
Question: Is AIDS still a death sentence?
Seth Berkley: You are likely to die of HIV and its related conditions if you develop HIV. Luckily, with treatment now, you can go for a long period without getting sick and dying. How long that can be, we don’t know. Some people tolerate the medicines really well. They might approach a normal life expectancy. Some people take the medicines for a few years, have problems with tolerating them, get sick from the medicines, have viruses that break through and will die from it. So at the moment, we haven’t had a long enough experience with all these medicines to talk about what the tale is but we think that you’re getting something like seven to eight years of additional life expectancy on these drugs, which is a big deal for what was a 100% fatal disease in the past.
Question: Are you worried the world is less vigilant?
Seth Berkley: There has been a lot of recidivism and that’s in behavior change. Some of the extraordinary things that happened early on when people realized that this was a terrible disease and perhaps the most important part of that was seeing people around them get sick and die; that’s an enormous motivator so we had enormous changes in behavior. There has been some recidivism particularly among young people who aren’t seeing the epidemic in its big way, seeing all the things that are going on. So that is a problem. In terms of the disease itself, it is still a big problem globally -- 33 million infected people; still, as I said, large numbers of deaths going on around the world. So I think it’s not any sense of less of a problem. The issue is, is that people perceive it differently because of the new drugs that have been approved.