Document 0195
 DOCN  M9590195
 TI    HIV/AIDS: learning from experience.
 DT    9509
 AU    Pinching AJ; Department of Immunology, Medical College of Saint
       Bartholomew's; Hospital, West Smithfield, London, UK.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:78 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291904
 AB    We are at a turning point in our response to the pandemic of HIV and
       AIDS, passing from the steep learning curve of the early years to the
       slower phase of consolidation and more gradual progress. We have faced
       the rise in caseload, from the first, deeply instructive handful of
       patients to a truly horrifying scale of HIV infection and AIDS,
       affecting millions of people across an increasingly complete global
       compass. From the earliest experiences we have learned to challenge many
       personal, professional and social assumptions, recognising the
       inadequacy of previous responses to disease and its social impact. We
       have discovered many new aspects of the clinical expression of viral
       infection and immunodeficiency and learnt more about the biology of
       viral immunopathogenesis and the regulation and effector mechanisms of
       immune defence against infection than from any previous example. We have
       established new partnerships in models of clinical care, in the process
       of clinical investigation and in coping with the social impact of
       disease. These substantial revolutions in our thinking and philosophy
       and the sheer enormity of the pandemic and its human impact have raised
       formidable expectations. It can now be seen that there is an increasing
       disparity between what we can conceive of and what we can realistically
       achieve with present means. The new challenge is to maintain our
       momentum through the inevitable disappointments and the necessarily
       longer time-scale of response, and to retain the sense of what can be
       done, while conserving the benefits of the pioneering days. As HIV and
       AIDS take their place in the wider pantheon of human pathology, we need
       to ensure that the spirit in which prior assumptions have been
       successfully challenged is sustained and indeed extended to other
       diseases. We must beware the increasing pressure to normalise AIDS as an
       issue, which all too often means to bring the response down to that
       applied elsewhere. Rather we must recognise the successes in AIDS that
       can allow our response to other disease to be brought up to the same
       level, while admitting the tremendous gulf that remains between our
       aspirations and current reality. This will require of us greater
       fortitude and patience, and a greater humility, than we allowed
       ourselves at the outset.
 DE    Acquired Immunodeficiency Syndrome/*IMMUNOLOGY/PSYCHOLOGY/THERAPY
       England  Forecasting  Health Policy/TRENDS  Human
       HIV/*IMMUNOLOGY/PATHOGENICITY  Philosophy, Medical  Research  Sick Role
       MEETING ABSTRACT

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