Modern Medicine's Frontiers and Ethics

The first clinical reports of what would later be identified as AIDS (acquired immunodeficiency syndrome) appeared in the United States in 1981, when the Centers for Disease Control and Prevention described unusual clusters of rare infections and cancers among young gay men. The virus responsible, human immunodeficiency virus (HIV), was identified between 1983 and 1984 by a French team led by Luc Montagnier and Francoise Barre-Sinoussi at the Pasteur Institute and, separately, by the American researcher Robert Gallo at the National Institutes of Health, whose competing claims to priority caused a protracted and bitter scientific and legal dispute that was only partly resolved through a 1987 political agreement between the French and American governments; Montagnier and Barre-Sinoussi were ultimately awarded the Nobel Prize in Physiology or Medicine in 2008. Effective treatment remained elusive until the mid-1990s, when combination antiretroviral therapy, using several drugs simultaneously to suppress the virus, transformed HIV infection from an almost universally fatal diagnosis into a manageable chronic condition for patients with access to treatment. International programs such as UNAIDS and, from 2003, the United States' PEPFAR initiative have since expanded treatment access globally, although the epidemic continues to disproportionately affect low-income regions, especially sub-Saharan Africa.