The context you need, when you need it

When news breaks, you need to understand what actually matters — and what to do about it. At Vox, our mission to help you make sense of the world has never been more vital. But we can’t do it on our own.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

The 45-year fight against HIV is one of humanity’s greatest victories. It’s also in danger.

We have the tools to end the virus. The question is whether we’ll abandon them.

On June 5, 1981, the Centers for Disease Control and Prevention published a brief, clinical report in its Morbidity and Mortality Weekly Report about five young men in Los Angeles who had developed a rare and deadly form of pneumonia.

The write-up, barely a page long, ran in between a report on dengue infections among US travelers and an assessment of measles cases. No one who read it could have known this was the opening chapter of the deadliest infectious disease epidemic since the 1918 flu — one that would kill an estimated 44 million people worldwide and reshape medicine, politics, and culture in ways we’re still reckoning with. It would eventually be called human immunodeficiency virus, or HIV.

A weekly dose of stories chronicling progress around the world.

For the next 15 years, an HIV diagnosis was, functionally, a death sentence, as the immune system was hollowed out on a slow march to full-blown AIDS. The virus mutated so rapidly that every early attempt at treatment felt like trying to hit a moving target in the dark. And the dark was where many of the earliest victims were forced to live, stigmatized by society. It took until September 1985 for President Ronald Reagan to even say the word “AIDS” publicly, by which point some 6,000 Americans had already died.

Botswana’s incredible HIV success story, explained in one chart

By 1993, HIV had become the leading cause of death for all Americans aged 25 to 44. Not just gay men. Not just intravenous drug users. Everyone in the prime of their lives. In 1995, at the epidemic’s American peak, 50,628 people died of AIDS in a single year. Globally, new infections peaked the following year at around 3.4 million. In the hardest-hit cities of sub-Saharan Africa, one in five adults were HIV positive. Entire generations of parents were being wiped out. By 2000, AIDS was the leading cause of death on the African continent.

The story could have ended there: The virus had won while the world looked away. But it didn’t. What happened instead, through a combination of activist fury, scientific ingenuity, and an act of bipartisan political will that still seems improbable in hindsight, is one of the great reversals in the history of medicine. It’s a narrative that provides hope not just that we might one day get to zero and eradicate HIV, but that the world can overcome what may seem like the most hopeless challenges.

Miracle drugs — and a community that wouldn’t die

For the first decade of the epidemic, the US government’s response was defined by indifference, until activists decided to make that impossible. The group Act Up turned unimaginable grief into political force, storming the Food and Drug Administration, shutting down Wall Street, and transforming funerals into protests. They were loud and........

© Vox