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It was 1981. In a Los Angeles doctor's office the men sitting in white coats were worried: within a few weeks they had diagnosed their fourth case of a condition so incredibly rare they had hardly expected to see it in their collective professional lifetime. They were baffled by the series of strange pneumonias that got worse despite normal antibiotics. All of the patients were men. All were young. All of them had died.
Three and a half thousand miles to the east, at a hospital in New York, several doctors were faced with a similar problem: strange tumours and lethal pneumonias in young men. What was going on?
The cases were all reported to the infectious disease centre. Could this be some sort of epidemic? Were the pneumonias and cancers caused by the same thing? What did the men have in common? Every day new reports of deaths came flooding in. It was becoming clear that most, if not all, of the deceased were men who had had sex with other men. The disease quickly became labelled `the gay plague'. How wrong they would turn out to be.
Dozens of strange infections were seen---with all the classic signs of weakened natural defences. The disease was called AIDS---Acquired Immune Deficiency Syndrome. It took some time to discover that the culprit was a tiny virus, called the Human Immunodeficiency Virus or HIV. It is now known that someone can be infected with HIV for ten years or more before developing the illness called AIDS.
Just five years later, by November 1986, 15,345 people had already died, another 12,000 were dying, and a further 30,000 were feeling unwell.
People were concerned that maybe up to a million people in the United States were also infected but were not yet ill. At first the `experts' predicted only one in ten of those infected would die, then two in ten, then three in ten, then nine out of ten. Now we know that almost everyone with the infection will die as a result.
Most estimates from the early 1980s were exceeded. By April 1990 in the United States there were over 126,000 cases reported. (There were estimates of possibly 200--300,000 feeling unwell and maybe 700,000 infected, representing up to one in sixty of all men in the United States between the ages of twenty and fifty. In New York, AIDS became the commonest cause of death for men and women aged twenty-five to fourty-four, with 100 AIDS deaths every week. One in every sixty-one babies carried HIV. By 1993 more people were dying of AIDS in the United States each year than died in the entire ten-year Vietnam War---compared to 6,000 deaths total in the UK. By 2002 over 45,000 American citizens were still being infected every year, despite 15 years of prevention campaign.
The number of people already doomed in the United States made the Vietnam tragedy look like a minor skirmish, with one new infection every thirteen minutes. The coffins, if placed end to end, would stretch for 1,000 miles.
Yet while all the attention at first was on America, another similar but far more catastrophic disaster was silently destroying another continent, and no one had noticed.