Friday, April 12, 2013

AIDS researcher Dr. Michael Gottlieb talks to the Daily Princetonian

Dr. Michael Gottlieb, who in 1981 identified a disease now known as acquired immune deficiency syndrome, spoke on campus Thursday afternoon about lessons the public and scientific communities have learned from the epidemic. The Daily Princetonian spoke with him about his career and the future of HIV/AIDS research.
The Daily Princetonian: You’re in a relatively unique situation, specializing in a disease that didn’t exist when you went through your medical training. Did you ever anticipate your career evolving the way that it did?
Michael Gottlieb: Most people who are in AIDS did something before AIDS. A common question that we ask amongst ourselves at meetings is ‘what did you do before AIDS?’ But HIV/AIDS is so compelling that once you start doing it, you’re hooked. Most people who are in HIV/AIDS left something that they did before and devoted their careers to it. For some of them, particularly people who started working on it early on, it was kind of like reading a good book that you couldn’t put down because new things were happening all the time. It’s not a stale feel. It’s always moving, so that makes it exciting.
DP: You mentioned in your lecture that sometimes the public doesn’t always think about the patients themselves on the personal level. Do you see that as a trend that might continue in the future, and do you also think that doctors themselves sometimes don’t step down to the patient level?
MG: I think what’s happening now is that, in the '80s, the patients were so ill that there was a characteristic appearance of someone who had AIDS, and there was some television coverage and photographs of those people. But today the average person living with HIV looks remarkably normal. And yet that average person generally is uncomfortable disclosing their HIV status, and so they remain in the shadows, and we don’t see them. And they don’t talk about their HIV. As I was talking about stigma, you can’t get rid of stigma unless you bring it out in the open and talk about it. So it’s becoming invisible.
DP: The diseases that are the biggest killers in the United States are things like influenza and pneumonia, whereas AIDS is a more global-scale disease that kills. Do you think that America’s a little bit too self-centered on what’s important in terms of medical development and treatment?
MG: Well, America is certainly on the cutting edge in terms of new treatments in all sorts of diseases. America also has been a leader in HIV/AIDS. Where we are today globally has a lot to do with what has been made in America. Once again, I know it’s a worldwide effort, but American taxpayers and industry are funding major initiatives toward a vaccine. So it’s got to be a balance. I don’t think we’re ignoring the rest of the world. We can’t afford to treat the whole world alone. And that’s where things like the Global Fund [to fight AIDS, tuberculosis and malaria] come in.
DP: In terms of the evolution of public opinion and political response, did you ever predict that it would take the trajectory it did when you made that first diagnosis in 1981?
MG: No, I was very surprised. I waited seven years for Ronald Reagan to say the word "AIDS." I never anticipated that. It was shocking to me that he basically paid little attention to the largest epidemic of recent centuries because of a political and religious judgment. 
DP: At what point did you finally realize that you were dealing with a whole new disease when you made that diagnosis?
MG: Probably in a couple of months. We published our report in June 1981. The Centers for Disease Control and Prevention sent teams into other large cities and found lots of patients with AIDS, and at that point we knew it was a multi-city epidemic. It was much larger than just five patients in Los Angeles.
DP: What do you see as your personal role moving forward in the future of the development of treatment for AIDS?
MG: For me personally, it is to get younger people excited about working in the field.

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