Today is World AIDS Day

• Aids, Hope: global goals for 2020 failed

• AIDS, 38 million people in the world are living with the HIV virus

• AIDS, new virus strain discovered: first time in 19 years

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December 1, 2021 It is December 1, 1988 when

is established

. An epochal change for HIV prevention and to promote correct information on an atrocious disease, which began to be talked about in 1981, forty years ago, when the Centers for Disease Control and Prevention reported an inexplicable increase in pneumonia in young homosexuals.

The virus is isolated and identified three years later by Robert Gallo. With an unprecedented scientific effort, the first antiretroviral drug to control the infection arrived in less than six years. Another decade and HAART was making its debut, the combined therapy with multiple drugs capable of reducing mortality.

Today there are many goals achieved in treatment, but problems remain in the management of a health scourge that has led to the death of

and

. World AIDS Day this year also celebrates the need to pursue all the objectives set: the first of which is to defeat the epidemic by 2030.

"Since the HIV virus was first identified in 1984 , caused more than 35 million deaths "worldwide, making AIDS" one of the most destructive pandemics in history ". And while "the world's attention is focused on Covid-19, we cannot forget" this "another deadly virus that has devastated lives and communities for nearly 40 years" says 

, regional director of the World Health Organization (WHO) for Europe, who together with the European Center for Disease Prevention and Control (Ecdc) released a report.

Of the

, according to data from Unaids, 36.2 million are adults and 1.8 million are children under the age of 15. In recent years, significant progress has been made in combating the disease, not only in the richest countries, but also in those with low and middle income: the number of new diagnoses has decreased over time from the peak of 1998 with 2.8 million new infections to 1.7 million in 2019.

Also at the end of December 2020 they were

, compared to 7.8 million in 2010.

This progress now seems put at risk by the pandemic . The phenomenon was also observed in Italy, where, according to the Istituto Superiore di Sanità (Iss), diagnoses were reduced by 47% in 2020 compared to 2019 (for a total of 1,303 new diagnoses and an incidence of 2, 2 for every 100,000 residents). A similar decrease was recorded in AIDS cases, which went from 605 in 2019 to 352 in 2020. For the ISS, the reduction could be a difficulty in accessing tests due to Covid-19. The target group remains that of young people between 25 and 29 years old.

In our country, 6 out of 10 new diagnoses are identified late, and this jeopardizes the effectiveness of the therapies. In terms of blood transfusions, for over 25 years there have been no cases of HIV infection, and in 2020 from the data released by the National Blood Center (CNS) none in the over 2.8 million transfusions, a trend that is also confirmed in the first months of the current year.   

Speaking to the UN General Assembly, Fauci said tackling Covid-19 has broken the chains of law enforcement and increased the risks for people with HIV to be infected with other deadly viruses. "To address these challenges we must step up our collaborative research efforts and unlock supply chains through investment and regulatory action," he said, "we must also ensure that people with HIV in all countries have early access to effective vaccines and treatments. against Covid-19, while their supply of anti-HIV drugs is also maintained ".

The efforts against Covid-19, he added, "also reveal that as a global society we are still struggling with longstanding inequalities in access to health care and very real health communication challenges linked in some countries to declining trust in institutions. central ".

He said much of what scientists and public health experts have learned from the long investment in HIV / AIDS research "has been successfully applied to the Covid-19 pandemic." In turn, he added, "the important discoveries spurred by Covid-19 may also help us make progress against HIV / AIDS," by identifying vaccines with messenger RNA and the pool of substances that are effective in vaccines.

While waiting for a vaccine, today the challenge remains that of extending as much as possible access to diagnosis and antiretroviral drugs and the control of the phenomenon of resistance to treatments.

In 2020, at least

contracted HIV, one every two minutes. Another

from AIDS-related causes, one every five minutes.

the world is living with HIV without knowing it, and only just over half of children with HIV have access to antiretroviral treatments. About 88% of AIDS-related child deaths have occurred in sub-Saharan Africa and the Covid-19 pandemic is aggravating the situation. This is the picture described in the new Unicef ​​"HIV and AIDS Global Snapshot" report.

"The HIV epidemic enters its fifth decade in the context of a global pandemic that has overloaded health systems and restricted access to life-saving services. Meanwhile, growing poverty, mental health problems and abuse are increasing the risk of contagion for children and women, "said UNICEF Director General Henrietta Fore in a statement. The report highlights that, due to Covid-19, many countries have experienced significant disruptions in HIV services. HIV testing for infants in high-prevalence countries fell by 50% to 70%, while new treatments initiated in children under 14 fell by between 25% and 50%.

Globally, access to antiretroviral therapy is very limited for children compared to that of pregnant women (85%) and adults (74%). In East Asia and the Pacific only 59% have access to treatment, 57% in East and Southern Africa, 51% in Latin America and the Caribbean and 36% in West and Central Africa. 

In the early 90s, in Cagliari, during a national congress, while the World Health Organization was focusing on the risk of transmitting the infection even through a kiss, a very young HIV-positive activist is immortalized while symbolically kissing the immunologist Ferdinando Aiuti. A photo to demonstrate that HIV is not transmitted with a kiss, but also to fight the stigma of the society of the time. 

"A friend of mine from Japan sends me a fax. Even the Japanese newspaper had published the photo. Then I realize that that kiss had gone around the world ... And it made public opinion reflect." Rosaria Iardino, president of The Bridge Foundation, tells of years of struggles, the turning point of drugs, life prospects and that deliberately provocative symbolic gesture. In the 1980s and 1990s, talking about AIDS and HIV status was taboo. AIDS is a double problem, health and social: it is seen as a divine punishment. And as had happened in the past to lepers and the mentally ill, the virus loses its scientific character and takes on another one, that of the stigma. The victim, before being a sick person to be treated, is a subversive ofestablished order and this disease is seen as a just punishment, a shame to be ashamed of. "And die before the virus kills you…". 

"Since 1981, the year in which the first cases of AIDS were reported - explains today the director of Infectious Diseases Roberto Cauda - extraordinary results have been obtained, allowing HIV to be successfully treated in the same way as other chronic diseases. From 'despair' in the early years we moved on to 'hope' and today to 'cure' ", he recalls.

But the fight is not over yet.