     
DECEMBER 30, 1996/JANUARY 6, 1997 VOL. 148 NO. 29
Some ages are defined by their epidemics. In 1347 rats and fleas
stirred up by Tatar traders cutting caravan routes through
Central Asia brought bubonic plague to Sicily. In the space of
four years, the Black Death killed up to 30 million people. In
1520, Cortes' army carried smallpox to Mexico, wiping out half
the native population. In 1918 a particularly virulent strain of
flu swept through troops in the trenches of France. By the time
it had worked its way through the civilian population, 21
million men, women and children around the world had
perished--more than were killed in World War I. Today we live in the shadow of AIDS--the terrifyingly modern
epidemic that travels by jet and zeros in on the body's own
disease-fighting immune system. More than 15 years after the
first rumors of "gay plague" spread through the bathhouses of
New York City and San Francisco, nearly 30 million people--gays
and straights alike--have been infected by HIV, the virus that
causes what has been, until now, an almost invariably fatal
disease. This year, for the first time, there is something that looks
like hope. Early this summer AIDS patients taking therapeutic
"cocktails" that combine protease inhibitors with other
antiviral drugs began experiencing remarkable recoveries. Their
viral loads fell. Their T-cell counts climbed. Their health
improved--perhaps temporarily, but often dramatically. Hospices
and AIDS clinics across the U.S. began to empty. Then in July, at an international AIDS conference in Vancouver,
a virologist named David Ho reported on a most promising
experiment. By administering the protease-inhibitor cocktails to
patients in the earliest stages of infection, his team seems to
have come tantalizingly close to eliminating the virus from the
blood and other body tissues. Mathematical models suggest that
patients caught early enough might be virus-free within two or
three years. This is, as an AIDS expert puts it, hope with an asterisk. Even
if Ho's treatment works, there is still no magic bullet for
patients in late stages of the disease and no vaccine that will
inoculate against HIV infection. The cost of the cocktails (up
to $20,000 a year) puts them beyond the reach of all but the
best-insured patients--and out of the question for the 90% who
live in the developing world. Nevertheless, we have learned this year what may be the most
important fact about AIDS: it is not invincible. This was not the work of one scientist alone. There is no Louis
Pasteur of AIDS. Science today is too costly and too complex for
that. Modern research, and especially AIDS research, is a richly
collaborative effort. But in the shared achievement of the
thousands of scientists and physicians who have helped bring
AIDS this year to what seems to be a historic turning point, one
name stands out. Dr. David Ho was one of a small group of researchers who
recognized from the start that AIDS was probably an infectious
disease. He performed or collaborated on much of the basic
virology work that showed HIV does not lie dormant, as most
scientists thought, but multiplies in vast numbers right from
the start. His insights helped shift the focus of AIDS treatment
from the late stages of illness to the first weeks of infection.
And it was his team's pioneering work with combination therapy,
reported in Vancouver, that first raised hope that the virus
might someday be eliminated. Ho is not, to be sure, a household name--like Bill Clinton, who
dominated the front page this year with his masterful comeback
victory, or Bill Gates, who deftly extended the scope of his
software empire into news, television and the Internet. But some
people make headlines while others make history. And when the
history of this era is written, it is likely that the men and
women who turned the tide on AIDS will be seen as true heroes of
the age. For helping lift a death sentence--for a few years at least, and
perhaps longer--on tens of thousands of AIDS sufferers, and for
pioneering the treatment that might, just might, lead to a cure,
David Da-i Ho, M.D., is TIME's Man of the Year for 1996.
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