THE BLOG

HIV, Infants, Science and Sequestration

03/06/2013 03:01 pm ET | Updated May 06, 2013

No one knew what was wrong with the boy. He had fevers, diarrhea, unusual infections and abnormal blood counts. For weeks, doctors prodded and tested him, but he did not seem to fit any clear diagnosis, or get better. No one could figure it out.

Finally, a medical student suggested that perhaps he had AIDS. The medical team was shocked. No one in the hospital had ever heard of or seen AIDS in a child who was not also a hemophiliac who had received blood. The first report, of seven cases, was published shortly thereafter.

The year was 1983. Since then, millions of children have been born with HIV. For years, no treatment existed. Most died.

But in 1994 a major breakthrough occurred when scientists, funded by the National Institutes of Health (NIH), discovered that a single dose of the medication Zidovudine (or AZT) could substantially reduce mother to child transmission -- from 40 percent to 8 percent. Thousands of new-born children in the U.S. and other wealthy countries were spared from this horrific disease.

Yet millions of children born with it in the developing world still died. The Center for Disease Control (CDC) and NIH then launched studies to see if, in the developing world, too, treating pregnant women would prevent HIV transmission to infants. It did and the U.S. government helped roll out treatment in sub-Saharan Africa and elsewhere, saving millions of lives.

The announcement this week that an infant has been cured of HIV marks an extraordinary advance. In less than 30 years, scientists have identified, and treated this dreaded disease, and now cured an infant with it. This relatively rapid discovery of a disease and its cause, treatment and cure are virtually unprecedented in human history.

Yet the announcement highlights, too, vast challenges that remain.

The fact that the mother did not know she was infected until giving birth, and had not seen a doctor while pregnant, raises concerns.

For every 100 patients in the U.S. who need treatment, only 28 end up on effective doses. Though antiretroviral drugs (ARVs) have been rolled out in the U.S. and elsewhere, 25 percent of individuals infected with the virus in this country do not know it. Yet they are far more infectious than any other patients. Of those who know they harbor the virus, only three-quarters get linked to care, only two-thirds of these stay in care, and fewer take their medications as much or consistently as needed. Luckily, researchers are beginning to examine how to overcome these barriers.

The past two years have seen other extraordinary advances as well. Research has shown that taking medications before being exposed to the virus can prevent later infection in the first place. Scientists discovered, too, that treating an infected person will prevent the virus from spreading to his or her uninfected partner. Our government´s war on AIDS has had great success, and proved a remarkable investment, saving millions of lives in the U.S. and abroad.

Scientists are now on the cusp of other enormous discoveries as well that can extend and improve human lives -- treating and preventing not only HIV, but a wide range of other problems, from cancer to genetically-caused ailments.

Yet, news of this latest advance, and of other recent triumphs occurs at the same time as government budget cuts, known as the sequestration, begin. These budget slashes now severely threaten research at the NIH, CDC and elsewhere throughout the country. The financial dangers of these cuts on the economy have received much attention. But the sequestration will impair not only jobs and the economy, but science, and all of our lives.

The sequestration's full effects are not all clear, but it will severely impede scientific progress across the country, along with various public health programs.

The phenomenal cure of this young patient from AIDS should remind us see how far we have come, and inspire us to continue to forge ahead in scientific breakthroughs. We don't yet know all the details, and such a cure may prove to be expensive and unavailable to many. Nonetheless, this achievement should serve as an opportunity to celebrate how much government-supported scientists have done, but also underscore how far we still have to go.

In the end, future generations will remember us for how we handled not only the fiscal cliff, but science, and our own health and that of others.