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October 12, 2005


JAMA. 2005;294(14):1826-1827. doi:10.1001/jama.294.14.1826-b

The AIDS epidemic is a tragedy that now plays primarily on a developing world stage. Yet this was not the case when AIDS exploded onto the epidemiologic scene. By the early 1980s, the dramatic success of antibiotics and the eradication of smallpox had fostered a degree of complacency toward infectious disease among many epidemiologists; indeed, in 1969 Surgeon General William H. Stewart famously proclaimed to Congress that the “war against pestilence is over.”1 The sudden appearance of clusters of Pneumocystis pneumonia and Kaposi sarcoma among gay men in American cities sent shock waves through the public health community. Initially called GRID (gay-related immunodeficiency disease), the syndrome rapidly developed from a medical curiosity into a disease that subsumed other socially marginal communities, including injection-drug users and prostitutes, and quickly revealed itself as a pandemic that engulfed Europe, Africa, and Asia as well as the Americas.

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