Wednesday, Dec. 1, the world will pause, take a deep breath and envision a future without AIDS. World AIDS Day is a time to discern the devastation around us and beyond: A moment to remember those who have passed, millions victim to something undetectable to the naked eye. A chance to give a nod, to use the blind eye often turned, to wake up and smell the roses, to pull our head out from under the sand. It’s a day of mourning, deliberation and of vision. A day bulging at the seams, replete with obligations to a world struck hard by an unforgiving epidemic. Foremost, it’s a day of hope.

In this week’s feature, “Beyond our backyard: AIDS Day 2004”, the reader is lambasted with data and statistics designed to demonstrate the magnitude of loss as a result of AIDS. Newspapers, television, journals and sound bites will resonate with heart-rending stories and incalculable numbers, causing our heads to fall, our shoulders to slump and our hearts to grieve. And as we shrink back in response, let us remember: the day is also about hope.

If a person developed AIDS when AIDS was first recognized in 1981, it meant certain death. Within a few years at most, you were expected to die – a word or two such as, “make arrangements” or “put things in order”, were offered as consolation. Today, people are living longer, healthier lives as scientists develop an arsenal of drugs used to suppress the HIV virus and improve the quality of life for those inflicted with the disease. In an effort not to sugar coat, those with HIV/AIDS today brave innumerable challenges including side effects to medication, social stigma, facing mortality and new dynamics in relationships and dating. However, many physicians believe they hold the tools necessary to keep someone who is newly infected with HIV alive for a normal to near-normal healthy lifespan. And for HIV veterans, with new drug combinations steadily emerging, treatment failure continues to be eluded.

World AIDS Day represents progress. Not long ago people had but few options to treat HIV infection, such as the first reverse transcriptase (RT) inhibitor. With the arrival of AZT, followed by the discovery of combination drug therapy, HIV treatments proved increasingly effective. Then in December 1995, the first protease inhibitors (PIs) appeared, dramatically changing the outlook for thousands. Many went from “waiting for death” to “undetectable” in a matter of years.

As infection rates continue to rise, cities such as San Francisco – once devastated by AIDS – report rates stabilizing due to widespread use of these anti-AIDS drug cocktails which dampen HIV incidence as lower viral loads translate into lower risk of transmission.

And the research continues. Currently, researchers around the world are focusing on creating a vaccine designed to stimulate the body’s immune system to combat the HIV virus, reducing dependencies on drug combination therapy high in toxicities. Just this month, French researches announced, in laboratory conditions they stimulated antibodies which dramatically barred the AIDS virus from infecting human immune cells, opening up interesting prospects for the development of a vaccine against AIDS.

Current treatment options face continuous scrutiny as the HIV community demands more tolerable, less toxic drug regimes. Issues of lipodystrophy – a collection of changes in people taking anti-HIV medications including fat loss, fat deposits and metabolic changes – may be a thing of the past as researchers scramble to develop new PIs responsible for fewer side effects. Moreover, long-standing treatment standards are being reevaluated as more and more people live longer drug free, choosing to begin drug therapy later and interrupt treatment.

Albeit these successes, the end of the epidemic is far from realized. While the Western world exhales a sigh of relief, millions in Africa, Asia and South America struggle to keep their heads above water. Despite the existence of life-saving drugs, thousands in less developed countries die each day. Initial steps have been made granting poor nations the right to manufacture, buy and import cheaper generic HIV/AIDS drugs. And while many attempts to bring medications to the Third World have come up short, there is no doubt that one day all nations will be given the tools to rescue their populations.

World AIDS Day will come and go. Don’t let it pass by without participating in some way. When faced with an adversary such as AIDS, it’s easy to throw up your hands, but there are things you can do. This World AIDS Day (and throughout the year): wear a red ribbon; attend a World AIDS Day event; volunteer for an HIV organization; write letters to politicians and representatives; talk to your family, friends and sex partners about HIV/AIDS and safer sex; research HIV/AIDS statistics in your local area; give dollars to HIV/AIDS organizations; and most importantly, treat people living with HIV and AIDS with respect, understanding and dignity.