The first World AIDS day was on December 1, 1988. We had little to celebrate…

The number of reported AIDS cases in the United States was nearing 80,000 and rising rapidly. Thousands more in this country were living with HIV. Globally, AIDS cases already had been reported from more than 135 countries. An AIDS tsunami clearly was looming, but we had few defenses at our disposal.

For those of us caring for people with AIDS, it was a dark time. We had just one anti-HIV medicine in our pharmacies, AZT, a drug that the virus rapidly defeated by mutating and developing resistance. Lacking other medicines to slow the relentless replication of HIV and its destruction of a person's immune system, we did our best to help our patients by managing to the extent possible their AIDS-related infections and complications. But the life span of most of the patients was measured in months.

Two decades later, much has changed. An unprecedented research effort has led to more than two dozen anti-HIV drugs, more than for all other viral diseases combined. Taken in proper combinations, these medications have dramatically improved the prognosis for people living with HIV by increasing their life span by at least a decade and providing the possibility of a normal life span with continued therapy.

Scientifically proven prevention approaches -- education and outreach to at-risk populations, voluntary HIV testing and counseling, condom distribution, prevention of HIV transmission from mother to baby, harm reduction approaches for drug abusers, mass-media campaigns and the screening of donated blood -- have been deployed with great success in the United States and many other countries.

Innovative programs such as the President's Emergency Plan for AIDS Relief and the Global Fund for HIV/AIDS, Tuberculosis and Malaria, as well as the efforts of nongovernment organizations, have reached millions of people in low- and mid-income countries worldwide with HIV-related services, at a scale unimaginable a few years ago. And gradually -- but too slowly -- we have begun addressing AIDS-related stigma in this country and abroad.