Robin A. Weiss is Professor of Viral Oncology at University College London. Born in 1940, he studied biology at the University of London, and has spent most of his research career studying retroviruses, including the discovery of endogenous viral genomes transmitted in a mendelian manner in host DNA. He was Director of the Institute of Cancer Research, London, 1980-1989. Dr. Weiss' research contributions to AIDS include the identification of CD4 as the binding receptor for HIV, the early demonstration that 'Slim' disease in Uganda was AIDS, and more recently, research on the etiology and molecular virology of Kaposi's sarcoma, the most frequent tumour occurring in Africa.


From Pan to pandemic: HIV and AIDS

Little did we realise when small pox was eradicated in 1977 that a new pestilence was brewing. AIDS was first recognised in 1981; in the past 20 years, it has claimed 19 million lives, while 35 million people are estimated to be infected with HIV today (Piot, 2000). Scientific developments have been remarkably rapid. HIV was discovered in 1983, diagnostic blood tests introduced in 1985, and the first clinical trial of an antiretroviral drug in 1986. Since 1996, AIDS mortality has plummeted among those who have access to treatment with drugs rationally designed from the molecular biology of HIV. Our most pressing problem, however, remains elusive: the development of a safe, efficacious HIV vaccine. Society's response to AIDS is as varied as HIV's gene sequences. Out of discrimination came empowerment, when 'activist' gay men realised they knew more than their doctors about the disease, and employed the internet to disseminate this knowledge. But novel threats evoke ancient responses: stigma, blame, vengeance, and blind denial. Conspiracy theory finds fertile ground,such as the widespread view in Africa that HIV arose as a virus deliberately engineered in the USA by recombinant DNA technology, tested on gay men, drug addicts and Africans. 'Cock-up' theories are also popular, e.g., that an early polio vaccine trial was responsible for HIV crossing hosts from chimpanzee to human (Hooper, 2000). The zoonosis is evident but its route remains hotly debated (Hahn et al., 2000; Korber et al., 2000). Was it a natural phenomenon or was it iatrogenic? Denial that HIV causes disease, even that AIDS is transmissible (Duesberg, 1991) seemed to be the preserve of a few virological 'flat-earthers', until the South African government recently heeded these siren voices that HIV is harmless - so why preach abstinence, hand out condoms, screen blood or purchase drugs to prevent mother-to-child transmission? With a vigorous response from the scientific and medical community (Nature, 2000) and indeed the lay press, we trust the tide will indeed turn. AIDS is a danse macabre of sex, drugs and death which demands the fullest engagement of science with society.