Although world is not on track to end AIDS by 2030 but it is no less than a miracle when we take into account the scientific and community-led progress which has powered the global AIDS response since 1981 – when for the first time AIDS was reported in the world.
In lead up to world’s largest HIV science conference (13th International AIDS Society (IAS) Conference on HIV Science (IAS 2025), let us remember when first few people with HIV were diagnosed in Mumbai, India and Thailand. CNS (Citizen News Service) spoke with Dr Ishwar Gilada from India (who is credited to establish India’s first AIDS Clinic in 1986) and Dr Praphan Phanuphak from Thailand, both of whom are widely known to help diagnose first people with HIV.
40 years back, Dr Ishwar Gilada, India’s longest serving HIV medical expert was working as a senior consultant at government-run JJ Hospital in Mumbai, India. News reports of 1980s show that he was actively campaigning amongst sex workers to encourage them on protecting themselves from sexually transmitted infections including HIV. Noted filmstar Sunit Dutt and several other known personalities had also joined his crusade. Noted journalists Jayashree Shetty and Gopal Shetty have co-authored a 2023 book: “The Blunting Of An Epidemic: A Courageous War On AIDS” chronicling Dr Gilada’s tireless and courageous crusade against AIDS for over four decades.
First three HIV infections were in sex workers from Mumbai’s Kamathipura in 1985
Dr Gilada said: “We were doing active disease surveillance in Mumbai’s sex work area, Kamathipura. In December 1985, three of the blood samples drawn from sex workers tested positive for HIV. One of them was a transgender person. I tested them at the Skin and Sexually Transmitted Diseases (STD) Department, JJ Hospital on kits donated by Abbott Laboratories in December 1985. The first HIV clinic in India was established in JJ Hospital by me on 5th March 1986.”
“But confirmation of our HIV tests had to be done at government’s National Institute of Virology in Pune in January 1986. However, Dr Khorshed M Pavri, then Director of National Institute of Virology, chose to withhold results. Dr Pavri came personally to collect fresh blood samples of people presumptive for HIV. I had to get all 6 sex workers to come to JJ Hospital once again to give their blood samples to Dr Pavri. She then sent samples to CDC Atlanta, USA, which caused inordinate delays in providing confirmation. Dr Pavri then published her scientific article, “First HIV culture in Indian patients” where I am listed as a co-author along with Dr Jeanette J Rodrigues,” shared Dr Gilada. Dr Pavri was India’s first virologist, as well as first woman Director of National Institute of Virology.
In clinical practice, Dr Gilada’s first clinical HIV case was of a German national who was referred to him from Goa Medical College in July 1987. He recollects the first Indian national with HIV who came to his clinic – a former sex worker who had stopped sex work in 1979. She was under his medical care but despite best of efforts, she could not be saved and died of AIDS in JJ Hospital. Her postmortem examination confirmed she had HIV and abdominal TB. This was also the first postmortem examination in India of a person positive for HIV. It was done by Dr DN Lanjewar in 1988.
Flashback: When first HIV cases were diagnosed in Thailand
“I was accidentally involved in HIV/AIDS arena. I am not an infectious disease doctor, but an allergist and clinical immunologist trained in USA. The first patient, an American gay man living in Thailand, was referred to me at King Chulalongkorn Hospital in October 1984 to investigate the cause of his recurrent muco-cutaneous infection. Immunologic investigations revealed that his T-helper cell numbers and T-cell functions were moderately low, but no diagnosis was made. In February 1985 the patient was admitted into the hospital with confirmed diagnosis of Pneumocystis carinii pneumonia (PCP) and his T-cell numbers and functions were further deteriorated. With the diagnosis of PCP and severe T-cell defect, AIDS was diagnosed at that time,” said Dr Praphan Phanuphak, a living legend who helped shape Thailand’s HIV response since the first few AIDS cases got diagnosed in the land of smiles in 1985.
Dr Praphan Phanuphak is a distinguished Professor Emeritus of the Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand. Together with late Professors Joep Lange and David Cooper, Prof Praphan co-founded HIV-NAT (the HIV Netherlands, Australia, Thailand Research Collaboration), Asia’s first HIV clinical trials centre in Bangkok in 1996. Prof Praphan served as the Director of the Thai Red Cross AIDS Research Centre for 31 years (1989-2020) and is currently the Senior Research and Policy Advocacy Advisor of the Institute of HIV Research and Innovation (IHRI) in Bangkok as well as the Advisor of HIV-NAT.
Dr Phanuphak shared: “During the same month, a Thai male sex worker was referred to Chulalongkorn Hospital because of multi-organ cryptococcal infection. His T-cell numbers and T-cell functions were also severely impaired. AIDS was diagnosed in this second patient since he had sexual contact with a foreign man who had sex with men. The girlfriend of this patient was asymptomatic but had generalised lymphadenopathy, Her T-cell numbers and functions were moderately impaired. This patient was counted as the third case. Sera collected from these 3 patients were tested for HIV in May 1985 when the anti-HIV test kit was available in Thailand. All were HIV-positive. These are the first 3 HIV/AIDS cases diagnosed in Thailand, all in February 1985. With the increasing availability of HIV test in Thailand, more and more patients were diagnosed. This accidentally drove me deeper and deeper into the HIV field, coupled with the fact that there were not very many infectious disease doctors in the early days who were willing to see HIV patients.”
Way forward towards ending AIDS
Dr Phanuphak’s and Dr Gilada’s lifetime contribution and continuing guidance to shaping HIV responses is commendable.
Governments have promised to end AIDS by 2030. Ending AIDS means that all people living with HIV should have viral load undetectable (so that they can live normal healthy lives and there is zero risk of any infection spread from them as per the WHO). In addition, all people in all their diversities, must have access to full range of science-based HIV combination prevention options in a person-centred and rights-based manner. But global AIDS response is slipping and is off the mark. With recent funding cuts, it becomes even more challenging to ensure that HIV response gets on track to end AIDS. But if we are to deliver on the promises enshrined in SDGs and #HealthForAll, then ending AIDS is clearly a human rights imperative.
Shobha Shukla – CNS (Citizen News Service)
(Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here www.bit.ly/ShobhaShukla)
