spotlight Spring 2009 Focus: Maurice Tempelsman Receives HAI Leadership Award he Harvard School of Public International and a senior partner in the Health AIDS Initiative honored firm of Leon Tempelsman & Son. He T Maurice Tempelsman with served as the Chairman of the Corporate its Leadership Award at a dinner at the Council on Africa from 1992 to 2002. He Knickerbocker Club in New York on is past Chairman of the Africa-America January 15th. The HAI Leadership Award Institute. He has served on several is presented to individuals who have Presidential Commissions, including the displayed outstanding vision, leadership, President’s Commission for the Observance and courage in the worldwide struggle of Human Rights. against AIDS. In presenting Mr. Tempelsman with Maurice Tempelsman receives the HAI Mr. Tempelsman serves as Chairman the award, Dr. , Chair of HAI, Leadership Award from Max Essex of HAI’s International Advisory Council. said, “He is more than a Renaissance man. He has been instrumental in helping When it comes to AIDS in Africa, he is Previous recipients of HAI’s Leadership HAI establish research collaborations in also an action figure. Others not only listen Award include Arthur Ashe, President Africa. Such programs train students and to his advice, they follow it. For numerous Festus Mogae of Botswana, Ambassador researchers and help build capacity in people in Africa and around the world, Richard Holbrooke, Diana, Princess of developing countries. this has resulted in the saving of many lives Wales, Richard Gere, and Deeda Blair. Mr. Tempelsman is Chairman of the and the prevention of much suffering and To view a slide show of the event, visit Board of Directors of Lazare Kaplan anguish. For this we are deeply grateful.” our website, www.aids.harvard.edu.

Study on Deaths Due to AIDS Policy in Makes Front-Page News “Study Cites Toll of AIDS Policy in South More than 330,000 lives were lost to Africa” was the front-page headline of The HIV/AIDS in South Africa from 2000 New York Times on November 25th. “A and 2005 because a feasible and timely new study by Harvard researchers estimates antiretroviral (ARV) treatment program that the South African government would was not implemented. In addition, an have prevented the premature deaths of estimated 35,000 babies were born with 365,000 people earlier this decade if it HIV during that same period in the had provided antiretroviral drugs to AIDS country because a feasible mother-to-child patients and widely administered drugs transmission prophylaxis program using to help prevent pregnant women from nevirapine (an anti-AIDS drug) was not infecting their babies.” implemented. The paper that garnered international The authors estimated that by 2005, attention, “Estimating the Lost Benefits of South Africa could have been providing Antiretroviral Drug Use in South Africa,” is ARVs to 50 percent of those who needed the first peer-reviewed quantitative analysis them, but had reached only 23 percent. of lives lost in South Africa due to the AIDS Dr. Pride Chigwedere By comparison, Botswana was already policy of President , who School of , graduating in providing treatment to 85 percent of those resigned his office in September 2008. June 2008. He came to HSPH from in need. The lead author, Dr. Pride Chigwedere, , where he was a practicing To download a copy of the paper, visit earned his doctoral degree from the Harvard treating AIDS patients. our website, www.aids.harvard.edu. ViewpointsViewpoints An Interview with Ireen Kiwelu Spotlight: What kind of work are you doing in the Essex Lab in Boston?

Kiwelu: I came here because of the facilities and training, which are not available in my country. Working with samples from the Moshi Women’s Health Project, I’ve learned how to use advanced techniques in HIV/ AIDS research, including DNA extraction, PCR [polymerase chain reaction], gene cloning and DNA sequencing. I’m currently using a new technique called single-genome sequencing. I’m in the lab from morning through evening, from Monday through Sunday. It’s interesting because with single-genome sequencing you’re able to see the variation of viral diversity within a single person, as well as between people.

Spotlight: Why is this work important?

The Moshi Research Team. Ireen Kiwelu is second from the right in the second row. Kiwelu: The findings from our research will contribute to HIV/AIDS Ireen Kiwelu is a Fogarty Fellow conducting Spotlight: Why did you follow bar and interventions, mainly the future design research in Dr. Max Essex’s lab at the Harvard hotel workers in particular? and development of therapeutic strategies School of Public Health. Born in Moshi, and HIV vaccines suitable for people in Tanzania, at the base of Mt. Kilimanjaro, she Kiwelu: These women are at high risk Tanzania. HIV variation and subtypes was educated in Tanzania, Denmark, England of HIV . Though prostitution have been shown to be important factors and Norway. She returned to her hometown is illegal in Tanzania, many bar and hotel in transmission, diagnosis, treatment and to work as a Senior Research at workers engage in part-time commercial disease progression. the Kilimanjaro Christian Medical Center. sex work to supplement their incomes. She is working towards her PhD in molecular We conducted a pilot study in 2000 that Spotlight: What happens next? biology. showed that bar and hotel workers have a much higher HIV prevalence than the Kiwelu: We hope to begin publishing Spotlight: What is your current research general population. In our cohort, we results from the study this summer. On project? found that 17% of the women were HIV- completion of my Fogarty Fellowship, positive, compared to about 7% of women I hope to return to Tanzania to use my Kiwelu: I’m working on the Moshi overall in Tanzania in 2007. knowledge and skills towards strengthening Women’s Health Project, a prospective training and research on HIV/AIDS, a cohort study that characterizes HIV- Spotlight: What were the objectives of the disease that threatens many lives in my 1 in Tanzanian women. Working from study? country. It is my dream to establish a December 2004 through March 2007, molecular biology laboratory within the we enrolled 800 female bar and hotel Kiwelu: The objectives were to determine Research Laboratory in Moshi, in which we workers in Moshi. Women were followed HIV and sexually transmitted disease would be able to conduct techniques such for 12 months. Interviews were conducted prevalence, as well as the incidence or as PCR, DNA sequencing and screening at quarterly visits to collect information occurrence of new HIV in for HIV drug resistance. This would build about sexual behavior and risk factors for the women. We wanted to know what scientific capacity in my country and also HIV infection. In addition, blood and subtypes of HIV we have in Moshi. We are help to minimize the cost and time of genital tract samples were collected for also looking at the variation of the virus in traveling to other countries in order to genetic analyses. individuals over time, including how much analyze samples. the virus changes in a 12-month period.

2 An Interview with Ireen Kiwelu HAI Friends Trip to Botswana

Though dinner with President Festus Mogae was one of the highlights of the 2008 Friends Trip to Botswana, several travelers cited the small meetings with participants in the Botswana–Harvard Partnership’s (BHP) clinical trials as the most valuable experience. It is one thing to read about HIV-positive women receiving antiretroviral drugs during pregnancy to prevent their children from being born with HIV. It is an entirely different experience to sit next to a young mother in an examining room and have her tell you with a shy smile that yes, her baby was born without the virus, is doing fine, and is just now learning to walk. In addition to meeting with participants in clinical trials, Friends also toured the lab at the BHP, heard presentations on studies and training programs, and Robert Preyer with his three daughers: Jill Preyer, Sally LaVenture and Liz Adamson met with doctors, graduate students, of Gaborone and a sunset game drive at LaVenture of Boulder, CO. Also on the trip and government officials. One morning Mokolodi Nature Reserve, followed by were William Haseltine of Washington, was spent touring the village hospital African dancing and a bush braai, the local DC, Sofi Bergkvist of Hyderabad, India, in Mochudi and meeting with residents version of an outside barbecue. and Jorge Dominguez, Vice Provost for under the kgotla, the traditional thatched- The 2008 Friends trip included Robert International Affairs at Harvard. If you’re roofed meeting space. Preyer of Lexington, MA, and his three interested in joining the 2010 trip, please The trip was not all science and daughters, Jill Preyer of Raleigh, NC, contact Martha Henry at mshenry@hsph. . Friends also enjoyed a bus tour Liz Adamson of Brevard, NC, and Sally harvard.edu. news & events

to Fight AIDS, Tuberculosis and Malaria. Long-Term Effects of ARVs SPOTLIGHT is published by the Dr. Cotton spoke about comprehensive On November 19th, HAI co-sponsored Harvard School of Public Health AIDS Initiative AIDS care in Africa. Dr. Moatti addressed a symposium in Boston, AIDS in Africa: 651 Huntington Avenue, 6th Floor the scale-up of access to ARVs. Other Boston, MA 02115 Long-Term Effects of ARV Therapy, which Phone: 617-432-6106 topics covered in the symposium included explored the challenges of long-term use Fax: 617-432-4545 drug resistance to ARVs, prevention of Email: [email protected] of antiretroviral (ARV) therapy to fight mother-to-child transmission, and TB/ Web: aids.harvard.edu HIV/AIDS in Africa. Dr. Max Essex, Chair: Dr. Max Essex HIV co-infection. who moderated the symposium, said that Executive Director: Dr. Richard Marlink Publications Staff because efforts to develop an effective AIDS Editor: Martha Henry vaccine will likely take a decade or longer, Economic Evaluation and Print & Web Designer: Kim Morrisseau more and more people will be taking ARVs Analyses Contributors: Lendsey Melton, Erika Fardig, Danae Roumis for longer periods of time. We must plan Dr. Richard Marlink, Executive Director ahead for the long-term consequences of of Harvard AIDS Initiative, was co-editor The research, training, and education this scenario. of a special July supplement to the journal programs of the Harvard AIDS Initiative Keynote speakers were Dr. Deborah AIDS on “HIV/AIDS Interventions in depend upon your support. Your tax-deductible contributions Cotton, Chief Medical Officer of the Developing Countries: Using Economic make a difference. Clinton Foundation HIV/AIDS Initiative, Evaluation and Analyses to Help Guide For details on making a donation, visit our and Dr. Jean-Paul Moatti, Senior Adviser to Policy and Action.” website, www.aids.harvard.edu/donate. the Executive Director of the Global Fund 3 Prevention and Control Conference

A group of over 50 participants gathered accessibility to a comprehensive package this June in Gaborone to address future of prevention interventions.” HIV/AIDS surveillance and prevention Participants in the conference strategies in a three-day conference, included epidemiologists, virologists, Prevention and Control of the HIV Epidemic biostatisticians, behavioral , in Botswana: Surveillance, Modeling and clinicians, government officials and experts Implementation of Interventions. from the Botswana Ministry of Health, In her welcoming remarks, Lesego the World Health Organization, and the Motsumi, Botswana’s Minister of Health, U.S. Centers for Disease Control. The gave the group a clear mandate. “We need conference was organized by the Harvard to seriously take stock of what we have AIDS Initiative (HAI) and generously done so far and what needs to be done sponsored by the African Comprehensive in the future, particularly in the area of HIV/AIDS Partnerships (ACHAP).

New Book Highlights HAI’s Work in Africa

Poignant full-color photographs help become one of the world’s largest; Senegal, tell the story of A Line Drawn in the Sand: often celebrated for its effective response to Responses to the AIDS Treatment Crisis HIV/AIDS; and Tanzania, where extreme in Africa, edited by HAI researchers Dr. poverty threatens efforts to control the Phyllis Kanki and Dr. Richard Marlink. epidemic. A Line Drawn in the Sand captures the By emphasizing both the challenges determination of several African nations and achievements of AIDS research and in tackling the challenges of providing treatment in Africa, A Line Drawn in the lifesaving antiretroviral therapies to their Sand provides a moving account of how citizens: Botswana, which has the second both individuals and an entire continent highest HIV infection rate worldwide; are affected by HIV/AIDS. Nigeria, where the epidemic threatens to

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