Miller School Gives Foreign Journalists Close-up View of War on HIV/AIDS

As the International AIDS Conference wrapped up in Washington, D.C., last week, 25 journalists from 25 countries visited the Miller School campus for an up-close view of how the U.S. is fighting the epidemic in the clinical and research arenas.

The U.S. State Department’s Foreign Press Center selected the Miller School for the July 27 site visit because it is, and from the start has been, at an epicenter of the crisis, and the efforts to end it. Florida has the nation’s second highest number of estimated AIDS diagnoses and Miami-Dade County leads the nation in the number of new AIDS cases per capita.

That’s the reason, Mario Stevenson, Ph.D., professor of medicine, chief of the Division of Infectious Diseases, and co-director of the administrative core of the newly designated Miami Center for AIDS Research (CFAR), told the journalists from Africa, Asia, Europe and Central America that he and fellow AIDS researcher David Watkins, Ph.D., joined the University recently from much colder climates. Watkins, professor and vice chair of pathology, just received a $10 million grant to develop an AIDS vaccine.

“We came here because if you’re going to fight the war against HIV, it’s better to fight it on the front lines, and Miami is really the epicenter of the AIDS epidemic in the United States,” said Stevenson, who with Watkins also took the visitors on a tour of their lab. “And some of the greatest disparities that are standing in the way of effectively controlling the infection are in this geographic location.”

Yet Stevenson gave an emphatic yes when asked if physicians and scientists are winning the war against AIDS. He noted that NBA legend Magic Johnson, who has lived with the virus for 20 years, is “as healthy as any of us,” because he religiously takes the antiretroviral drugs that have turned HIV/AIDS from a fatal to a chronic disease.

And therein lies the biggest source of both the hope and the frustration Stevenson and fellow leaders of the Miami CFAR, which the NIH just elevated from a Developmental Center for AIDS Research, conveyed to their attentive audience: If everyone infected with HIV took antiretroviral medications properly, they would not only be healthier, their virus would be undetectable and almost impossible to transmit.

“If we get to everyone infected and treat them, then we stop the epidemic,” said Margaret Fischl, M.D., professor of medicine, director of the AIDS Clinical Research Unit, and co-director of the CFAR’s administrative core, who was an original investigator of AZT. Just five days after patients stop taking their medications, Fischl added, the virus is detectable in their blood again.

Gwendolyn Scott, M.D., professor of pediatrics and director of the Division of Pediatric Infectious Disease and Immunology, who pioneered the use of AZT to prevent perinatal infection, drew applause when she described how the U.S. has all but eliminated the transmission of the virus from infected pregnant mothers to their newborns.

“We’re putting ourselves out of business, which is great,” she said. “We hope we can do this around the world.”

Watkins, who discussed his proposal to develop an AIDS vaccine using the vaccine for yellow fever, predicted an AIDS vaccine is still 10 to 15 years away.

Also addressing the journalists were Susanne Doblecki-Lewis, M.D., assistant professor of medicine, and Allan E. Rodriguez M.D., professor of medicine. Doblecki-Lewis discussed the projects in the U.S. aimed at determining the effectiveness of giving antiretroviral therapies to HIV-negative people before exposure to the virus (pre-exposure prophylactic, known as PrEP), a strategy that has proved safe and effective at preventing HIV infection in clinical trials.

Rodriguez gave an overview of the UM/Jackson Memorial HIV/AIDS clinic, which treats some of the most challenging HIV-infected patients – those without insurance. Yet, Rodriguez emphasized, lack of insurance is not a barrier to care and treatment in Miami. Antiretroviral medications are available to anyone who needs them, a fact which impressed Roselyne Sachiti, a feature writer for The Herald in Zimbabwe.

“It’s very interesting to see the other face of HIV/AIDS,” said Sachiti, who, like the other journalists, was invited to the AIDS conference and the Miami site visit by the U.S. Embassy in her home country. “It’s quite different from Africa, in terms of the health delivery system. There is more education, social safety nets and outreach here.”

Fellow journalist Edgar Tsimane of the Sunday Standard in Botswana was equally impressed. He called the site visit “very valuable, educational and interesting.”

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