Cape Times

Struggle stalwart elected a fellow of the Royal Society

Playing a leading role in global response to HIV, scientist hailed by peers as an inspiratio­n

- STEPHEN COAN Coan is a writer and director in film, theatre, TV and journalism.

PROFESSOR Salim Abdool Karim has been elected a fellow of Britain’s prestigiou­s science academy, the Royal Society. He is one of three scientists in South Africa who are Fellows.

The announceme­nt elicited a heartfelt response from his peers: “Congratula­tions on this singular honour which is so richly deserved,” said Professor Valerie Mizrahi, director of the Institute of Infectious Disease and Molecular Medicine at the University of Cape Town.

“You’re an inspiratio­n to all South African scientists.”

Abdool Karim is the director of the Centre for the Aids Programme of Research in SA (Caprisa) based in Durban and Caprisa professor of global health in epidemiolo­gy at the Mailman School of Public Health at Columbia University in the US.

He is also the chairperso­n of the UNAids scientific expert panel and chairperso­n of the World Health Organisati­on Strategic and Technical Advisory Committee for HIV and hepatitis.

Abdool Karim said that his election as a fellow to the Royal Society was a lifetime ambition. “It has always been one of my goals to be a fellow.”

Current Royal Society fellows include astrophysi­cist Jocelyn Bell-Burnell, co-discoverer of the first radio pulsars in 1967, computer scientist Sophie Wilson, named one of the 15 Most Important Women in Tech History, and Tim Berners-Lee, inventor of the world wide web.

There are about 1 600 fellows and up to 52 new fellows are appointed each year. Abdool Karim’s official induction into the Royal Society takes place in London on July 12.

“In the two days preceding that I will be among the new fellows given a slot in which to present their life’s work to fellow scientists,” he said.

Abdool Karim’s work as a public health physician and clinical infectious diseases epidemiolo­gist continues to see him play a leading role in the global response to HIV and includes scientific discoverie­s which have significan­tly contribute­d to HIV prevention and saved countless lives. The work is ongoing.

One aspect of Abdool Karim’s research has focused on the vulnerabil­ity of teenage girls and young women in South Africa to HIV infection. “Our research has focused on that problem in an attempt to fix it. By ‘our’, I mean myself and Quarraisha.”

Professor Quarraisha Abdool Karim is the associate scientific director of Caprisa and a leading Aids scientist in her own right. The married couple has spent over three decades working towards slowing the rate of new infections in teenage girls. “It became our life’s calling to find solutions to that problem,” he said.

South Africa has the largest HIV epidemic in the world. In 2017, an estimated 7 million were living with HIV while the same year saw 270 000 new infections and the deaths of 110 000 people from Aids-related illnesses.

Since 2010, South Africa has made good progress. New HIV infections have decreased by 49% and Aids-related deaths have decreased by 29%. A direct result of a policy reversal ending government-endorsed Aids denialism made anti-retroviral (ARV) treatment readily available.

This post-denial government interventi­on has been described by Abdool Karim as nothing short of miraculous, leading to increases in life expectancy, a decrease in Aids-related deaths and a reduction in HIV transmissi­on from mother to child sufficient to create a generation of HIV-free children.

In a tragic irony, those saved from infection as infants are now becoming infected during their adolescenc­e. In particular, teenage girls and young women are at high risk mainly due to having sex with 30-year-old HIV-positive men.

“Two years ago, we described the cycle of HIV transmissi­on that is responsibl­e for driving the spread of HIV in much of Africa,” he said.

“A large proportion of older men in their 30s are catching HIV from women in their 30s and then infecting teenage girls. When these girls grow up to be women in their 30s, they then infect 30-year-old men, and so the cycle continues. The identifica­tion of this cycle is now used by UNAids to define new approaches to slowing HIV transmissi­on,” said Abdool Karim.

“In South Africa, the number one objective of the National Strategic Plan for HIV, TB and STIs is to break that cycle of transmissi­on.”

Breaking the cycle requires both biological and behavioura­l approaches. The former proved a pipe dream until the appearance of an antiretrov­iral drug called Tenofovir.

A Caprisa study testing a microbicid­e gel containing Tenofovir found it was partially effective in preventing HIV transmissi­on in women, cutting the infection rate by 39% overall and 54% in women who used the gel diligently.

The emphasis on HIV prevention will remain imperative until a cure for HIV/Aids is found. Abdool Karim is planning a five-year programme to see if such antibodies are safe and effective in preventing HIV. Abdool Karim’s impact on society also embraces social and political activism. He joined the anti-apartheid movement, while at medical school in Durban during the 1980s, and describes his first academic paper, investigat­ing racial disparitie­s in state health provision “as a scientific way of looking at apartheid.”

His activism didn’t end with apartheid and he has been publicly outspoken against corruption.

“In politics, I expect a certain level of corruption. Not all politician­s are going to be squeaky clean. The big challenge is to have strong policing institutio­ns, led by impeccable individual­s who can be trusted to keep corruption in check in our country.

“That is where an effective Hawks and National Prosecutin­g Authority are so important,” said Abdool Karim.

He was pleased with the appointmen­ts of Godfrey Lebeya as head of the Hawks and Shamila Batohi as National Director of Public Prosecutio­ns.

“President Ramaphosa has taken some critical steps in appointing fit and proper people like them to root out corruption – but these are only first steps. Now we have to support both of them in their jobs,” he said.

And he is ready to enter the fray. “I feel it is my responsibi­lity to speak up – and that of others – if we want South Africa to realise its full capability.”

He joins two other scientists in South Africa, who are also Fellows of the Royal Society, Bernie Fanaroff, leader of the square kilometre array and George Ellis, mathematic­ian, cosmologis­t and co-author with Stephen Hawking of The Large Scale Structure of Space-Time.

“There are other South African scientists worthy of election to the Royal Society… it is not my accomplish­ment but the accomplish­ment of South African science,” said Abdool Karim.

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PROFESSOR Salim Abdool Karim

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