Medical & Science:
A Houston doctor rallied a global force to treat children with AIDS.
It was the word “extinction” in a 2002 New York Times article that caught Dr. Mark Kline’s attention. The president of Botswana feared that would be the fate of his people if the war on AIDS was lost.
Was it possible? Kline considered the countless children he watched die in Houston and beyond. He decided it was. So he flew to Botswana, met with the minister of health and offered help.
In that manner, the softspoken pediatrician at Baylor College of Medicine and Texas Children’s Hospital waged a revolutionary campaign against the most menacing epidemic facing modern medicine.
He bore the flag of an oftoverlooked demographic in the battle: children. Kline’s legacy is a global network of AIDS clinics that pulled thousands of children from the brink of death and remain vital institutions in developing parts of the world.
Once a nerdy teenager in San Antonio, Kline spent nights and weekends building science fair projects that made local news and volunteering at a research lab.
Born in 1956 in the Rio Grande Valley, Kline turned down admission to the prestigious Johns Hopkins Medical School because he missed a girl in Houston and opted instead to attend Baylor College of Medicine.
“Nobody leaves Johns Hopkins,” said Dr. Roger Waid, 88, who supervised Kline’s teenage lab work and still sees him every month. “We teased him for years about that decision.”
By the time Kline finished his medical education in 1987, AIDS had emerged as a global emergency. Acquired Immunodeficiency Syndrome is caused by the Human Immunodeficiency Virus, a tiny organism that kills the body’s defenses and leaves victims vulnerable to every floating germ. Before specialists and treatment, those infected would wither painfully under a spate of uncommon infections until they passed.
In Kline’s first job, he was asked by chance to assume care part time for 15 boys infected with the virus. It was grueling work — the frail children needed constant care. Baylor asked Kline in 1990 to take the helm of a program that grew from 75 patients to 400 patients in four years. The work required Kline to be on call virtually around the clock for seven years. He coached parents on administering up to 35 pills a day to their children. There were many funerals.
By 1996, researchers had developed an effective treatment, called highly active antiretroviral therapy (HAARVT). It was a complex drug cocktail that could suppress the debilitating effects of AIDS for life. Kline and the Baylor lab formulated a recipe for kids, and it worked.
It seemed the virus was beaten. Kline felt triumphant, he said, even smug. Then it all fell apart.
That year he went to see an AIDS clinic for children in Constanta, Romania. Hundreds of kids withered without basic care. He realized that all the progress back home meant nothing for children in poor parts of the world.
He decided to change that and spent the flight home scribbling ideas on a note pad, ignoring peers who insisted nothing could be done. At first, all Kline could do was take scant funds leftover from his projects to return to Romania with simple relief: nutrition supplements, dentistry and treatments for common infections. But he aimed higher and named his effort the Baylor International Pediatric AIDS Initiative.
Kline wanted to build an entire institution to solve the problem. That would begin with raising money for a building, bringing advanced treatment and training doctors.
Peers said he was crazy. The treatment required meticulous dosing of up to 16 pills per day, and it was toxic if not given in precise amounts. And if patients didn’t take it forever, the virus would develop immunity, worsening the situation.
Undeterred, Kline found donors to build a center. He persuaded the philanthropic arm of drugmaker Abbott Laboratories to donate medication for 500 patients for life.
“There were many people back then who thought it was a waste of money,” said Jeff Richardson, then vice president of the Abbott Fund. “That it was foolhardy.”
Kline and his Baylor team taught Romanian doctors how to recognize and treat complications and how to use the medication.
In two years following the center’s 2001 opening, the death rate for children in the clinic fell from 15 percent to 1 percent. Kline proved the doubters wrong, but still wanted to show it wasn’t a fluke.
That’s when he read the Times story about Botswana. It was ground zero of the epidemic with the world’s highest infection rate and no clinic for children. At Kline’s urging, the country’s health minister provided a plot of land on the hospital grounds and the Bristol-Myers Squibb Foundation donated $6 million over five years.
The center, which opened in 2003, treated 1,200 kids in its first year. Despite the immense initial doubts, the model proved a worthy investment for global health funds aiming to address the epidemic in poor places. Under the flag of Baylor, clinics would open in Uganda, Swaziland, Libya, Malawi, Kenya, Mozambique, Tanzania, Ethiopia and Lesotho.
But so many clinics would need more U.S. doctors to train staff. So in 2005 Kline wrote a proposal to fund the Pediatric AIDS Corps. The foundation gave $22 million to send U.S. pediatricians to teach doctors abroad, and Baylor offered $10 million to help repay student loans of physicians who applied.
A legion was dispatched and the fleet of centers came online in a couple of years. The global epidemic was beginning to taper.
“Dr. Kline’s programs became models for the rest of the developing world,” said John Damonti, president of the Bristol-Myers Squibb Foundation.
More than a dozen centers, many without U.S. doctors today, would eventually treat more than 300,000 children in Africa.
In 2009, Kline left dayto-day operations at Baylor International Pediatric AIDS Initiative at Texas Children’s. He was tapped after a yearlong search to replace his mentor, the late Dr. Ralph Feigin, as top doctor at Texas Children’s.
In his office at the Abercrombie Building on Fannin Street, Kline sits near a statue of himself, carved from an ebony log and gifted to him by the president of Botswana, who once feared extinction of his people. Kline is depicted surrounded by a dozen young smiling faces, symbols of the lives he restored.