Since witnessing the beginnings of the HIV/AIDS crisis as a doctor in South Africa in the 1990s, Dr. Glenda Gray has dedicated her life to finding a way to stop it.
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In the 1990s, Dr. Glenda Gray was an activist and medical student, fighting to end segregation in the hospitals of apartheid South Africa and mobilize communities around health issues. The burgeoning AIDS crisis soon became the center of her community organizing mission. It later informed her work as a doctor, where she saw the effects of the virus firsthand.
"HIV started to explode in the children's ward where I was working," Gray told me over the phone. "Literally overnight, one in two children born at the hospital were HIV infected. I started my career witnessing the increase and devastation of HIV in children." As an activist, she said, she had to do something: "You can't stand by and watch people die."
In 1993, Gray founded a perinatal HIV clinic at the Chris Hani Baragwanath Hospital and shifted her focus to researching interventions that could stop the virus from being passed at birth from mothers to their children. In 2002, she was given the Nelson Mandela Award for Health and Human Rights for her pioneering work in the field.
Now in her 50s, she is the president of the South African Medical Research Council and still leading the charge against the HIV epidemic in South Africa. Her organization of researchers, along with other public and private institutions that make up the P5 Partnership, is beginning to conduct the largest HIV vaccine clinical trial. If successful, the vaccine could be the key to stemming the devastatingly high rate of HIV transmissions in South Africa and in the rest of the world.
The vaccine is modeled on a previous version of the drug that was tested in Thailand in 2009. While the older version was moderately effective, Gray hopes she and her researchers will be able to improve its results. "We tried to optimize the vaccine to make it more potent and more durable than what's in the old one," she explained.
The trial will be conducted with 5,400 participants who range in age from 18 to 25 years old, and both men and women will be a part of the trial. "South Africa has the highest number of HIV infections in the world. Everyone, everywhere, has a family member—a brother, sister, mother—or friend who has HIV," Gray said. But Gray emphasizes that a viable vaccine would reduce the burden of HIV for women in particular. At a conference earlier this year, Gray called the possibility of an HIV vaccine the "ultimate female empowerment."
We wanted [to develop] something that women can use without the knowledge of the men.
According to AVERT, an organization that provides information and education on HIV, women make up the majority of new HIV infections in South Africa. But right now, the best available prevention method for women remains condoms, which don't give women complete control over their health. Though PreP is becoming increasingly available in South Africa, the prevention drug is largely being targeted at men who have sex with men.
"We wanted [to develop] something that women can use without the knowledge of the men because we know that women have the highest rate of intimate partner violence. Violence to women and HIV are linked," Gray said. "It's hard for women to negotiate condom use, particularly in the patriarchal society that South Africa has. Intergenerational sexual relationships are common in South Africa, so it's hard for young girls to negotiate condom use with older men."
She added, "Biomedical interventions hold the fort while we try to win other battles for people, like poverty, like jobs, ending intimate partner violence, and making equity available."
Gray says she will have the results of the trial by 2020. "At the same time we are working in parallel to try and realize how to get the chemical into the community as soon as possible," she said.