Hurricane Can't Dampen Determination
By Carla Garnett
Photos by Bill Branson
On the Front Page...
NIH's 1999 observance of Hispanic Heritage Month held on Sept. 16 tackled two tough opponents, one unexpectedly Hurricane Floyd, an unwelcome intrusion into the area that produced drenching rains and kept turnout low at the event. However, bad weather couldn't diminish the battle with the program's prime target HIV/AIDS, which continues its deadly advance into minority communities nationwide. As the event's 1999 theme emphasized, "Awareness of HIV Infection in the Hispanic Community" is a top priority.
According to data presented by Dr. Gary Nabel, director of NIH's Vaccine Research Center who gave an update on the "Search for an AIDS Vaccine," 16,000 new HIV infections occur daily in the United States and nearly one million Americans are infected with the virus. As troubling as those figures are, they pale in comparison with global statistics, which estimate that as of December 1998, 22.5 million people are infected in Sub-Saharan Africa and 6.7 million in Asia. To put the AIDS threat in perspective, Nabel also shared the following graphic comparison: About 32.9 million people were killed in the major wars of the 20th century; so far, 34 million people worldwide are infected with HIV, with the majority of new cases in Sub-Saharan Africa and Asia.
He also discussed the research steps involved in vaccine development in general, the mission of the VRC in this research and its role in developing AIDS/HIV vaccines. Nabel described the scientific challenges presented by the AIDS virus, which requires complex strategies in the development and testing of vaccines.
Dr. Gary Nabel
Dr. Carmen Zorrilla, an associate professor of obstetrics and gynecology at the University of Puerto Rico School of Medicine, shared highlights of her research on "Mother to Infant Transmission" of HIV. She discussed labor duration, mode of delivery (vaginal versus Caesarean) and even instrumentation used during delivery, all of which have been found to have a bearing on rates of HIV transmission. Zorrilla also compared European transmission prevention strategies, which rely more on Caesarean delivery, with American prevention approaches that focus more on drug regimens such as AZT.
"Why do we have the same declines in transmission rates when we have such different approaches and strategies to prevention and delivery?" she asked. Her studies seek to find the answers to this and similar questions.
Zorrilla also touched briefly on several ethical issues she has faced in her research and treatment of women with HIV. For example, before the effects of powerful drug treatments such as AZT on fetuses were known, should pregnant women with HIV have been given the therapies? The question caused much hand-wringing early in the epidemic, she recalled. According to results from several clinical trials, she said scientists now are able to say with confidence that women living with HIV should be offered optimal retroviral therapy regardless of pregnancy status.
In addition to exploring the impact of HIV/AIDS worldwide and urging more education in minority communities in particular, the NIH Hispanic heritage program organized by a committee led by the NIH Hispanic Employee Organization also looked inward to efforts in and around the agency to better serve all the health and health education needs of the nation's Latino population.
"The 1999 Hispanic Heritage Month observance offers us the opportunity to reflect upon many contributions that Hispanics have made to the nation," said NIH deputy director Dr. Ruth Kirschstein, in welcoming remarks. She represents NIH on the Health and Human Services minority initiatives steering committee, which oversees the department's Hispanic Agenda for Action (HAA); she also chairs an NIH Hispanic task force to implement HAA. "With tremendous growth predicted in the Hispanic community, not only is it important that their health needs be addressed by clinical and scientific research efforts, but it is also equally important to make efforts to ensure that there are health professionals and scientists from this community involved in all ongoing research and treatment efforts. I speak for the NIH leadership in assuring you we are intimately involved in several initiatives to address underrepresentation of Hispanics in biomedical research and health disparities between minority and majority populations."
Mechanisms NIH is using to improve Hispanic representation in its workforce, and in science in general, include the National Hispanic Youth Initiative, the Hispanic Association of Colleges and Universities internship program, and the Loan Repayment Program of NIH's Office of Intramural Research, which Kirschstein said has been so successful that NIH is attempting to export it to colleagues at universities and academic institutions. In addition, she noted, an NIH Academy "to help fill the pipeline with people who can and will do outstanding science" is in developmental stages, under the auspices of the Office of Intramural Research.
"We are committed to the challenge," Kirschstein reiterated. In conclusion, she said NIH can be particularly proud that one of its initiatives the Office of Research on Minority Health had been singled out for mention by President Clinton in this year's proclamation of Hispanic Heritage Month.
Carlos Ugarte, coordinator of the NIH Hispanic Communications Initiative, and Dr. Carlos Caban, president of HHS's Hispanic Employees Organization (HEO), also reported on NIH efforts to reach out to the community.
"It was clear to all of us early on," Ugarte said, "that if we were going to have a significant impact on these health disparities, then taking action in the area of communications is vitally important."
Just over a year ago, he recalled, the HCI an unprecedented initiative, both at NIH and department-wide was formed within the NIH Office of Communications and Public Liaison with the goal of improving the health of the Hispanic community by providing "solid, credible and timely health information to the Latino community nationwide." Since its establishment, Ugarte noted, HCI has launched and maintains a Spanish language Web site on NIH's home page that garners about 2,500 hits each month "and that's without virtually any promotion of the site" and contributed NIH health information to several editions of El Pulso De La Salud, a Spanish language newspaper supplement.
Caban discussed HEO, a voluntary group that was chartered in 1981 by HHS to advise the department on issues of concern to its Hispanic employees. The organization also serves as the umbrella for individual agencies' Hispanic employee organizations under HHS; NIH, for instance, established its HEO branch in 1995. The HHS-HEO goal since 1990, he said, has been to develop a customer service model to help improve quality and delivery of the department's services to the nation's more than 35 million Latinos.
Paramount among HEO objectives currently is to recommend ways to increase Hispanic representation in the HHS workforce and various department committees, Caban noted. Over the last 4 years, the percentage of Latinos employed in the department has risen only 0.2 percent, from 2.7 percent in 1995 to 2.9 percent in 1999, he pointed out. "That's not a lot of improvement for that amount of effort in that amount of time," Caban said. In contrast, the civilian labor force is 10 percent Hispanic and Hispanics account for 6 percent of the federal workforce.
To help get the word out to Hispanics about HHS program and policy issues relevant to Hispanics, recruitment efforts, and job and funding opportunities within the department, as well as other federal employment issues, the group established an electronic mailing list that continues to grow and publishes electronic updates several times a month. Caban also said the HHS-HEO will continue to monitor the progress of the secretary's Hispanic Agenda for Action and other issues relevant to Hispanics. He also recommended the HHS Hispanic home page (http://www.hhs.gov/about/heo/hispanic.html) as a source of further information.
Throughout the program, however, the theme of education whether about a global health crisis affecting the Latino community, or about addressing health care disparities between majority and minority populations or about opportunities for Hispanics in science and research rang true.
"We have to protect our youth and we have to teach our parents," stressed program moderator Dr. Marta Leon-Monzon of NIH's Office of AIDS Research, president of NIH's HEO. "It's very important to have big conferences and big meetings, but if we don't get to the houses and we don't get to the families, then the message is lost."
Presentations were also given on the NIH Bone Marrow Center and a number of HIV/AIDS community programs. In a novel effort to present the gravity of the threat of HIV/AIDS to the Hispanic community, the heritage celebration concluded with a play, No Le Digas a Nadia [Don't Tell Anybody] by the Gala Theater and La Casa del Pueblo. The play tells the story of five women who have become infected with the HIV virus through different modes of transmission. It depicts the effect transmission has had on their lives and aspirations, as well as upon their children, one of whom was born HIV positive. Importantly, it concludes with emphasis on the prevention of virus transmission.
A reception in the Clinical Center lobby followed the program.
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