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Vol. LXII, No. 14
July 9, 2010

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HIV/AIDS Studies Continue
NIH’s Research in Haiti Alive and Well

On the front page...

The earthquake that struck Haiti on Jan. 12 knocked much of Port-au-Prince down, but Dr. Jean “Bill” Pape told a Masur Auditorium audience during a recent visit that the devastation couldn’t crush the country’s spirit.

Pape is the founder of GHESKIO, known by its French acronym, and the first such organization in the world to be dedicated to fighting HIV and AIDS; he is a longtime NIH grantee. Pape has worked in Haiti for more than 30 years on a variety of public health issues that challenge the impoverished nation, researching illness, treating patients and training the next generations of scientists in GHESKIO labs.


  Dr. Jean “Bill” Pape  
  Dr. Jean “Bill” Pape  

Most notably, he and his colleagues have helped to lower the prevalence of HIV in the population by more than half, from 6.2 to 2.2 percent. With support from NIH and other funders, GHESKIO has pursued a three-pronged approach, focusing equally on training, research and service delivery.

“Capacity building has been essential and research has been the cornerstone of that,” Pape said. “Clearly, without this there is no way we could have coped with the earthquake.”

Though still facing rebuilding efforts and spending some resources on post-earthquake health recovery, GHESKIO has been able to resume nearly all of its pre-earthquake offerings and is looking forward to even more growth.

“It is my extreme pleasure and honor to know Bill,” said NIAID director Dr. Anthony Fauci, who introduced Pape’s talk along with Fogarty director Dr. Roger Glass. Fauci and Pape are alumni of the same medical school. “Even while [Pape] was at Cornell, we all knew he would be a star.” Pape’s appearance was sponsored by Fogarty, NIAID and the Office of AIDS Research.

Early in his work in Haiti, Pape’s first task was bringing down the infant mortality rate, which had hovered between 40 and 45 percent due to diarrheal dehydration. In a year’s time, Pape and his team dropped that percentage to 1 with targeted interventions.

“Babies should not die of neglect, of [health care workers] not knowing how to correct mild to severe dehydration,” he said. “The importance of nurses and mothers and education is critical.”

His next move was to tackle a number of pervasive infectious illnesses that seem to plague the Caribbean country—tuberculosis, syphilis, HIV, AIDS and other sexually transmitted diseases that were spreading unchecked. While HIV/AIDS became the main focus, Pape and his team discovered they could cover additional ground by testing and treating patients who presented with these complicating factors.

The concept of complicating factors of all kinds has for centuries been the name of the game in Haiti. After a torrid history that involved conquests and occupations by the Spanish and the French, the country today still has problems maintaining a stable government and providing for its people. By Pape’s count, the country has had 22 governments since 1986. Its most recent one collapsed following the earthquake, leaving the country’s disaster relief and medical response to the international community and to organizations such as GHESKIO.

Pape visits with audience members after his recent talk in Masur Auditorium.
Pape visits with audience members after his recent talk in Masur Auditorium.

Pape explained that, just after the earthquake, the grounds beside GHESKIO became a tent city. While this situation gave staff access to patients, treating injuries was still a challenge. GHESKIO facilities sustained massive damage, buildings were unusable and an acute care field hospital had to be erected in order to cope with the influx of sick and injured. The field hospital, built by HHS and the 82nd Airborne, “saved thousands of lives,” Pape said. “The U.S. Navy evacuations to the [USS] Comfort were also a tremendous resource.”

But in order to respond to the immediate crisis, all other programs had to stop. All research projects ceased enrollment, training ground to a halt and every person available traded in lab coats for medical scrubs and headed out to help. GHESKIO lost four staffers in the quake and many more lost family members.

Now, several months out from the initial devastation, GHESKIO is getting back to normal. Research programs exploring when to start HIV antiretroviral therapies are recruiting again and nearly at pre-quake levels, the organization’s biosafety level 3 lab is back up and running and the tent city has been moved to higher ground. Even without tents outside its front doors, GHESKIO has a unique opportunity to work with those who live in these makeshift towns, Pape said.

“Our new focus is to transform these tent cities into model global health villages with an emphasis on health and nutrition, microcredits and job creation, vocational school and primary school and overall better habitats for the community.”

Instituting this type of transformation may be a challenge, particularly in a country where the literacy rate barely breaks 50 percent, but it’s one Pape feels is achievable.

“When you explain and take the time to teach them, they understand,” Pape said of Haitians. “They are smart people.”

And unquestionably resilient. NIHRecord Icon

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