By: Zuri Sullivan
This is Durban, South Africa. Aside from being a surfing mecca, a thriving center of Zulu culture, and the largest port on the African continent, Durban (located in KwaZulu-Natal province) is the global epicenter of the HIV and tuberculosis (TB) epidemics. TB is the leading cause of death amongst South Africa's HIV-infected population, which is the largest of any country in the world. And a huge proportion of South Africa's affected population resides in KwaZulu-Natal.
I extremely fortunate to have been able to study these infections in the laboratory and the classroom as an undergraduate. But when it comes to infectious diseases, some of the hardest questions can only be answered by studying them in hard places. This was, in large part, the motivation for the founding of the KwaZulu-Natal Research Institute for Tuberculosis and HIV in Durban, and was also my motivation for moving thousands of miles away from home for two years to conduct research there. I wrote about my experience for a new magazine about science and society, called Method. Check out the excerpt below, and read the full story here. And be sure to read all of the other great content that Method has to offer.
Between 2005 and 2006, an outbreak of extensively drug resistant tuberculosis (XDR-TB) killed all but one patient at the Church of Scotland Hospital in Tugela Ferry, South Africa. The median survival time following diagnosis was a mere 16 days, and of the patients tested, all were co-infected with HIV. The situation was desperate, the fatality rates unprecedented, and the community unprepared for an outbreak of this magnitude. Though this calamity sent shockwaves through the TB and HIV research communities, the situation was not unique. XDR-TB had been detected in all of South Africa’s nine provinces, all of its neighboring countries, and dozens of other countries across the globe. HIV was fueling the TB epidemic, and Africa was the only region of the world in which TB incidence was on the rise. No new TB drugs had been discovered in nearly 40 years. Effective vaccines against HIV or TB infection remained a dream.
More than 8,000 miles away, in Chevy Chase, Maryland, American researchers at the Howard Hughes Medical Institute (HHMI), the largest private funder of academic biomedical research in the United States, were meeting to discuss their international program. At this meeting, Dr. Bruce Walker, an HHMI investigator who leads an HIV research lab at Harvard Medical School, proposed using a model similar to what has historically worked for HHMI in the United States: investing in individual investigators who were doing great work in biomedical science.
“But,” Dr. Walker recalls, “In a place like Africa, truly transformative support would require establishment of critical infrastructure and a critical mass of investigators.” Indeed, this meeting identified two important and intricately related problems in the developing world: the desperate need for cutting edge biomedical research, and the rarity of sites in which to conduct such research...Read more
Reprinted with permission from Method Quarterly.