Glenda Gray | |
---|---|
Born | |
Nationality | South African |
Alma mater | University of the Witwatersrand Colleges of Medicine of South Africa |
Known for | HIV research President of the South African Medical Research Council [1] [2] |
Spouse | Jacobus Kloppers |
Children | 3 |
Scientific career | |
Fields | Medicine, pediatrics, HIV |
Institutions | University of the Witwatersrand South African Medical Research Council Columbia University |
Glenda Elisabeth Gray MB BCh, FC Paeds, DSc (hc), OMS is a South African physician, scientist and activist specializing in the care of children and in HIV medicine. In 2012, she was awarded South Africa's highest honour, the Order of Mapungubwe (Silver). [3] She became the first female president of the South African Medical Research Council [2] in 2014, was recognized as one of the "100 Most Influential People" by Time [4] [5] in 2017 and was listed amongst "Africa's 50 Most Powerful Women" by Forbes Africa in 2020. [6] Her research expertise involves developing microbicides for sexually transmitted diseases and HIV vaccines. [7]
Gray was the fifth of six children born in the gold mining town Boksburg, South Africa in 1962. Her father was a mechanical engineer at the mines and her mother was a bookkeeper. Under the apartheid government of the time, Boksburg was a low income, racially segregated town. Her family were not typical of the residents of the town in that they had black friends. [8]
Gray decided from the age of 6 that she would become a doctor. Her family valued education greatly: her father was the first in his family to attend college and five of the six children went to university. Three of them, including Gray, continued to higher degrees and pursued academic careers, but their father did not live to see this as he died when Gray was 16. [8]
Gray entered the University of the Witwatersrand in 1980 where she studied at the medical school for six years followed by seven years of specialization in pediatrics. [9] Her siblings were already at the university and one of her brothers was involved with a radical student union that was opposed to apartheid. Gray joined the Health Workers Association, a group intent on desegregating South Africa's hospitals. In 1983 the first HIV/AIDS cases and deaths were confirmed in South Africa and Gray committed to educating South African communities about how to prevent HIV. [8]
By the time that Gray completed her training as a pediatrician in 1993, HIV was prevalent among many children admitted to Chris Hani Baragwanath Hospital, the largest hospital in Africa, [10] situated on the outskirts of South Africa's largest black township, Soweto. In 1993 Gray, along with colleague James McIntyre, co-founded a perinatal HIV clinic.
In 1996, Gray started the UNAIDS PETRA study, in five urban settings in South Africa, Tanzania and Uganda, to determine the effectiveness of a shorter anti-retroviral regimen. [11] [12] In 1999 she was awarded an International Fogarty Fellowship to study Clinical Epidemiology. [12]
She was the executive director of the Perinatal HIV Research Unit (PHRU), [13] [14] part of the Medical School of the University of the Witwatersrand, based at Chris Hani Baragwanath Hospital prior to her appointment as president of the medical research council in 2014. [2] HIV was generally not recorded as a cause of death during the 1990s and 2000s but its effects could be seen in the infant and child mortality rates. [15]
In early 2020, an efficacy study for an HIV vaccine led by Gray was stopped early. The study, involving 5407 HIV-uninfected participants, was started in 2016 and should have continued until 2022. However, preliminary data viewed in January 2020 to evaluate safety and efficacy showed 129 HIV infections in the vaccinated group and 123 in the placebo control group. Many HIV scientists did not believe the study would succeed, as a previous efficacy study in Thailand had shown an efficacy of only 31%. Gray believed that owing to the severity of the HIV epidemic in South Africa a new trial was worthwhile pursuing. The independent monitoring board that evaluated the interim results concluded that it was futile to continue with the study. [16]
Gray is a member of the Academy of Science of South Africa, a foreign associate of the United States Institute of Medicine, an A-rated National Research Foundation of South Africa scientist, [5] a co-principal investigator for the HIV Vaccine Trials Network [18] and a fellow of the American Academy of Microbiology. [19] [20] [21]
In addition:
Gray has not been a stranger to controversy. At her first research presentation in 1996 at an international AIDS conference, she championed the position that HIV positive women in developing countries should feed their babies infant formula rather than breast milk to avoid the transmission of HIV from mother to child. The prevailing opinion at that time was that the risk of infant death by diarrheal diseases, caused by mixing contaminated water with the infant formula, outweighed the chance of contracting HIV. [28] Gray's research in the Soweto communities indicated that infant formula could be safely used,[ citation needed ] but this put her in direct conflict with the activists who had led boycotts against Nestle, because of their infant formula, since the 1970s. [29] Subsequent research on the topic demonstrated high deaths in formula fed compared to breastfed children of HIV-infected mothers. [30] [31]
The drug Zidovudine (also known as azidothymidine (AZT)) is an anti-retroviral drug that can be used to prevent the transmission of HIV from mother to child during childbirth. The course of the treatment was 14 weeks, and women in developing countries could not afford this. Despite criticism from an editorial of The New England Journal of Medicine , Gray conducted a trial (replicating a study from Thailand) using a shorter course of treatment against a placebo which proved that the shorter course was effective. [8] [32] [33] However, the South African government, under president Thabo Mbeki and health minister Nkosazana Dlamini-Zuma, refused permission for the drug to be used, as it was considered too expensive. Gray was involved in the clandestine procurement of the drug and treatment of patients, in opposition to the government. [8]
Gray was involved in starting the Treatment Action Campaign (TAC), along with Zackie Achmat and others, as an HIV/AIDS activist organisation. [8] Only after Gray received the 2002 Mandela Award for Health and Human Rights and the legal battles in 2003 involving the TAC, were nevirapine, a drug more effective than AZT in preventing mother to child transmission of HIV, [34] and other anti-retrovirals officially sanctioned by the government for use in South Africa. [35] By then, Nkosazana Dlamini-Zuma had been replaced as Minister of Health by Manto Tshabalala-Msimang and the argument against anti-retrovirals had changed from one of affordability to the endorsement of traditional African medicine over conventional treatment. [36]
In 2020, Gray was appointed to the South African government's Medical Advisory Committee owing to the COVID-19 pandemic in South Africa. On 26 March 2020, the South African government imposed an almost total lockdown on all inhabitants. From 1 May 2020, the lockdown was gradually lifted under a five-stage plan. On 15 May 2020, Gray said, "Initially, there was good reason to implement the lockdown to slow down the spread of the virus and buy time to ready the health system, and this was largely achieved". She now felt that "the lockdown should be eradicated completely, and that non-pharmaceutical interventions (NPI), such as handwashing, wearing masks, social distancing and prohibitions on gatherings, should be put in place." [37] In addition she noted that:
She told the media: [37]
This strategy is not based in science and is completely unmeasured. [It's] almost as if someone is sucking regulations out of their thumb and implementing rubbish, quite frankly. In the face of a young population, we refuse to let people out. We make them exercise for three hours a day and then complain that there's congestion in this time. We punish children and kick them out of school and we deny them education. For what? Where is the scientific evidence for that?
Health minister Zweli Mkhize stated that Gray had "made factually incorrect and unfounded statements". [38] He pointed out that the government had appointed a research subcommittee to which Gray belongs to advise them. He said that the thumb-suck comment "undermines the joint work and effort that the National Coronavirus Command Council, Cabinet and government as a whole have been engaged in." [38] With regard to the comment on schooling he said: "The Department of Basic Education has been engaged in various consultations with its stakeholders on the correct approach to take in the process of opening schools." [38]
Subsequent to Mkhize's comments, the acting director general of the Department of Health, Anban Pillay, said that an investigation into Gray's conduct was needed. [39] On 25 May 2020, the South African Medical Research Council apologized for Gray's statements and barred its staff from speaking to the media [40] while more than 250 academics issued statements of support for her. [41] [42] [43]
On the following day, 26 May 2020, Mkhize said that he "considers the Professor Glenda Gray matter closed", and he mentioned that "there is no basis to suggest any interference with academic freedom". [44]
Gray has authored or co-authored more than 300 scientific articles, including: [24]
Gray has contributed to and been featured in several books including:
The global pandemic of HIV/AIDS began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally. Of these, 29.8 million people (75%) are receiving antiretroviral treatment. There were about 630,000 deaths from HIV/AIDS in 2022. The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year. Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa. As of 2023, there are about 1.3 million new infections of HIV per year globally.
Christine Joy Maggiore was an HIV-positive activist and promoter of HIV/AIDS denialism. She was the founder of Alive & Well AIDS Alternatives, an organization which disputes the link between HIV and AIDS and urges HIV-positive pregnant women to avoid anti-HIV medication. Maggiore authored and self-published the book What If Everything You Thought You Knew about AIDS Was Wrong?
The human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. It can be managed with treatment. Without treatment it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). Effective treatment for HIV-positive people involves a life-long regimen of medicine to suppress the virus, making the viral load undetectable. There is no vaccine or cure for HIV. An HIV-positive person on treatment can expect to live a normal life, and die with the virus, not of it.
HIV/AIDS is one of the most serious health concerns in South Africa. South Africa has the highest number of people afflicted with HIV of any country, and the fourth-highest adult HIV prevalence rate, according to the 2019 United Nations statistics. About 8 million South Africans out of the 60 million population live with HIV.
PATH is an international, nonprofit global health organization. PATH is based in Seattle with 1,600 employees in more than 70 countries around the world. Its president and CEO is Nikolaj Gilbert, who is also the Managing Director and CEO of Foundations for Appropriate Technologies in Health (FATH), PATH's Swiss subsidiary. PATH focuses on six platforms: vaccines, drugs, diagnostics, devices, system, and service innovations.
Arthur J. Ammann was an American pediatric immunologist and advocate known for his research on HIV transmission, discovering in utero transmission and the risk of contaminated transfusions and blood products, and his role in the development of the first successful vaccine to prevent pneumococcal infection in 1977. He founded Global Strategies for HIV Prevention and was Clinical Professor of Pediatrics at the UCSF Medical Center.
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Quarraisha Abdool Karim is an infectious diseases epidemiologist and co-founder and Associate Scientific Director of CAPRISA. She is a Professor in Clinical Epidemiology, Columbia University, New York and Pro-Vice Chancellor for African Health, University of KwaZulu-Natal, South Africa.
Anna-Lise WilliamsonMASSAf is a Professor of Virology at the University of Cape Town. Williamson obtained her PhD from the University of the Witwatersrand in 1985. Her area of expertise is human papillomavirus, but is also known on an international level for her work in developing vaccines for HIV. These vaccines have been introduce in phase 1 of clinical trial. Williamson has published more than 120 papers.
Deborah Leah Birx is an American physician and diplomat who served as the White House Coronavirus Response Coordinator under President Donald J. Trump from 2020 to 2021. Birx specializes in HIV/AIDS immunology, vaccine research, and global health. Starting in 2014, she oversaw the implementation of the President's Emergency Plan for AIDS Relief (PEPFAR) program to support HIV/AIDS treatment and prevention programs in 65 countries. From 2014-2020, Birx was the United States global AIDS coordinator for presidents Barack Obama and Donald J. Trump and served as the United States special representative for global health diplomacy between 2015 and 2021. Birx was part of the White House Coronavirus Task Force from February 2020 to January 2021. In March 2021, Birx joined ActivePure Technology as Chief Medical and Science Advisor.
Caroline Tiemessen is a virologist and researcher involved in HIV related research. She heads the Cell Biology Research Laboratory within the Centre for HIV and STIs at the National Institute for Communicable Diseases and is a research Professor in the School of Pathology at the University of the Witwatersrand (WITS). Her research interests include the study of HIV vaccines and the search for an HIV cure in both children and adults. In 2018 she was part of the research team involved with the transplantation of a liver from an HIV-positive woman to her HIV-negative child.
Linda-Gail Bekker MBChB, DTMH, DCH, FCP(SA) is a Professor of Medicine and Chief Operating Officer of the Desmond Tutu HIV Foundation. She is also Director of the Desmund Tutu HIV Centre at the University of Cape Town. She is a Past President of the International AIDS Society (2016-18).
The COVID-19 pandemic in South Africa was part of the pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Gita Ramjee was a Ugandan-South African scientist and researcher in HIV prevention. In 2018, she was awarded the ‘Outstanding Female Scientist’ award from the European and Developing Countries Clinical Trials Partnership. She died in uMhlanga, South Africa, from COVID-19 related complications.
Karithi Ruth Wanjiru Nduati is a Kenyan Pediatrician and Epidemiologist who also teaches at the University of Nairobi College of Health Sciences. She is also currently leading an interdisciplinary program through the University of Nairobi School of Medicine to educate physician-researchers to best implement HIV treatment and prevention methods backed by research. The program was funded by the Fogarty Training Grant which is a part of the PEPFAR funds the country of Kenya received.
Chloe Meave Orkin is a British physician and Professor of HIV/AIDS medicine at Queen Mary University of London. She works as a consultant at the Royal London Hospital, Barts Health NHS Trust. She is an internationally renowned expert in HIV therapeutics and led the first phase III clinical trial of injectable anti-retrovirals. She is immediate past chair of the British HIV Association, where she championed the Undetectable=Untransmittable (U=U) campaign within the United Kingdom. She is president elect of the Medical Women's Federation. Orkin is gay and was on the Top 100 Lesbian influencer lists in both the UK and in the US in 2020. She considers herself a medical activist and much of her work focuses on inequalities in healthcare and in Medicine.
Clarence Mazwangwandile Mini was a South African doctor, anti-apartheid activist, freedom fighter, human rights activist. Mini was regarded as a pioneer of the medical industry in South Africa, especially for his crucial contributions in eliminating the HIV/AIDS from the country. He also actively advocated against apartheid during his career and also voiced against corruption which mounted during the presidency of Jacob Zuma. He served on the Board of Healthcare Funders, at times as its chair. He died on 12 May 2020 due to COVID-19 complications at the age of 68 while serving as the chairperson of the Council of Medical Schemes. His term as chairperson of CMS was due to end by September 2020.
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Eftyhia Vardas FC Path is an honorary extraordinary professor in medical virology at the Department of Medical Virology, University of Stellenbosch, and head of virology at Lancet Laboratories in Johannesburg. She is a member of the COVID-19 Ministerial Advisory Committee to the South African minister of health.
This article is about the timeline of events during the COVID-19 pandemic in South Africa which was part of the ongoing pandemic of coronavirus disease 2019 (COVID-19) that was first recorded in South Africa on 1 March 2020. Since that date the pandemic has hit the country in four waves.
Interestingly, HIV/AIDS mortality is not particularly apparent in the neonatal period, but there is a definite 'AIDS signature' (a peak between months 2 and 4), which develops over the course of the epidemic.
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