Harvard Partnership Fights HIV/AIDS in Botswana

Botswana-Harvard Partnership
Shree Bose

As Harvard School of Public Health professor Myron “Max” Essex begins his day in his office in Boston, his mind is already thousands of miles away. Essex—a renowned immunobiologist and virologist—spends much of his time on conference calls with partners in Botswana, chairing the Harvard-Botswana Partnership for HIV/AIDS research from afar.

Since the onset of the HIV/AIDS epidemic in the 1980s, Essex has focused his career on researching the disease. His discovery that HIV is a retrovirus earned him the Lasker Award, one of the most prestigious prizes in the medical field.

Today, Botswana­—a small nation in southern Africa­—is the object of almost all of Essex’s research.

As in many countries in the region, HIV/AIDS remains a dramatic problem in Botswana. But, thanks in part to the Harvard’s collaboration with the government, conditions on the ground have improved in the past decade as the partnership employs methods that combine vaccination, prevention efforts, and treatment.

‘THERE TO HELP’

In 1996, executive director of Harvard’s AIDS Initiative Richard G. Marlink worked with Essex to forge a partnership between Harvard and the Botswanan government using a framework that had been implemented in similar programs in Senegal, Tanzania, the former Zaire, and Nigeria. Since the 1980s the AIDS Initiative—a program dedicated to AIDS research—had operated as an extension of the School of Public Health.

But the situation in Botswana was different than that in the Initiative’s other base countries. The infection rate of the small, sparsely populated country in southern Africa was higher than that of most of its counterparts and showed no signs of leveling off.

Seeing this anomaly led Essex to hypothesize that the strain of AIDS affecting southern Africa, specifically Botswana, was a different type than the typical strain encountered in the United States or other parts of Africa.

The Botswana-Harvard Partnership began to expand rapidly between 2000 and 2001. Today, more than 250 people work in the partnership, most of them Botswanan researchers, technicians, and support staff. The organization is based on the campus of the Princess Marina Hospital, one of the largest hospitals in Botswana.

Describing the spirit and strategy of the endeavor, Marlink explained three stringent rules for employees that have allowed the partnership to operate successfully over the years.

“We want this relationship to be almost familial,” he said. “This is their country, their money, and they will be able to implement solutions to the problem in the most sustainable way possible. We are only there to help.”

REDUCING THE NUMBERS

The Harvard-Botswana Partnership’s research procedure is complex and varied, according to Essex, and is unified only by its reliance on asking questions that have thus far remained unanswered.

“We have done research on pregnant women almost since day one,” Essex said. “Over time we’ve perfected combinations of drugs—free drugs—to give to pregnant women starting at the beginning of the third trimester.”

The success of the strategies developed by Essex and his team have been recognized by international organizations. The World Health Organization adopted guideline recommendations developed by the team to reduce maternal transmission of HIV in developing countries, according to the Harvard AIDS Initiative’s website.

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