Anatomy of Glenda Gray and the war against HIV
- By Heather Dugmore
Professor Glenda Gray of the Wits-affiliated Perinatal HIV Research Unit (PHRU) is a world authority on HIV. She says the next 10 years are going to produce vaccines, microbicides and even cures for HIV that were never thought possible.
In 1993, when Professor Glenda Gray graduated as a paediatrician from Wits, a severe and horrific epidemic had emerged and she witnessed many HIV-positive babies and children dying in public hospitals in Johannesburg.
“There was no choice but to become involved in HIV because every third child in the ward at Bara was infected with HIV, and HIV was the most common cause of death in children admitted. It was a terribly depressing state of affairs and as a doctor you felt helpless because our goal is to help people live,” says Gray.
That year she started doing research into mother-to-child transmission and in 1996 she co-founded the Perinatal HIV Research Unit (PHRU) at Chris Hani Baragwanath Hospital in Soweto.
“The thing about researching HIV is that as a virus it so elusive,” she explains. “Back then many people thought I was mad to make a career of clinical research in HIV, which was a very new field at the time.”
Soon after it was established, the PHRU expanded its portfolio to include HIV prevention research such as vaccines, interventions to prevent heterosexual transmission and HIV treatment. Under Gray’s directorship it is now a 400-strong unit which has achieved international recognition for its research and results in the care, treatment and prevention of HIV.
Gray has received multiple awards for her work and was recently elected to membership of the Institute of Medicine (IOM) of the National Academies. Members worldwide are elected for their excellence, commitment to service and professional achievements.
The PHRU is now in its 16th year, and Gray is hopeful that the long, dark years are behind them.
“It is a great relief to be where we are now because it was a battle for the first 10 years with antiretroviral (ARV) drugs not being affordable in South Africa and interventions still being researched.
“What is really wonderful today is that some of the children I delivered in 1993 who were born with HIV are now in matric and doing well on therapy. If they keep taking all their medicines the sky is the limit and they will be able to lead full lives until they are old.”
She is equally positive about the HIV vaccines and interventions they are working on at present. “Within the next 10 years we will have an HIV vaccine and/or a microbicide that women can use. Scientists are also working on a cure through, for example, gene therapy. We are going to see results we never thought possible,” says Gray, adding that she is “very lucky to have a career in HIV because it offers you the opportunity to change the course of events in the lives of people all over the world. It’s such a devastating epidemic and the more we understand it, the more we can control it and do good.”
The ultimate HIV control technology is a vaccine, she explains. It will be a lifesaver for women whose partners victimise them if they ask them to use condoms or to be tested for HIV. “With a vaccine no one ever sees it being put in your arm,” says Gray. Her unit is looking at two HIV vaccine agendas and they are hoping that an actual vaccine can be submitted for licensure in South Africa by 2017.
“We first got an inclination from a study in Thailand that an HIV vaccine could be effective. Based on this data, a group of scientists got together to replicate these findings and optimise the vaccine design. I became involved in the South African study because we need a vaccine that acts on subtype C, which is predominant in South Africa, where we have one of the worst HIV epidemics in the world.”
There are various subtypes of HIV that circulate across the world. Subtype C circulates mainly in South Africa, China and India. Subtype B dominates in America and Europe and subtype E in Thailand.
Gray is working with Professor Helen Rees, also from Wits, on microbicides and they have just started a study that is looking to confirm the findings from the CAPRISA 004 study conducted in KwaZulu-Natal and released in 2010. “The study conducted in Durban showed that if women apply a particular gel just before and just after sex, it was 44% effective in preventing HIV,” says Gray. “Now we want to license this gel for women, which is exciting because it’s the first time we’ve been involved in an HIV prevention licensure study and we are hoping to make the product available to women in three years’ time.”
The same gel is being studied by the unit in another intervention that is looking at a once-a-day dose of the gel irrespective of sexual intercourse, but at R7 per application it’s expensive. They are therefore looking at a “sex dose”. This intervention is also being studied in Uganda, Kenya and Zimbabwe.
While these interventions offer potential relief to millions of people, Gray emphasises the ongoing need to reduce risk-taking and to know your HIV status and your partner’s.
“I’m committed to improving survival, particularly among the children in South Africa,” says Gray. She would like to see a time when the number of children dying in South Africa, currently 45-120 per 1 000 live births, is no more than the number of children dying in Sweden, which is 2.74 per 1 000 live births.
As a world authority on HIV, Gray travels extensively, presenting at conferences and collaborating in global HIV research. People from all over the world also come to study at the PHRU because Gray and her team are open-minded and collaborative, and they encourage people to use their data.
What all this means is that Gray leads an overfull and complex life, one that she has to balance with being a wife and mother of three.
“I make their lunches at 5am, help with their homework and discuss medicine with my eight-year-old son Joab, who enjoys browsing through Gray’s Anatomy and examining all the body parts.”
She counts herself fortunate to have a husband who is the rock of the family and who looks after the children when she is travelling. “He is wonderfully tolerant of my work as I frequently have conference calls in the evening with collaborators in other parts of the world.”
Her husband, Jacobus Kloppers, is a renowned South African artist.
“Artists and scientists work well together as creative thinkers,” says Gray. “Jacobus has incredible vision and he sees the world completely differently to me. He offers insight when I’m dealing with problems at work and it is also so nice to just go home and be with him and our family and not talk about death and dying.”
To get away from it all they have a hideout in the Karoo village of Nieu Bethesda, where Kloppers lived for some years. Gray met him there in 2000. “We liked each other instantly,” she says.
“Our home there is an old shepherd’s cottage and it’s incredible to spend time in this isolated desert where I can walk in the veld or ride my bicycle. If we feel like a meal out, we can go to the Three Goats Deli and drink their homemade beer and eat their homemade cheese and bread.
“On Saturday nights we attend the social at the tennis club with the locals and farmers. We chew the fat and drink lots of gin and tonic. You also experience the seasons there – the snow in winter and the intense heat in summer. I always return from Nieu Bethesda refreshed. It gives me new perspective and new ideas come just from being there.”