LSIPR 50 2018: Dreaming big to fight HIV

During her time as a paediatrician at Chris Hani Baragwanath Hospital in Soweto, Glenda Gray was faced with an influx of HIV in young babies, infants and children. All the while, HIV was becoming more prominent in pregnant women. Gray recognised
an issue that needed addressing and, alongside James McIntyre, founded the Perinatal HIV Research Unit (PHRU).

Gray is also president of the South African Medical Research Council (SAMRC). Her field and administration experience provided her with the knowledge to lead the best possible research response strategies in South Africa.

Gray’s experience as a medical doctor and paediatrician, and her involvement in clinical research, have provided her with a solid foundation to make a significant impact in improving the understanding of HIV in her country.

She says that being a medical doctor gives you an appreciation of a country’s health challenges. To make good decisions, she says, requires knowledge of what people are dying from.

Health priorities

“Our mandate is to fund and conduct research that changes the lives of South Africans, so understanding health priorities as seen in hospitals helps you steer the institution in a clear direction,” Gray says.

PHRU’s aim is to conduct adult, paediatric and adolescent HIV treatment and prevention research and investigations into tuberculosis and other HIV co-infections—when a person with HIV is suffering from a different disease at the same time. The
unit also carries out behavioural and social science research, alongside advocating for research
access.

Since its beginnings in 1996, the PHRU has been involved in clinical research, operational research and the implementation of its findings. Through its work, the unit has helped to decrease the number of HIV infections in children.

“We were in a position based on our clinical experience with antiretrovirals to support the treatment of HIV in adults and children, and with the assistance of the US President’s Emergency Plan for AIDS Relief funding, put 1,000 people on treatment in Soweto in nine months,” notes Gray.

Taken in combination, antiretroviral therapy can help prevent the growth of the HIV virus.

Currently, Gray and her team are investigating the role of neutralising antibodies to prevent HIV infection.

“This is only possible because one could start identifying the potent neutralising antibodies in humans and start to learn how to make monoclonal antibodies, and manufacture them,” she explains.

According to Gray, through employing structural biology, one can start to see which parts of the viral gene are impenetrable and which are more susceptible for making antigens to target in HIV vaccine development.

“Making long-acting antiretrovirals may open the door for potent biomedical interventions to prevent and manage HIV,” she adds.

National recognition and dreaming big

Gray lists her most significant achievements as helping to increase the number of female scientists in South Africa and improving racial diversity in terms of who gets funding.

PHRU has supported the collaboration between the SAMRC and the Beijing Genome Institute to create whole genome sequencing capacity in Africa.

“This will enable scientists on African soil to be in control of their own science,” Gray says.

Gray has been recognised with the Order of Mapungubwe—considered South Africa’s highest honour—as well as the Nelson Mandela Health and Human Rights Award.

These awards recognise two achievements: the work Gray carried out in bringing to light the reality of AIDS in South Africa; and her work highlighting “the plight of babies in our country who died needlessly because of the lack of caring and short-sightedness of politicians and governments who do not put the needs of their people first,” she recalls.

Despite her success, Gray remains humble.

“I am being recognised for being the leader of a team that believes in improving the health of humankind,” she says. “It is a privilege.”

Gray has already made numerous contributions to treating HIV, but she has no plans to slow
down.

She has ambitious goals to help improve the South African healthcare landscape. This includes investing in the next generation of scientists and funding historically under-resourced universities to help nourish this talent.

“We have aggressive transformation strategies in our intramural programme and in who we fund. We want to increase the number of women getting grants and the number of black African scientists,” she adds.

Also on her to-do list is increasing investment into innovation and scholarship programmes.

To top off her impressive accolades and accomplishments, Gray was named one of Time Magazine’s 100 most influential people in 2017.

What advice does Gray have for other budding game-changers?

“Be passionate in your work, dream big, and never let go of your dreams,” she advises. “Believe in your cause, work hard, and magic will happen.”