AIDS in Africa

The IHV has a longstanding presence helping to combat HIV in Nigeria, the African nation in the heart of the global AIDS epidemic. Since 1991, in fact, when Alash'le Abimiku, an assistant professor in the Institute's Epidemiology and Prevention Division, helped set up the first research laboratory in Jos equipped to diagnose HIV/AIDS. That was five years before the official opening of the Institute of Human Virology and formed the very foundation of a pioneering partnership designed to equip Nigeria with the professional skills and training needed to better detect, treat and prevent the virus that causes AIDS. Abimiku has had a hands-on presence, spending much time in the laboratory she helped create, and her contributions have been pivotal to AIDS advances in Africa. It was Abimiku, in fact, who first isolated, then scientifically analyzed and characterized the HIV strain most prevalent in Nigeria and the rest of West Africa and now recognized as the second leading cause of HIV infection worldwide. In the decade to follow, the IHV has become an invaluable asset whose presence and expertise have proven crucial in addressing what has since become the deadliest epidemic in medical history, most dramatically and disproportionately in developing nations such as Nigeria where medical care and resources are scarce and sometimes non-existent.   Alash'le Abimiku-Lorentzen, M.Sc. Ph.D., born in Nigeria, is one of nine children, all university graduates. She credits her father, who was ostracized by family for his progressive stance that included sending even his seven girls to college, for fostering their career ambitions at a time when only boys were sent to school and girls were married off for a handsome dowry at a young age. As a virologist at the IHV, Abimiku's scientific work has proven pivotal in addressing the AIDS epidemic in Africa.

"We literally had to go in and build from scratch," says Abimiku, explaining that there were few doctors trained to diagnose or treat HIV, very few clinics available to provide testing or counseling, no community outreach or public education programs in place to spread the word on ways to prevent infection when her work began in Jos.

IHV is currently developing HIV prevention programs designed for specific high-risk populations under the AIDS Prevention Initiative in Nigeria (APIN) with funding from the Bill and Melinda Gates Foundation and in collaboration with the Harvard School of Public Health. This program will expand access to care to help prevent mother-to-child infection and fill gaps in knowledge identified in research surveys.

The Centers for Disease Control and Prevention recently awarded a $4.4 million grant to the IHV to provide technical assistance and scientific expertise to Nigeria, where one of five HIV infections in Africa occur in sub-Saharan Africa's most populous nation. The focus of this work is to build capacity to support the request of the Nigerian Government to develop four national centers of excellence for HIV care. These centers will promote prevention of mother-to-child transmission, provide high quality HIV care and allow Nigerian physicians to give antiviral therapy based on a high level of understanding of how complex, multi-drug regimens work. To this end, IHV is providing in-depth training to physicians, counselors, social workers, nurses and lab personnel who make up the multidisciplinary team required to give HIV care.

The U.S. Navy, meanwhile, under its Department of Defense HIV/AIDS Prevention Program, has retained the Institute to build laboratory infrastructure for HIV diagnosis in the Nigerian Army, identify high-risk behavior and design appropriate intervention programs to help halt infection and the IHV has since been recruited to extend that project into the Nigerian Air Force.

Much of the work is behind the scenes, she says, working with civilian, military and African leaders and policy decision makers. Days often are filled with meetings, training seminars, interviews with media, tours of facilities and - sometimes - visits home.

Her cultural background, Abimiku acknowledges, provides the scientific community at large an edge in earning trust in the African communities where HIV has been most uncontrollable and caused the most mass destruction.

She knows first-hand of loved ones who've succumbed to this disease. "I'd be surprised if you could find any Nigerian who has not lost a close relative to HIV/AIDS," she says.

Despite the staggering statistics - nearly three-quarters of all HIV infections worldwide are on this single continent -- most Africans refuse to openly discuss the risk of HIV infection. Sex is a taboo subject and women may be ostracized and beaten for suggesting use of a condom to prevent HIV transmission.

"AIDS is synonymous with sex," says Abimiku. "Promiscuous sex. Meanwhile, in a polygamous society, what we have are a lot of innocent women - and children -- getting infected."

Spouses often find out, after a partner is deceased, that their mate was infected or that they themselves are.

Abimiku says one of her most important tasks is helping to dispel the myths associated with this deadly disease and heightening public awareness and sensitivity. Her work, she says, has and must go far beyond the confines of the laboratory.

"It cannot only be research. You have to build infrastructure that supports the social aspect of things. We must marry pure science and research with education," she says. "That will be the only way to change high risk behavior."

Interesting Trivia:
Abimiku decided early on that medicine, viewed as the most elite and ambitious of the professions, would be her specialty. She opted for microbiology when she "chickened out" at the sight of a cadaver.