From the front lines

2013-05-06 00:00

WHEN Quarraisha Abdool Karim matriculated, her options in terms of studying further were wide open. She loved maths, accounting, science, history — in fact, she loved learning about anything and everything, and excelled in all subjects. So it was quite a challenge deciding on a career path. “Sometimes I wished I was born in the Renaissance period like Da Vinci — where we weren’t put into a box, and could do many things at once — I found making a choice constraining,” she says with a smile. In spite of people close to her trying to influence her to do what they thought was best for her, in the end Abdool Karim settled on science, and has had no regrets since. “Science and my involvement in Aids research have enabled me to consolidate two things which are important to me — knowledge and values,” she explains. “I don’t like knowledge for the sake of it; I want to see how it impacts on people and I’ve found there to be a good nexus between my scientific curiosity and my interest in human rights and public good.”

The impact of Abdool Karim’s extensive work in the field of Aids research has not gone unrecognised. On Freedom Day, she was awarded the Order of Mapungubwe in recognition of her “outstanding work in the field of HIV/Aids and tuberculosis research and health policy development” by President Jacob Zuma. It was a humbling moment for her. “It means a lot of things. It’s an incredible honour and privilege, but it’s also the validation of a lot of collective effort in working on the epidemic,” she says. “It also signifies the long road we have travelled as a country from the Mbeki era, during which government denied the relationship between HIV and Aids, to the post-Mbeki era when the deputy president as well as President Zuma have put a lot of effort into the area, and we can see the gains in three to four years of concerted investment, which is encouraging though sad, because we lost those years before.”

Abdool Karim grew up in Tongaat, a small previously Indian town on the North Coast, largely established around sugar-cane plantations. She was inquisitive as a child, constantly asking her elders questions, as a result of which her uncle, the principal of a primary school, arranged for her to start school when she was just four years old. She has distinct memories of her early years at school. “The teachers were absolutely committed. I remember my Grade 1 and Grade 2 classes took place in a huge hall on the grounds of a temple. We had six classes in there. Each teacher had to get the class ready. We were all seated next to each other; some of us even used the stage. Now that I think about it, I don’t know how we did it. Once you got to Grade 3, you moved to a classroom, in which there were 40 kids of different learning abilities.”

Consequently, although younger than the other children, her teachers always encouraged her to assist the other kids in understanding concepts. “A lot of my ability to explain things comes from my teachers’ encouragement to help the other children,” she admits.

After completing her schooling at the age of 16, Abdool Karim enrolled at the University of Durban-Westville, where she completed a BSc degree majoring in microbiology and biochemistry. It was then that she became increasingly fascinated by immunology — how the body defends itself. “It was a very new emerging field,” she recalls. “There were not many immunologists in the country and one of the best immunology departments was based in Johannesburg at the South African Institute for Medical Research (SAIMR), which was affiliated to Wits University.”

When she graduated, she promptly made her way to Johannesburg, where she persisted in trying to secure an internship position at an immunology laboratory at SAIMR, and was finally put in touch with Dr Reuben Sher, who was researching leprosy. “There was quite a sizeable leper colony in Pretoria and we started to look at the immunology — the underlying pathology leprosy manifests with,” she says. “Dr Sher suggested I spend time in a routine lab at SAIMR to get a better sense of immunology.”

It was while working at this laboratory in 1982 that Abdool Karim and her colleagues started to hear about a new disease affecting gay men in the United States. “Dr Sher and a colleague of his posed the question as to why the disease would be affecting gay men in the U.S. but not in SA, and they started what would become one of the first Aids initiatives at SAIMR. At the time, the epidemic was just being described — nobody knew that HIV caused Aids. It was something new. People were presenting and dying.”

Abdool Karim was impressed by the dignity and respect her superior, Sher, afforded his patients. “I had a good solid background in immunology by this time, and I knew this was what I wanted to do.”

She completed an honours degree at the department of medical biochemistry at Wits University, and later a Masters in parasitology at Columbia University. The rest, as reflected by the Chancellor of Orders’ citation which accompanied the presidential award, is history: Abdool Karim “is pushing the boundaries of scientific excellence in her quest to curb the scourge of HIV/Aids, particularly in young women in Africa. She has been devoted to stemming the global Aids epidemic for more than two decades; culminating in her recent scientific discovery that Tenofovir gel prevents HIV infection and genital herpes in women … the world’s first HIV protection technology for women.”

Abdool Karim has spent more than 20 years unravelling the reasons for the high incidence of HIV in young women and developing new approaches and technologies to empower women to protect themselves.

Her research on tuberculosis and HIV infection has had a direct impact on the way this co-infection is treated internationally. She has served as an adviser to WHO, UNAids, UNDP, Unicef, and numerous other international organisations on Aids policy matters. She served as the first national director of the South African National Aids Programme established by the Mandela government in 1994.

She has received several major local and international awards, including the 2011 President’s Award for Outstanding Achievement in World Health from the international Drug Information Association (DIA), the 2012 Prize in Medical Sciences from The Academy of Sciences for the Developing World (TWAS) and the Olusegun Obasanjo Prize for Scientific Discovery and Technological Innovation from the African Academy of Sciences.

Abdool Karim wears many hats. Mainly based in KwaZulu-Natal, she’s the associate scientific director of the Centre for the Aids Programme of Research in South Africa (Caprisa). She’s also associate professor of epidemiology at Columbia University in New York and adjunct professor of public health at the Nelson R. Mandela School of Medicine of the University of KwaZulu-Natal.

A mother of three, she’s married to Salim “Slim” Abdool Karim, the current director of Caprisa, as well as the president of South African Medical Research Council. This makes her life considerably easier, she admits.

“I have a very supportive husband. We’re both doing research together and we both understand the importance of public health. We are very supportive of each other. One rule we have is that our children won’t be competing with our careers. We always have breakfast and dinner together, and if we are required to travel, it’s very rare that one of us doesn’t stay at home. Our children understand what we are doing. I don’t think they have ever felt short-changed.”

When Zuma awarded Abdool Karim the Order of Mapungubwe, he told her he was proud of the contributions she had made, and he hoped the work would continue. Her response was emphatic: “I told him that the work is not over — yet.”

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