Think “infectious disease” and “Africa,” and Ebola is the first thing that comes to mind. But HIV remains the most widespread virus in Africa. In 2013, more than 1 million people in Africa died of HIV/AIDS, and there were more than 1.5 million new infections, according to UNAIDS. On the front lines of the fight against HIV is Dr. Harvey Friedman, director of the Botswana-UPenn Partnership, founded in 2001. The Merion resident speaks about the organization’s work on March 4 at the Wayne Art Center’s Home Grown Lecture Series.
MLT: Why Botswana—and why you, for that matter?
HF: In 2001, the percentage of Botswana’s population infected with HIV was the highest in the world, but the country didn’t have healthcare workers trained to deal with the epidemic. The head of Botswana’s government reached out for help, and the Merck and Gates foundations decided to take action. I was the chief of HUP’s infectious disease division, so I got the call.
MLT: Why did Botswana wait until 2001 to take action?
HF: It wasn’t just Botswana. Many African leaders refused to admit that HIV was a real thing. Others had a mistrust of Western medicine, which is something we see repeating itself with Ebola. Experts had their own mistrust of HIV patients in Africa. They believed patients wouldn’t be compliant with treatments, which involves an extensive number of pills—expensive pills.
MLT: So what did you do first when you arrived in Botswana?
HF: Through Merck and Gates funding, we set up porta-cabins to serve as clinics. Then we trained local medical providers on HIV care. We grew the program over time, thanks to [federal] funding. At the same time, the Clinton Foundation pushed pharmaceutical companies to allow drugs to be made off-patent for patients in Africa. Now, Botswana has a program where HIV patients get their medication for free, and 90 percent of citizens who need them are taking them.
MLT: What’s Penn Medicine’s involvement?
HF: Approximately 200 Penn medical students and residents go to Botswana to work with healthcare workers there and students from the country’s medical school.
MLT: What are the results?
HF: When we started, the life expectancy of someone with HIV was 40 years, and now it’s in the 50s. The infection rate from mother to fetus has dropped from 40 percent to less than 2 percent. From 2001 to 2008, we helped cut the spread of HIV by 50 percent. Unfortunately, the infection rate has gone back up in Botswana.
People are living longer, so that increases the odds they’ll spread it. People aren’t using protection religiously, and the number of partners among young people is high.
MLT: How has Ebola had an impact?
HF: It hasn’t. If the disease shows up in Botswana, we’ll shut down.
MLT: What went wrong with Ebola here?
HF: Those taking care of sick people didn’t use proper protection. Now, the CDC has identified sites, doctors and nurses for Ebola care. Hopefully, that prevents it from spreading further in this country.