Dr. Michael Gottlieb
In 1981 I reported the first cases of what we now call AIDS. The patients were five adults in their early thirties. The first cases in children with AIDS were identified in early 1982, and the cause of the immune deficiency, HIV, was identified in 1983. By the mid-eighties demands for HIV treatment gained momentum and escalated with Rock Hudson’s diagnosis and the formation of ACT-UP.
But by the late ‘80’s no individual or organization had taken up the cause of children with the virus. Pediatricians administered gamma globulin infusions with limited benefit. The prevailing medical opinion was that treatment for HIV positive children could only be palliative because the virus quickly decimated immature immune systems. The prognosis was bleak.
One woman, Elizabeth Glaser, changed all that. Elizabeth was all about the children, initially her own and then every child with HIV. Her diagnosis came about only after her daughter Ariel’s unexplained illness was found to be HIV. As her doctor I witnessed how much Elizabeth wanted to live and for her children to survive.
In 1987 federal funding for any kind of HIV treatment research had only just begun. AZT, the only antiretroviral on the market, was approved for adults only. Elizabeth was furious about why funding for research on children with HIV was not part of the first round of grants, and why drug development for kids always lagged far behind adults. Determined to make a difference she harnessed her deeply competitive instincts, enlisted her friends and family, and tapped her connections in politics and Hollywood to shake up the status quo.
The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) became the first organizing and funding body for scientists around the world studying pediatric AIDS. For me the early days of EGPAF were reminiscent of Camelot, a golden age of collaborative research, with think-tank retreats and tequila toasts. The most striking outcome from that scientific effort was the ability to routinely prevent mother to child transmission of HIV (PMTCT), a remarkable scientific success that became the principal mission of EGPAF.
Much has changed for the better since those early days. In the U.S. mother to child transmission of HIV is now exceedingly rare. EGPAF is a principal force in extending PCMTC to all corners of Africa. The development of new antiretrovirals with pediatric formulations allow many children born with HIV to reach adulthood. Young women born with the virus safely deliver HIV-free children. Just last year the case of a Mississippi infant offered new hope that if treated at birth babies may be able to achieve functional cure of their HIV.
The Elizabeth Glaser Pediatric AIDS Foundation is a leading light in creating the AIDS-free generation in Africa called for by Secretary of State Hillary Clinton. Elizabeth will be remembered as the courageous woman who started us down that path. We owe it to her to sustain the momentum toward a world where all children have a chance to be healthy and live lives free of HIV and all infectious diseases,
Dr. Michael Gottlieb is the physician who described AIDS as a new disease in 1981. He was Elizabeth Glaser’s physician and friend, and an early collaborator in the formation of EGPAF.