Remembering Dr. Cathy Wilfert

Few people can say that their life’s work saved millions of lives. But in the case of Catherine Wilfert, M.D.—who played a pioneering role in the prevention and treatment of HIV—it would be completely accurate.

• 2020 Statement on Dr. Wilfert’s passing from EGPAF CEO Chip Lyons
• 2015 Blog Post Honoring Cathy Wilfert, M.D.: “The times had changed dramatically, and EGPAF changed with them.”

Few people can say that their life’s work saved millions of lives. But in the case of Catherine Wilfert, M.D.—who played a pioneering role in the prevention and treatment of HIV—it would be completely accurate.

Born in Inglewood, California, Dr. Wilfert graduated with distinction from Stanford University and summa cum laude from Harvard Medical School in 1958 as one of five women in her class. In 1969, Dr. Wilfert began a faculty position in Pediatrics at the Duke University School of Medicine and contributed significant work in virology and epidemiology of Rocky Mountain Spotted Fever. In 1976, Dr. Wilfert was named the division chief of Pediatric Infectious Diseases, and in the mid-1980s, she saw her first case of pediatric AIDS. Facing the grim realities of HIV—then a virtual death sentence for those diagnosed—Dr. Wilfert stepped forward and began treating children living with HIV. Recognizing the rapidly increasing number of infants and children who were infected with the virus, she established the university’s first pediatric infectious disease clinic.

Dr. Wilfert led the National Institutes of Health’s ACTG 076 study that proved that the drug azidothymidine (AZT) could reduce mother-to-child transmission of HIV by up to 70%. Dr. Wilfert’s groundbreaking research in preventing maternal transmission of HIV led to a two-thirds reduction in the transmission of the disease from mother to child through pregnancy in the United States[1]. Further research dropped the transmission rate to less than 1%, an accomplishment only possible through her research and advocacy. The American Academy of Pediatrics named this achievement one of the “7 Great Achievements in Pediatric Research.”

With her extraordinary background and experience, Wilfert was uniquely qualified to lead EGPAF’s research and programmatic agenda when she retired from Duke in 1996. That year, Dr. Wilfert was named scientific director of EGPAF and took the research worldwide, leading international efforts to prevent mother-to-child transmission of HIV in low-income countries and solidifying EGPAF’s position as the global leader in prevention of mother-to-child HIV transmission (PMTCT).

“It was too soon to measure it, but we all knew that in a developed country, if you could provide AZT as the standard of care, you could reduce transmission. It seemed that in the developed world we would progress,” said Wilfert. “Later, it became feasible that we could do it internationally [with single-dose nevirapine].”

It was too soon to measure it, but we all knew that in a developed country, if you could provide AZT as the standard of care, you could reduce transmission. Later, it became feasible that we could do it internationally [with single-dose nevirapine]. Cathy Wilfert

Initially, Wilfert’s primary role was reviewing grant applications and awarding funds to Elizabeth Glaser Scientist recipients and other researchers. Then, in 1999, Wilfert directed EGPAF’s first international project, A Call to Action, shepherding grants to PMTCT programs in Thailand, South Africa, Kenya, Cameroon, and Uganda.

“We invited applications from overseas to propose systems in the local clinics or public health system to prevent mother-to-child transmission,” said Wilfert. “We didn’t have international offices at the time. We just had clinical investigators who were willing to work within systems in countries.”

“Then, countries requested an in-country presence, so we set up offices in many countries,” Wilfert continued. “I helped establish the in-country functioning of all the programs. I wrote grants, developed research, and encouraged in-country research. We were awarded monies from USAID [the U.S. Agency for International Development].”

In 2004, soon after the creation of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), EGPAF applied for and was selected as a partner for a project with the Centers for Disease Control and Prevention (CDC). Through Project HEART (Help Expand Antiretroviral Therapy to children and families), EGPAF delivered HIV care and treatment services to countries outside of the United States. It was a large leap from the organization’s previous work.

“As we grew, we acquired additional physicians, and ultimately, pediatricians. The times had changed dramatically and EGPAF changed with them.” Cathy Wilfert

“As we grew, we acquired additional physicians, and ultimately, pediatricians,” said Wilfert. “When I left EGPAF in 2010, the times had changed dramatically and EGPAF changed with them.”

The world took notice of her groundbreaking work. In 1999, Dr. Wilfert became only the second female president of the Infectious Disease Society of America, and she was inducted into the Institute of Medicine. In 2001, Dr. Wilfert was presented with a Lifetime Achievement Award in HIV from the Third International Meeting on HIV. And in 2019, Governor Roy Cooper presented her with the North Carolina Award, which recognizes significant contributions to the state and nation in the fields of fine arts, literature, public service, and science. In addition to countless other awards and recognitions, Dr. Wilfert served as a mentor to hundreds of physicians globally and continued to be a leading advocate in pediatric AIDS prevention and treatment.