Saving the world is on Sue Desmond Hellman’s to do list

FILE PHOTO: Susan Desmond-Hellmann, CEO of Bill & Melinda Gates Foundation, speaks at the 2019 Milken Institute Global Conference in Beverly Hills, California, U.S., April 29, 2019. REUTERS/Lucy Nicholson/File Photo

By Chris Taylor

NEW YORK (Reuters) – If you had $50 billion to try to solve the world’s worst problems, what exactly would you do?

That is the daunting challenge that faces Dr. Sue Desmond-Hellmann when she walks into her office every morning as president of the Gates Foundation – the largest private foundation in the United States, set up by Bill and Melinda Gates.

For the latest in Reuters’ Life Lessons series, Desmond-Hellmann talked with us about the winding path that took her from the epicenter of the AIDS epidemic, through years in Uganda, to the top of the philanthropic world.

Q: When you were a kid growing up in Reno, Nevada, what money lessons did you learn from your parents?

A: Two things made huge impacts on me: One was that my mom and dad were both children of the Depression, and the first in their families to go to college, so they really knew the value of education. I was one of seven kids, and every night at dinner we talked about nothing but homework and school and books.

The other thing was the importance of values and faith. All the way through 12th grade, my life totally revolved around church and Catholic school.

Q: What was it like to begin your medical career in San Francisco in the 1980s?

A: I started at UCSF as an intern in 1982, and if you look at the history books, the first descriptions of HIV started appearing at that time. So I was literally becoming a doctor in the epicenter of the epidemic. In fact, my specialty was Kaposi’s sarcoma, which you see in a lot of AIDS patients.

Q: After that, you treated AIDS patients in Uganda. What lessons did you take away from that experience?

A: We were approached by the Rockefeller Foundation to study heterosexual HIV transmission in Africa, so my husband Nick and I sold our Honda Civics, sublet our apartment, and hopped on a plane.

We were extremely isolated. When we came back from Uganda, we never complained about anything ever again.

Q: How long did you and your husband grapple with student loans?

A: We were paying those off for the longest time. I still remember the coupons you had to rip off, and send in with your check. We had a lot of debt we had to get rid of, so we were very conservative with our money. It wasn’t until around 2000 where we were financially secure enough to start giving some away to charity.

Q: You have billions to work with, how do you decide where to direct that money?

A: We are in the equity business, the idea that all lives have equal value. So we believe in education as something that drives equity and that no matter your zip code or background or family wealth, you can get a good public education.

We complement that work with a focus on global health, which began after Bill and Melinda took a trip to Africa and saw children dying of diseases that could have been prevented with vaccines. The big drug companies tend to invest in health conditions that affect the rich world, so we focus on what affects the poor: things like TB, malaria, diarrhea, pneumonia.

Q: What is the best life advice you got from Bill and Melinda Gates?

A: The thing I admire about Bill and Melinda is that they are pretty even-keeled about setbacks. Most people tend to beat themselves up when they hit an obstacle, but they don’t get frustrated. They understand that most people overestimate what they accomplish in one year, but underestimate what they can accomplish in 10 years.

Q: What life lessons do you try to pass on to the next generation?

A: I have lots of nieces and nephews, and a couple of things have been North Stars for me. One is being generous: That can be through money, but it can also be through volunteering, or just how you interact and treat people.

The next thing is that when you have a setback, see it as an opportunity. I have had times in my life where I tried to go left, and the door was closed. So turn right and open another door, because there may be something great behind it. Setbacks are only temporary, so keep moving and don’t get stuck.

(Editing by Beth Pinsker and Jonathan Oatis)

Rogue Chinese scientist made ‘foolish’ choice in gene-edited babies

FILE PHOTO: Scientist He Jiankui speaks at his company Direct Genomics in Shenzhen, Guangdong province, China July 18, 2017. Picture taken July 18, 2017. REUTERS/Stringer

By Kate Kelland

LONDON (Reuters) – A rogue Chinese scientist who caused outrage last year when he said he had created the world’s first “gene-edited” babies in an attempt to protect them from HIV may also have put them at risk with a “foolish” choice of gene, experts said on Monday.

He Jiankui, then an associate professor at the Southern University of Science and Technology in Shenzhen, China, sparked an international scientific and ethical row when he said he had used a technology known as CRISPR-Cas9 to alter the embryonic genes of twin girls born in November 2018.

He said he had targeted a gene known as CCR5 and edited it in a way he believed would protect the girls from infection with HIV, the virus that causes AIDS.

But in a study published in the journal Nature Medicine on Monday, scientists found that people who have two copies of a so-called “Delta 32” mutation of CCR5 – which protects against HIV infection in some people – also have a significantly higher risk of premature death.

The researchers, Xinzhu Wei and Rasmus Nielsen of the University of California, Berkeley, said their findings showed the unintended consequences of introducing mutations in humans.

Robin Lovell-Badge, a leading geneticist and the organizer of a conference where He Jiankui made his revelation, said the results showed the Chinese scientist “was foolish to choose CCR5 to mutate in his attempts at germline genome editing”.

“We simply do not yet know enough about the gene,” said Lovell-Badge, a professor and gene expert at Britain’s Francis Crick Institute.

He Jiankui could not immediately be reached for comment.

Other specialists agreed the findings underline a need for extreme caution when considering possible human applications of gene editing technologies.

“This study should act as a stark warning that manipulation of the human genome with the aim of reducing susceptibility to specific diseases is not without considerable risk,” said Andrew Freedman, an infectious diseases expert at Cardiff University.

The Berkeley team’s study analyzed genotype and death register details from more than 400,000 people registered at the UK Biobank – a database of health and genetic information.

They found that people who have two copies of the Delta 32 mutation are about 20% less likely to reach age 76 compared with people who have one or no copies.

Chinese authorities immediately denounced He when he made his claim last year and issued a temporary halt to research activities involving the editing of human genes. He was fired after a subsequent Chinese health commission investigation found he had “deliberately evaded oversight”.

(Reporting by Kate Kelland; Editing by Andrew Cawthorne)

London HIV patient becomes world’s second AIDS cure hope

FILE PHOTO: A nurse (L) hands out a red ribbon to a woman, to mark World Aids Day, at the entrance of Emilio Ribas Hospital, in Sao Paulo December 1, 2014. REUTERS/Nacho Doce/File Photo

By Kate Kelland (Health and Science Correspondent)

LONDON, March 4 (Reuters) – An HIV-positive man in Britain has become the second known adult worldwide to be cleared of the AIDS virus after he received a bone marrow transplant from an HIV-resistant donor, his doctors said.

Almost three years after he received bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection – and more than 18 months after he came off antiretroviral drugs – highly sensitive tests still show no trace of the man’s previous HIV infection.

“There is no virus there that we can measure. We can’t detect anything,” said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man.

AIDS experts said the case is a proof of the concept that scientists will one day be able to end AIDS, and marks a “critical moment” in the search for an HIV cure, but does not mean that cure has already been found.

Gupta described his patient as “functionally cured” and “in remission”, but cautioned: “It’s too early to say he’s cured.”

The man is being called “the London patient”, in part because his case is similar to the first known case of a functional cure of HIV – in an American man, Timothy Brown, who became known as the Berlin patient when he underwent similar treatment in Germany in 2007 which also cleared his HIV.

Brown, who had been living in Berlin, has since moved to the United States and, according to HIV experts, is still HIV-free.

Some 37 million people worldwide are currently infected with HIV and the AIDS pandemic has killed about 35 million people worldwide since it began in the 1980s. Scientific research into the complex virus has in recent years led to the development of drug combinations that can keep it at bay in most patients.

Gupta, now at Cambridge University, treated the London patient when he was working at University College London. The man had contracted HIV in 2003, Gupta said, and in 2012 was also diagnosed with a type of blood cancer called Hodgkin’s Lymphoma.

LAST CHANCE

In 2016, when he was very sick with cancer, doctors decided to seek a transplant match for him.

“This was really his last chance of survival,” Gupta told Reuters.

The donor – who was unrelated – had a genetic mutation known as ‘CCR5 delta 32’, which confers resistance to HIV.

The transplant went relatively smoothly, Gupta said, but there were some side effects, including the patient suffering a period of “graft-versus-host” disease – a condition in which donor immune cells attack the recipient’s immune cells.

Most experts say it is inconceivable such treatments could be a way of curing all patients. The procedure is expensive, complex and risky. To do this in others, exact match donors would have to be found in the tiny proportion of people — most of them of northern European descent — who have the CCR5 mutation that makes them resistant to the virus.

“Although this is not a viable large-scale strategy for a cure, it does represent a critical moment,” said Anton Pozniak, president of the International AIDS Society. “The hope is that this will eventually lead to a safe, cost-effective and easy strategy…using gene technology or antibody techniques.”

Specialists said it is also not yet clear whether the CCR5 resistance is the only key – or whether the graft-versus-host disease may have been just as important. Both the Berlin and London patients had this complication, which may have played a role in the loss of HIV-infected cells, Gupta said.

His team plans to use these findings to explore potential new HIV treatment strategies. “We need to understand if we could knock out this (CCR5) receptor in people with HIV, which may be possible with gene therapy,” he said.

The London patient, whose case was set to be reported in the journal Nature and presented at a medical conference in Seattle on Tuesday, has asked his medical team not to reveal his name, age, nationality or other details.

(Reporting by Kate Kelland; editing by Catherine Evans)

More than 18 million on AIDS treatment a million more than 2015

A nurse (L) hands out a red ribbon to a woman, to mark World Aids Day, at the entrance of Emilio Ribas Hospital, in Sao Paulo

By Kate Kelland

LONDON, Nov 21 – More than 18 million people now have access to life-saving AIDS treatment, 1.2 million more than at the end of last year, the United Nations said on Monday.

In a report on the AIDS pandemic, which has infected 78 million people and killed 35 million since it began in the 1980s, UNAIDS said the consistently strong scale-up of treatment has seen annual AIDS-related deaths drop by 45 percent to 1.1 million in 2015 from a peak of about 2 million in 2005.

But, as more HIV-positive people live longer, the challenges of caring for them as they get older, of preventing the virus spreading and of reducing new infections are tough, UNAIDS said, even though drugs can reduce virus levels in a patient’s blood to near zero and significantly reduce the risk of passing it on.

“The progress we have made is remarkable, particularly around treatment, but it is also incredibly fragile,” UNAIDS’ executive director Michel Sidibe said as the report was published.

With detailed data showing some of the many complexities of the HIV epidemic, the report found that people are particularly vulnerable to HIV at certain points in their lives.

It called for “life-cycle” approach to offer help and prevention measures for everyone at every stage of life.

As people with HIV grow older, they are at risk of developing long-term side-effects from HIV treatment, developing drug resistance and requiring treatment for other illnesses such as tuberculosis and hepatitis C.

The report also cited data from South Africa showing that young women who become infected with HIV often catch the virus from older men. It said prevention is vital to ending the epidemic in young women and the cycle of HIV infection needs to be broken.

“Young women are facing a triple threat,” said Sidibe. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment.”

The report, saying the number of people with HIV getting life-saving drugs was 18.2 million, also showed that the rapid progress in getting AIDS drugs to those who need them is having a significant life-extending impact.

In 2015, there were 5.8 million people aged over 50 living with HIV – more than ever before.

UNAIDS said that if treatment targets are reached – the U.N. is aiming to have 30 million HIV positive people on treatment by 2020 – that number will soar.

(Editing by Louise Ireland)

UNICEF: Adolescent AIDS deaths have tripled since 2000

The number of adolescents who have died from AIDS has tripled in the past 15 years, and the disease is the second-leading cause of death in the age 10-19 population across the globe.

That’s according to data released Friday by the United Nation’s Children’s Fund, which added that the disease is the top killer for adolescents who are living in Africa. The organization, known more commonly as UNICEF, said adolescents are the only group that has not seen a drop in death rates in the past 15 years despite advances in disease prevention and treatment.

UNICEF said most of its data indicates most of the adolescents who are dying were infected with the disease when they were infants, when the treatments that help prevent infected pregnant mothers from passing the disease onto their children were not as common as they are today.

The UNICEF data showed that about 1.3 million children have been spared from the disease since 2000, largely thanks to improvements in mother-to-child transmission prevention. It said 60 percent of pregnant and breastfeeding women get medicine to prevent AIDS from spreading.

Despite those advances, the organization noted some shortfalls for the adolescent age group.

UNICEF said only one-third of the 2.6 million children under 15 who are living with AIDS are treated for the infection. It also announced that only 11 percent of 15-to-19-year-olds are tested for the disease in sub-Saharan Africa, where the infection rate is the most prevalent.

The disease also remains a problem for those who are not born with it.

UNICEF’s data showed that 26 new 15-to-19-year-olds become infected with the disease every hour, and 40 percent of those occur outside sub-Saharan Africa. The Associated Press reported that the United States, India, Indonesia and Brazil all had a “worrying rate” of teen infection.

UNICEF called for worldwide solutions that provide early diagnosis for babies (less than half of children are tested before they are two months old, and AIDS progresses quickly in newborns). It also seeks to keep women, children and adolescents treated and improve sex education.

Cuba Eliminates Mother-To-Child HIV Transmission

The World Health Organization (WHO) has announced that Cuba is the first country in the world to eliminate the transmission of HIV from mother to child.  The country is also the first to eliminate the transfer of syphilis.

WHO officials say that the discovery means an end to the AIDS epidemic is possible and they expect more nations to seek to reach the status where transmission is eliminated in their country.

“Eliminating transmission of a virus is one of the greatest public health achievements possible,” Dr. Margaret Chan, the WHO director-general, said in a Tuesday press release. “This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation.”

The WHO defines elimination as reduction to a level that it no longer constitutes a public health problem.  In 2013, only two babies were born in Cuba with HIV and only five with syphilis.

The WHO says that without treatment, a woman has up to a 45% risk of transmitting the virus to her child.  The WHO is currently undergoing a worldwide program to eliminate transmission but are struggling to meet their goal of only 40,000 infections in 2015.  The last reported total was 240,000 in 2013, a decrease of 160,000 from 2009.

New Disease Has AIDS-like Symptoms Without HIV

Researchers are reporting that a new disease is affflicting many in Asia and some in the United States with AIDS-like symptoms despite the patients not being infected with HIV.

The researchers do not believe the disease is infectious but like AIDS leaves the patients with damaged immune systems that leave them vulnerable to germs that an ordinary immune system can fend off. Continue reading