By Thomas Kohout and Jennifer Eder
Thirty years ago, the Human Immunodeficiency Virus was discovered. There was no cure, no treatment and little hope for survival.
As people across the globe observe World AIDS Day today, HIV is no longer a death sentence. But here in the nation’s capital, HIV/AIDS remains a major health concern.
With more than 3 percent of adults infected with HIV/AIDS, the District’s prevalence rate is among the highest in the nation.
George Washington University is trying to help to change that through research, advocacy and policy changes.
Last year, GW received a $3.75 million, five-year grant from the National Institutes of Health to fund the establishment of a Developmental Center for AIDS Research (D-CFAR). Led by Alan E. Greenberg, M.D. ’82, chair of the Department of Epidemiology and Biostatistics in the School of Public Health and Health Services; and Gary Simon, director of the Division of Infectious Diseases at the School of Medicine and Health Sciences, the center brings together researchers from SPHHS, SMHS, the Columbian College of Arts and Sciences, Children’s National Medical Center, Georgetown University, American University, Howard University and the Veterans Affairs Medical Center. The mission of the center is to provide scientific leadership and institutional infrastructure to promote HIV/AIDS research and to develop the next generation of investigators in Washington.
“The establishment of the D-CFAR in Washington, D.C. was a major step forward in our ability to confront the HIV/AIDS epidemic in our nation’s capital,” said Dr. Greenberg, D.C. D-CFAR director.
The program emphasizes interdisciplinary collaboration, especially between basic, clinical and behavioral investigators, and translational research where findings from the laboratory are brought to the clinic and community. The center, whose administrative home is at GW, is led by an executive committee and five coordinating bodies, or “cores” — administrative; developmental; clinical; basic science; and behavioral science, prevention and biostatistics.
“The D.C. D-CFAR is creating a community of scientists in Washington who can conduct the highest level of research on the disease,” said Dr. Greenberg.
NIH funded the CFAR program in 1988 with the goal of providing administrative and shared research support to academic institutions that conduct the best investigations involving HIV/AIDS. Today, NIH supports 17 full CFARs and four development centers, located at academic and research institutions across the country, including the one in the District. The goal for the D.C. D-CFAR is to become a standard center at the end of the initial five-year grant period.
So far, 12 D.C. D-CFAR members have received new NIH awards and 12 new HIV/AIDS investigators have been hired. The D.C. D-CFAR is helping to spur their research through the availability of competitive funds for HIV/AIDS research. Seven awards have been given out, totaling $229,000. The center also helped four investigators obtain supplemental NIH funding, totaling about $2.4 million. In addition to receiving funding, the D.C. D-CFAR has provided professional development and mentoring to its almost 130 faculty-level investigators while continuing to advance laboratory tests and studies, access to patient populations and specimens and consultation on study designs and statistics.
“Almost half way into its second year of funding, the D.C. D-CFAR continues to expand its efforts to strengthen the HIV/AIDS research infrastructure and to make D.C. a center for excellence for HIV/AIDS research,” said Dr. Greenberg.
In 2015, the D.C. D-CFAR will be evaluated on the collective success of the participating institutions’ HIV/AIDS research that will influence the field and ideally lead to better prevention and treatment.
“If the research and financial contributions are strong, and we do the things necessary to demonstrate that we took this opportunity and made the most if it, I’m confident that we can make the transition to a full CFAR,” said Dr. Greenberg. “This is something we can all be proud of because it gives us the chance to have a major impact on an epidemic that is harming so many people in our nation’s capital.”
Before teaching at GW, Dr. Greenberg, who earned a Master of Public Health from Harvard in 1999 after graduating from SMHS in 1982, served for two decades as a U.S. Public Health Service commissioned corps officer at the Centers for Disease Control and Prevention. He directed the center’s HIV Epidemiology Branch, where he supervised research studies in 28 states and nine countries in Africa and Asia. He is a principal investigator of the Public Health-Academic Partnership with the D.C. Department of Health; clinical research site leader for the D.C. site of the NIH-funded HIV Prevention Trials Network; chair of the Global Work Group on the Advisory Committee to the director at the CDC; and a voluntary HIV/AIDS physician at the D.C. Veterans Affairs Medical Center.
GW has more than 70 investigators in the D.C. D-CFAR including Michael Bukrinsky, professor and vice chair for research at SMHS’s Department of Microbiology, Immunology, and Tropical Medicine. Dr. Bukrinsky is studying cardiovascular disease in HIV infected patients. Monica Ruiz, an assistant research professor in the SPHHS Department of Prevention and Community Health, is evaluating the District’s policy on its syringe exchange program. And Gary Simon, co-director of the D.C. D-CFAR and vice chair of the Department of Medicine at SMHS, uses antiretrovirals to treat patients in his HIV clinic and also runs clinical trials.
Dr. Simon diagnosed the first recognized HIV/AIDS patient in the D.C. on Aug. 29, 1981. Since then Dr. Simon and his team studying the metabolic consequences of HIV infection and its treatment.
Jeffrey Akman, M.D. ’81, interim vice provost for health affairs and dean of SMHS, was one of a handful of psychiatrists who defined and developed the field of HIV/AIDS psychiatry in the mid-1980s and today is an expert in the psychiatric care of gay, lesbian, bisexual and transgender individuals. Earlier this year, D.C. Mayor Vincent Gray appointed Dr. Akman to serve on the Commission on HIV/AIDS.
And SPHHS is now offering a graduate certificate in HIV/AIDS studies. This program, which focuses on the biology, epidemiology, policy, surveillance, treatment and prevention of HIV/AIDS, prepares students to work in HIV/AIDS public health organizations, community-based organizations, AIDS service organizations and HIV/AIDS research.
“The D.C. D-CFAR looks forward to continuing its efforts and anticipates an even greater level of HIV/AIDS-related research going on in the District by World AIDS Day next year,” said Dr. Greenberg.