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Winter 2004
East Meets Westwood
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"The UCLA program has had an amazing impact
in the Far East," says Kenneth Bridbord, director of the
Division of International Training and Research at the John E.
Fogarty International Center, the international agency within
the National Institutes of Health that funds scientific research
to reduce global health disparities. "If you had to use
one word to describe it, it would be ‘leadership’
— leadership in science and in public health for that part
of the world where the UCLA/Fogarty AITRP has focused."
That ‘leadership’, spearheaded by founder
and director Roger Detels, extends well beyond the tutelage the
trainees receive while under the AITRP’s auspices. Through
the contacts he’s made over the program’s 16 years
— and on the basis of his groundbreaking work in the United
States as head of the long-running UCLA Multicenter AIDS Cohort
Study — Detels, a professor of epidemiology in the School
of Public Health, is often brought into HIV/AIDS-policy discussions
and scientific investigations in Southeast Asia and beyond, having
been invited to consult with numerous government and public-health
officials.
"Dr. Detels has a lot of experience, and at
the same time he also has a lot of vision about the future,"
says Warunee Punpanich, a pediatrician at a large hospital in
Bangkok, Thailand, that serves underprivileged children, 600 of
whom are currently being treated after being born to HIV-infected
mothers. She was sent to UCLA to become the facility’s first
physician fully trained in epidemiology. "[Detels] has seen
why some countries’ programs are successful and some are
not," she says.
HIV INITIALLY SPREADS THROUGH HIGH-RISK
GROUPS — in Asia, it has most commonly started
in sex workers and injection-drug users — before moving
into the general population. The most effective way to prevent
the spread of the disease is to protect these marginalized, high-risk
populations — not always a popular political move.
Yet, there are success stories. In Thailand, more
than a million people have been infected with HIV, but because
of aggressive campaigns for clean needles, condom distribution
and education, that’s nearly 400,000 less than had been
projected to occur by this point. The Thais responded swiftly
to the first sign of a problem, establishing an early-warning
system (known in epidemiology as "sentinel surveillance")
with assistance from Detels and one of his former trainees; they
followed up with bold strategies, including a strict edict requiring
brothels to ensure that condoms were used by every client. New
cases of HIV infection dropped by 80 percent.
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