Originally published in the Winnipeg Free Press on November 23, 2017
It was surreal, really. About 30 women gathered for a Thursday luncheon at the Manitoba Club, enjoying a chicken caesar salad while their guest speaker held the floor with a PowerPoint presentation to underscore his main points.
Suddenly, the screen was filled with a photo of male genitals covered in ulcers, or “chancroids,” the more technical term. This was not your usual meal for ladies who lunch and this wasn’t your usual luncheon speaker.
Allan Ronald cheekily smiled at us as he powered through his talk, unfazed by our discomfort. His international career, it would seem, all started because of those “chancroids.” He was there to outline the important work on HIV and AIDS, and he certainly got our attention.
The Order of Canada recipient and inductee into the Canadian Medical Hall of Fame got his start internationally as an infectious-disease expert working with the University of Nairobi. He was asked to help out by the head of microbiology, who was dealing with Kenya’s outbreak of chancroids.
What grew to become the University of Manitoba/University of Nairobi clinic for research on sexually transmitted diseases eventually attracted experts from all over the world. In 1984, AIDS would become a focal point and by 1986, they had set up an HIV unit in Nairobi.
Ronald has been recognized internationally for his contributions in the fight against AIDS.
The research from the clinic team has led to groundbreaking findings regarding how AIDS is transmitted.
HIV and AIDS are no longer viewed with the same trepidation they once were. People with HIV are living almost-normal lives in Kenya and in Canada. It’s no longer a death sentence, and individuals with the disease are no longer forced to leave their jobs, their homes or their communities.
But according to CATIE, an organization that tracks HIV and hepatitis C infections in Canada, there were seven new diagnoses of HIV in Canada every day in 2014 and there were 75,500 people living with AIDS in Canada at the end of 2014.
Globally, it’s estimated 36 million people have AIDS and of those, 1.8 million are children. Africa is the region most affected by HIV/AIDS.
Ronald is adamant, looking back on his career as an expert in infectious diseases, that science is vital in fighting the next epidemic. “Good science, good technology. Anything that can reduce transmission and anything we can do to get important information out there,” he says.
And he says that even though HIV and AIDS do not forecast an early death, those who are involved in risky behaviour should still get tested regularly for HIV and use a condom during sex. Risky behaviour includes having multiple partners or engaging sexually with sex-trade workers. Ronald says, “I’m telling you what you already know, but as a reminder, if you’re having risky sex, you must use a condom, which 95 per cent of the time will prevent HIV transmission. If the condom breaks, you get tested for HIV.”
At the age of 79, Ronald continues to teach, although now it involves smaller seminar classes at the University of Manitoba (and, thankfully, no marking). But he’s a consummate cheerleader for the researchers in Manitoba who are currently working in the field of HIV/AIDS and public health for mothers and children.
For example, Ronald was quick to share an article in Science magazine featuring two U of M researchers, lead author Adam Burgener and Lyle McKinnon, that provided a breakthrough on how vaginal bacteria metabolize the anti-AIDS drug tenofovir. This allows HIV to persist and gain access through the vagina despite the insertion of tenofovir vaginal suppositories to kill the virus.
In other words, just like our guts, women’s vaginas have certain kinds of bacteria that have an effect on the efficacy of medication. This provides even more answers to why certain women become infected with HIV, while others do not, even when taking the same anti-HIV medication.
There are other mysteries about the disease Ronald and his colleagues have tried to understand as well, including how to avoid HIV infection when living with an infected partner. Ronald says studies have indicated that when the male partner is found to be infected, his female partner leaves the relationship about 20 per cent of the time. However, when the female partner is found to be infected, the male partner leaves 50 per cent of the time.
In 2003, their research team’s longitudinal analysis in Kenya and Uganda, funded with help from a Bill and Melinda Gates Foundation grant, yielded findings that helped keep marriages together and prevented transmission in 97 per cent of both women and men.
As we approach the 29th World AIDS Day on Dec. 1, much of what is known about AIDS and HIV is understood because of the important research, which first began in Nairobi, by an unassuming Manitoban who hails originally from Portage La Prairie and who occasionally likes to shock unsuspecting ladies at lunch.
And it’s a better world because of people like him.
Shannon Sampert is an associate political science professor at the University of Winnipeg and the director and editor-in-chief of EvidenceNetwork.ca.