>> GOOD AFTERNOON.

MY NAME IS CLIFF LANE.

I'M CLINICAL DIRECTOR FOR

NIAIAD AND IT'S MY GREAT

PLEASURE TODAY TO WELCOME TO

THE NIH WEDNESDAY AFTERNOON

LECTURE SERIES.

DR. QUARRAISHA ABDOOL KARIM.

THE TITLE OF HER LECTURE IS

TENOFAVOR GEL, NEW HOPE FOR

H.I.V. PREVENTION IN WOMEN.

DR. KARIM RECEIVED A

BACHELOR'S DEGREE IN

MICROBIOLOGY AND BIOCEMETERY

FROM THE UNIVERSITY OF

DURBIN IN POINTS IN 81.

THAT WAS FOLLOWED BY AN

HONOR'S DEGREE IN

BIOCHEMISTRY FROM THE

UNIVERSITIES IN 1983 AND A

HIGHER EDUCATION DIPLOMA

FLOM FROM THE UNIVERSITY OF

SOUTH AFRICA IN 1986.

IN 1988 SHE RECEIVED A

MASTER'S IN SCIENCE AND IN

2000 RECEIVED A PH.D IN

MEDICINE FROM THE UNIVERSITY

OF NATAL.

PER PH.D THESIS ENTITLED

"WOMEN AND AIDS EPIDEM LOGIC

AND GENDER BARRIERS TO

PREVENTION" WAS A PREVIEW OF

HER WORK TO COME.

FOLLOWING HER PH.D, SHE WAS

APPOINTED TO THE FACULTIES

OF THE SCHOOLS OF PUBLIC

HEALTH AT THE UNIVERSITY OF

WASU IN NATAL AND AT

COLUMBIA UNIVERSITY, WHICH

ARE STILL IN PLACE TODAY.

OVER THE PAST 24 YEARS, HER

RESEARCH HAS FOCUSED ON

ACHIEVING A BETTER

UNDERSTANDING OF THE

EVOLUTION OF HIV/AIDS

EPIDEMIC IN SOUTH AFRICA, ON

DEVELOPING SUSTAINABLE

STRATEGIES TO INTRODUCE

COMBINATION ANTI-RETROVIRAL

THERAPY.

ON THE OPTIMAL TIMING OF

RETROVIRAL THERAPY IN THE

SETTING OF ACTIVE TB AND THE

TOPIC OF HER TALK TODAY,

DEVELOPING APPROACHES TO

H.I.V. PREVENTION, INCLUDING

THE USE OF TOPICAL

MICROBYCIDES.

SHE SERVES ASAT A SCIENTIFIC

DIRECTOR AT THE PROGRAM IN

SOUTH AFRICAY IS CO-CHAIR OF

THE H.I.V. TRIALS NETWORK

AND PLAYS A MAJOR ROLE IN

THE COLUMBIA UNIVERSITY

SOUTHERN AFRICAN FOGARTLY

AIDS INTERNATIONAL TRAINING

AND RESEARCH PROGRAM.

HER WORK HAS BEEN RECOGNIZED

WITH MANY DISTINCTIVE AWARDS

AND HONORS.

HER DEMONSTRATION OF THE

EFFECTIVENESS OF A TENOFAVOR

CONTAINING GEL AND

PREVENTING H.I.V. INFECTION

IN WOMEN WAS RECOGNIZED AS

ONE OF THE TOP SCIENTIFIC

ACHIEVEMENTS IN 2010 AND

LAST MONTH SHE WAS PRESENTED

WITH A NAG ALI AWARD FOR

ACHIEVEMENT IN PUBLIC HEALTH

AT THE CONFERENCE AND

RETROVIRUSS AND

OPPORTUNISTIC INFECTIONS.

ALONG WITH DIANE HAV LER AND

AL-SADR, SHE'S CURRENTLY

SERVE ACE CO-CHAIR FOR THE

COMMITTEE OF THE 19th

INTERNATIONAL AIDS

CONFERENCE TO BE HELD JULY

22 AND 27 IN WASHINGTON,

D.C..

SO I ENCOURAGE ANYONE WHO

HAS A ABTRACT THAT THEY'RE

WAITING TO HEAR ABOUT FOR

THE AIDS CONFERENCE HERE IN

JULY, BE SURE TO GO TO THE

RECEPTION BECAUSE AFTER HER

LECTURE HERE, DR. KARIM WILL

BE GOING TO WHAT'S

AFFECTIONATELY TROFRD AS THE

MARITIME MEETING, AT WHICH

TIME THE ABTRACTS WILL BE

SELECTED.

OKAY.

NOW WHAT I'VE JUST DONE,

THOSE OF YOU WHO ARE PART OF

THE NIH COMMUNITY, SNOW IS

THE STANDARD PROTICAL FOR --

MONT COLORADO FOR

INTRODUCING AN NIH SPEAKERS.

WHAT I'D LIKE TO DO IS TAKE

ONE MORE MINUTE AND ACTUALLY

TRY TO PUT HER

ACCOMPLISHMENTS INTO THE

PERSPECTIVE OF SOUTH AFRICAN

POLITICS.

KARIM GRADUATED IN COLLEGE

FROM SOUTH AFRICA WHILE

APARTHEID WAS AUTHORITY.

SHE PURSUED HIGHER EDUCATION

IN SOUTH AFRICA, DURING THE

TIME OF DECLARED STATE OF

EMERGENCY AND REVOLT IN THE

-- REVOLT IN THE SOUTH

AFRICAN TOWNSHIPS.

SHE RECEIVED HER PH.D AND

BEGAN HER INDEPENDENT

RESEARCH CAREER STUDYING

H.I.V. AT THE START OF THE

PRESIDENCY OF BEMI -- BECKI

AND THE RISE OF THE H.I.V.

DENIALIST MOVEMENT IN SOUTH

AFRICA AND THE POLICIES OF

THE UM BECKI GOVERNMENT,

POLICY THAT'S DENIED

ASSISTANCE TO THE GENERAL

PUBLIC.

TODAY SOUTH AFRICA IS HOME

TO THE LARGEST NUMBER OF

PATIENTS WITH H.I.V. OF ANY

COUNTRY IN THE WORLD.

IT HAS AN OVERALL H.I.V.

PREVALENCE OF 10%, WHERE

THREE THAT TIMES THAT NUMBER

ARE 30 PERCENT IN PREGNANT

WOMEN.

THE CURRENT GOVERNMENT UNDER

THE LEADERSHIP OF THE

PRESIDENT HAS TAKEN AN

AGGRESSIVE APPROACH TO THE

PREVENTION AND TREATMENT OF

HIV/AIDS AND HAS SET

AMBITIOUS, YET ACHIEVABLE

GOALS.

IT'S DUE TO WORK OF

DR. KARIM AND COLLEAGUES

THAT SOUTH AFRICA IS NOW ON

A PATH TO DEAL MUCH MORE

EFFECTIVELY WITH THE

CHALLENGE OF HIV/AIDS.

DURING MY TIME AT CLINICAL

DIRECTOR OF NAJISHGSD I'VE

HAD THE OPPORTUNITY TO

TRAVEL TO MANY COUNTRIES AND

WORK IN MANY UNIQUE AND

CHALLENGING SITUATIONING.

WITHOUT A DOUBT SOUTH AFRICA

HAS BEEN AMONG THE MOST

UNIQUE AND MOST CHALLENGING.

DR. KARIM'S ACCOMPLISHMENTS

IN THE FACE OF GREAT

ADVERSITY, ARE A TESTAMENT

TO THE OUTRAGE KRAIJ,

DETERMINATION, AND STRENGTH

OF SPIRIT OF THE SOUTH

AFRICAN PEOPLE.

WE ARE INDEED FORTUNATE TO

HAVE AS OUR SPEAKER TODAY

SOMEONE WHO EMBODIES THE

SPIRIT AS A HERO OF THE

SOUTH AFRICAN STRUGGLE.

PLEASE JOIN ME IN WELCOMING

TO THE PODIUM, DR. KREESHA

ABDUL KARIM TO DELIVER HER

TALK ENTITLED "TEN OH FAEFBOR

GEL, NEW HOPE FOR H.I.V.

PREVENTION IN WOMEN."

>> THANK YOU.

[APPLAUSE]

GOOD AFTERNOON.

COLLEAGUES, LADIES AND

GENTLEMEN.

IT'S A REALLY HONOR AND

PRIVILEGE TO BE ABLE TO

DELIVER THIS LECTURE THIS

AFTERNOON, AND WEDNESDAY

AFTERNOON LECTURE, BUT I'M

SURE YOU ARE AWARE IT'S

THURSDAY AFTERNOON.

I WANT TO START BY THANKING

CLIFF VERY MUCH FOR BEING

SUCH A WARM AND GENEROUS

HOST AND ALSO FOR THIS

INCREDIBLY WARM AND PERSONAL

INTRODUCTION.

I WANT TO SAY ONE MORE WORD

ABOUT CLIFF, THOUGH, BECAUSE

HE'S REFERRED TO AS THE DARKEST

DAYS OF YOUNG DEMOCRACY

DURING THE UM BECKI ERA.

AND I WANT TO PAY TRIBUTE TO

CLIFF DURING THAT TIME.

IT WAS A SPECIAL PANEL SET

UP BY PRESIDENT UM BECKI TO

GATHER INFORMATION FROM

DISSIDENTS AND FROM PEOPLE

WHO BELIEVED H.I.V. CAUSES

AIDS.

AND CLIFF WAS THE REAL STAL

WART ON THAT PANEL,

REPRESENTING CLEARLY THE

VIEWPOINT THAT H.I.V. DOES

CAUSE AIDS.

AND THOSE WERE TERRIBLE DAYS,

PARTICULARLY IN THE YOUNG

DEMOCRACY AND PEOPLE LIKE

CLIFF WHO PLAYED SUCH A

PIVOTAL ROLE ON THAT PANEL

AND OUR APPRECIATION CANNOT

BE UNDERSCORED.

AS I STAND HERE, I AM

PRESENTING RESEARCH HAS BEEN

UNDERTAKEN BOTH BY MYSELF

AND SLIM AND I THINK

WHATEVER AIDS RESEARCH I

PRESENT, I CAN'T REALLY

SEPARATE OUT WHOSE IDEA

WORKED AT FIRST BECAUSE A

LOT OF WHAT WE'VE DONE HAS

BEEN DONE JOINTLY.

AND WHILE I TAKE

RESPONSIBILITY FOR THAFRG

SAY, I WANTED TO ACKNOWLEDGE

THAT.

BUT IN ADDITION TO SLIM, WE

HAVE A LARGE GROUP OF PEOPLE

ACROSS SOUTH AFRICA THAT WE

WORK WITH COLLABORATEIVELY.

BUT AS WE CAME OUT OF THE

DARK DAYS OF APAR TIDE, THE

-- APARTHEID, THE NIH PLAYED

A CRITICAL ROLE IN

SUPPORTING OUR EFFORTS IN

WHAT WOULD LATER BECOME THE

EPICENTER OF THE PANDEMIC.

AND I PARTICULARLY WANT TO

THANK DR. JACK WHITE FROM

THE OFFICE OF AIDS RESEARCH

AND DR. CHIEF FROM NIAD AND

IT'S THROUGH SUPPORT OF

THEIR WORK THAT WE ARE ABLE

TO ACCOMPLISH THE PROGRAM

AWARD BUT ALSO THROUGH A

NUMBER OF RO1'S AND

NETWORK-RELATED RESEARCH

THAT WE HAVE BEEN ABLE TO

ADVANCE OUR UNDERSTANDING OF

THE EPIDEMIC AND ULTIMATELY

OUR RESPONSE BOTH TO H.I.V.

AND TO BE.

-- TB.

I'D LIKE TO RECOGNIZE FROM

THE CENTER DR. ROGER BLANC,

DR. GENE MCDORMANT.

THE SUPPORT THROUGH THE AIDS

INTERNATIONAL TRAINING AND

RESEARCH PROGRAM WAS PIVOTAL

IN STRENGTHENING THE SCIENCE

BASE IN SOUTH AFRICA TO

ENABLE THE RESEARCH THAT WE

UNDERTAKE ALL THE WAY FROM

BASIC SCIENCE TO SOCIAL

SCIENCES, INCLUDING ETHICS

TO BE UNDERTAKEN.

AND LAST BUT NOT LEAST, I'D

LIKE TO ACKNOWLEDGE DR. GRAY

HANLEY AND CARL DID HE HAVEENBAG 

HAVEENBAG.

GRAY HANLEY WAS AN ATTACHE

IN SOUTH AFRICA.

HE LITERALLY ARRIVED AT THE

TIME UMBEKI DECLARED HIS

DISSIDENT POSITION.

AND SOON AFTER THE GRANT WAS

ESTABLISHED, GRAY WAS PIVOTAL

IN SUPPORTING OUR EFFORTS TO

UNDERTAKE THE ACCEPTA TRIAL,

WHICH I'M NOT GOING TO TALK

ABOUT TODAY.

BUT IT WAS PIVOTAL IN TERMS

OF ADVANCING A CRITICAL

QUESTION, WHICH IS WHEN TO

START ANTI-RETROVIRAL

TREATMENT IN TB, H.I.V.

CO-INFECT THE PATIENTS.

AS YOU KNOW, THE FINDINGS

FROM THAT TRIAL HAS LED TO

CHANGES IN SEVERAL TREATMENT

GUIDELINES ACROSS THE WORLD.

SOME OF THE FOCUS TODAY ON

TENOFAVOR GEL AND NEW HOPE

FOR H.I.V. PREVENTION IN

WOMEN.

QUICK OUTLINE.

I'LL COVER VERY BRIEFLY AND

QUICKLY WOMEN IN H.I.V. IN

AFRICA AND PARTICULARLY THE

URGENT NEED FOR H.I.V.

PREVENTION IN WOMEN, AND I

AM GOING TO TALK ABOUT THE

TENOFAVOR GEL AND ITS

EFFECTIVEIVENESS AGAINST

H.I.V. AND MORE RECENTLY HOW

WE HAVE SEEN A CHANGING

LANDSCAPE IN PREVENTION OF

TRANSMISSION OF H.I.V. THAT

HAS RESULTED IN A CHANGE IN

THE DISCOURSE IN OUR

RESPONSE TO THE EPIDEMIC, AS

CLIFF MENTIONED, THE THEME

FOR THE 2012 AIDS CONFERENCE

IS TURNING THE TIDE

TOGETHER."

AND THAT TYPE OF DISCOURSE

WAS INCONCEIVABLE EVEN TWO

YEARS AGO.

I WANT TO TOUCH BRIEFLY ON

SOME PREPRELIMINARY ANALYSIS

THAT HAS BEEN UNDERTAKEN

FROM THE COPISA 400 TRIALS

THAT MAY HAVE GUIDED FUTURE

PREVENTION TRIALS AND END

WITH A FEW CONCLUDING

REMARKS.

I THINK THAT MOST OF US IN

THE ROOM WITH FAMILIAR WITH

THE MAGNITUDE OF THE H.I.V.

EPIDEMIC AND EVEN AT THIS

POINT IN TIME WE HAVE OVER

33 MILLION PEOPLE LIVING

WITH H.I.V..

WE CONTINUE TO SEE OVER TWO

AND A HALF MILLION NEW

H.I.V. INFECTIONS EACH YEAR,

AND 1.8 MILLION DEATHS.

WHAT'S ALSO SIGNIFICANT IS

MORE THAN 70% OF THOSE

INFECTIONS ARE IN SUBSAHARAN

AFRICA.

ALTHOUGH IT HAS LESS THAN 1%

OF THE WORLD'S POPULATION,

IT CARRIES 25.4 MILLION

H.I.V. INFECTIONS AND IS THE

COUNTRY WITH THE MOST AIDS

CASES.

I WANT TO GO BACK TO ONE OF

THE FIRST STUDIES THAT WE

UNDERTOOK IN SOUTH AFRICA.

POPULATION-BASED SURVEY,

THAT REALLY SET THE SCENE

FOR US UNDERSTANDING ONE,