Do you remember during grade school and high school all those kids who would sit in the science lab excited to dissect the fetal pig or to even shock each other just to watch involuntary reflexes? They were often the nerds and the geeks of your class. Often the last one picked for kickball, but the first one chosen for a science project. Well, decades later, those kids predictably became the scientists and clinicians who still get excited about learning how the body works. I was one of those students and in many ways, I still am. Those students eventually became adults who would spend their evenings reading scientific journals before bed instead of reading Harry Potter or watching Saturday Night Live. And this week, many of us nerds converged in Seattle for an annual get-together.
Each year, a high-level conference filled with clinicians, scientists, and researchers meet in the United States to discuss best practices for optimal clinical care and translational research based on cutting-edge science. It is the Conference of Retroviruses and Opportunistic Infections (CROI). There is very little glitz and glam. From the time that you arrive, it is “Just the Facts, Ma’am” and not much else. The criteria to even attend CROI are stringent and strictly followed. One must be an active researcher or clinician focused on serving people living with HIV, sexually transmitted infections, viral hepatitis, Ebola, Zika, and/or other communicable diseases. If not, one must watch and learn over webcasts.
CROI attendees maintain a laser-like focus on the infections that they study even while political turmoil in Washington, DC and beyond continues to quicken and potentially threaten our ability to study the aforementioned diseases – and even more so, to implement those lessons learned to all those in need . At CROI, you run into person after person who has dedicated their entire adult careers to trying to bring an end to one or more viruses. As a former basic scientist, it can be awe-inspiring to be around some of the greatest minds to currently walk the Earth.
Since the 1980’s we know all too well that these scientific conferences do not exist in a vacuum. CROI – similar to the International AIDS Conference – grew from a lack of a concerted effort by the majority of “developed” countries appropriately respond to diseases that were systematically wiping people out. These meetings developed because the powers that be were not overtly concerned with the death and carnage that has or continues to plague those people. Due to the political climates that exist in many of the respective countries of these international attendees, you could feel the tension in the air that all the advances discussed at CROI would never benefit impacted communities.
This week, we learned from the CDC that not all communities within the USA are experiencing decreases in new HIV infections. Major breakthroughs were tempered by the thought of how will we get these advances to the general public. For example, we have known for a few years that people living with HIV who are successfully taken their medications cannot transmit the virus. And today, the community is beginning to sound the alarm that Undetectable means Untransmittable, or UequalsU. We also heard about the development of injectable PrEP that will help eliminate the “human error” of forgetting to take your medication. HIV Cure is also back at the forefront of conversations as we inch a bit closer to ending the epidemic once and for all with broadly neutralizing antibodies and/or unlocking some of the secrets of how HIV has evaded destruction. And we even got an update on a clinical trial that may revolutionize treatment by removing the need for continuous ARV utilization altogether.
At CROI, there are roomfuls of these nerdy scientists from decades past. We are now today’s change agents and no longer seen just as the geeks and dorks than were picked on and bullied in school. We know full well what it means to be the one who drew the short end of the stick. But we carried on. If you get a chance to talk with many of us and ask why we began our careers in this particular health science, you will hear similar responses. Personally, my original interests were in Sickle Cell Anemia, but I was drawn to the field of HIV to help people near or far who were not benefiting from scientific advances at the time. So here we are.
A bunch of grown-up nerds. Sharing the idea that everyone deserves a full and healthy life. We will get there together.
Onwards!