
Hi, this is Roger Hoerl with the final blog entry on my Coolidge sabbatical studying HIV/AIDS. As noted in my previous update, I traveled for a month to Africa in August/September, spending time in Zambia, Uganda, and four regions of South Africa, after a brief stop at the Munich Research Center on the way. We visited numerous non-government organizations, orphanages, clinics, and AIDS activists, and met people suffering from AIDS along the way. By design, we tended to avoid the official government establishments, and focused more on interacting with people from all walks of life who are on the “front lines” of the battle against AIDS in Africa. As you can imagine, it was an amazing, once-in-a-lifetime experience, while at the same time being somewhat disturbing. We obtained a tremendous amount of information, too much to possibly summarize here. Let me say only that all of us, my family, my research colleague - Professor Presha Neidermeyer of West Virginia University, and one of her students, came away convinced that the AIDS crisis will not be solved anytime soon, but can be solved. We believe that it will be solved one village, one person at a time.
After my return, I gave a presentation at GE Global Research in Niskayuna on our experiences in Africa. This was not a formal presentation of our overall research findings from the six-month sabbatical, but rather an informal sharing, via pictures, of the people we met in Africa, and the fascinating stories they told us.
Based on the trip to Africa, as well as our ongoing research, Presha and I have identified five macro issues that will need to be addressed to produce a solution to the AIDS pandemic:
1. The need for more economically sustainable plans by HIV/AIDS assistance agencies. Much has been done, but more thought needs to go into making these efforts economically sustainable over time, once deaths from AIDS are no longer front-page news.
2. The need for more holistic approaches to addressing HIV/AIDS. By holistic, we mean efforts that address the whole needs of the individual, including their overall health needs. We need to avoid “stove-piped”, disease-specific programs, because these have the potential to debilitate, rather then reinforce basic health care infrastructure, thereby doing more harm than good. For example, some AIDS relief organizations have hired so many local doctors to implement their initiatives that basic health care needs have gone unmet, with the natural result that infant mortality, maternal mortality (death in childbirth), and death from other treatable diseases have increased. Fortunately, there are many good examples of how to address AIDS while at the same time enhance basic health infrastructure.
3. The need for broader access to basic education. In our research it is clear that those who have received a basic education are much more likely to take appropriate steps to protect themselves, and to receive proper medical treatment if they are infected. Significant ignorance exists about what HIV and AIDS are, how you get them, and how you can be treated, not only in the developing world, but also in the US.
4. The need to empower women with basic human rights on a global basis. In some cultures, women still do not have control over the most basic and fundamental aspects of their lives, including their sexuality.
5. The need for bolder leadership among political, religious, commercial, and community organizations to create the cultural changes needed to fight AIDS. Because of the controversial nature of AIDS, too many leaders, in all walks of life, have been uncomfortable discussing AIDS publicly. Bolder societal leadership is needed to develop and implement concrete plans to prevent and treat HIV infection.
Of course, HIV/AIDS is not just an African problem. There is serious concern among researchers about epidemics developing in India and China. Recent literature indicates that AIDS is on the rise again among gay men in the US and Western Europe, after decades of consistent decline. Current statistics show that AIDS is the #1 cause of death among African-American women between the ages of 25 and 34 in the US. So while Africa remains the epicenter of the battle against AIDS, Presha and I are not limiting the scope of our research to Africa. This research continues (on nights and weekends now!), and we have a proposal for a book on HIV/AIDS and what can be done about it under review by Wiley. In this book, which we are currently writing, we will elaborate on these five macro issues, and how we believe they should be addressed. In addition, we will present a model we have developed to depict the continuum of approaches to social investment, from one-time charitable contributions to the development of economically self-sustaining enterprises.
On the purely statistical front, I am working with Harry Ma, my colleague in the Applied Statistics Lab, to perform sensitivity analyses of published HIV infection models - used by the World Health Organization and others to project the future path of AIDS - in order to quantify their uncertainty, and their sensitivity to model assumptions. For some reason, such quantification has not been published previously. We plan to present our results at the American Statistical Association meetings this August.
In summary, I would again like to sincerely thank the General Electric Company for providing such a unique opportunity. If this research can help prevent one person from dying of AIDS, the time, money, and effort spent will have proven well worth it. Thanks for your interest!