The year was 1988. People were afraid. A total a 106,994 people had been diagnosed with HIV/AIDS in the U.S. and 62,101 were dead. Scientists were making progress, but there was no effective treatment. One night the evening news would feature protests by AIDS activists demanding faster drug approval. The next night the news featured parents demanding kids with HIV be barred from public schools.
On May 6, 1988, Harvard President Derek Bok announced the establishment of the Harvard AIDS Institute (HAI) to expand and accelerate AIDS research at Harvard. “The conquest of AIDS will require the commitment of experts concentrated at the School of Public Health, the Medical School and its teaching hospitals as well as from many disciplines throughout the University,” said Bok. “The Institute’s mission is to focus our resources and redouble our efforts.”
Bok named Myron (Max) Essex, a virologist at the Harvard School of Public Health (HSPH), to lead the Institute. According to Essex, “HAI was the brainchild of Harvey Fineberg,” who was HSPH Dean at the time.
“I wanted Harvard to declare a clear and compelling commitment to cope with the AIDS epidemic,” remembered Fineberg. “To deal with it not just as an intellectual problem, but as a practical and social problem. Max Essex was the obvious choice to lead the enterprise. He had been at the center of research on retroviruses and what later became HIV/AIDS research.”
After arriving at Harvard in 1972, Essex quickly made his mark. He showed that feline leukemia was caused by a type of infectious disease—a retrovirus— which could also suppress the animal’s immune system. In the early 1980s, when the Centers for Disease Control in Atlanta began investigating deaths in gay men with immunosuppression, Jim Curran, who led the investigation, called Essex for help and sent samples to his lab. Scientists were searching for the cause of what would later be named AIDS.
Essex was one of the first researchers to hypothesize that a retrovirus was the cause of AIDS. Later, he and a graduate student, Tun-Hou Lee, identified gp120, the envelope protein of the virus which became the basis for HIV tests. Essex and Phyllis Kanki, another graduate student, and their colleagues discovered SIV, an AIDS-like virus in monkeys. They also identified HIV-2 in West Africa, a virus similar to but less lethal than the more common HIV-1.
“It was a time when discoveries were happening almost monthly—major discoveries,” remember Richard Marlink, a young doctor who joined the Essex team. “Tun-Hou Lee and Phyllis Kanki and others were figuring out where the virus came from and how it worked.”
As AIDS took hold in the 1980s, Essex and his team collaborated with other scientists and clinicians in the Boston area, including Martin Hirsch, head of infectious diseases at Massachusetts General Hospital; William Haseltine, a molecular biologist at the Dana Farber Cancer Institute; and Jerome Groopman, an oncologist studying AIDS-associated cancers at the Deaconess Hospital.
In a 1986 New York Times article about the group of four researchers, Morton Hunt wrote, “They have abandoned much of the territoriality and competitiveness common among senior scientists and, sharing their latest findings and insights, are working together in an unusual collaboration. It is a symbiotic alliance: together, their four specialties give them a view of AIDS ranging from the human patient down to the individual genes inside the virus.”
The creation of the Harvard AIDS Institute brought the group into a more formal collaboration, which included other researchers, such as Howard Hiatt, a former HSPH dean who was interested in the behavioral and social aspects of HIV/AIDS, and Steve Lagakos, an HSPH statistician who was developing mathematical models for the spread of HIV/AIDS.
From the start, the goals of HAI were clear.
- To advance knowledge of the biology of the disease
- To develop and evaluate methods of prevention, diagnosis, and treatment
- To develop policy approaches and promote public understanding of AIDS
- To establish training and education programs for health professionals and others
- To undertake international projects combating AIDS
The world has changed a lot in the 30 years since HAI was created. In the late 1980s, scientists were hopeful that a vaccine would be available within a decade. That didn’t happen. But drug-combinations to treat HIV introduced in 1996 proved surprisingly effective and helped to slow the tragic loss of life. Today, over 37 million people worldwide are infected with HIV and more than half of those people now have access to life-saving antiretroviral treatment.
The goals of HAI have remained consistent throughout its 30-year history. Essex and his colleagues at Harvard and at the Botswana Harvard AIDS Institute Partnership, along with former students and trainees, have made significant contributions to understanding the biology of the virus and to developing the best methods to diagnose, treat and prevent HIV/AIDS. Thirty years later, though AIDS seldom leads the evening news, their work continues.