Sunday Times (Johannesburg) - November 25, 2001
Ruben Sher

In December 1982 I took one of my sons to the US because he developed a sort of haemorrhagic disease. I took him to the National Institutes of Health and the Centres for Disease Control in Atlanta to see if anybody could help him. That's when I read about HIV - in US newspapers. We didn't know anything about it.

By training I'm an immunologist. While at the Centres for Disease Control I met some of the leading doctors. I was worried because we had a lot of gay men working in South African Airways. They were flying to the US and indulging in homosexual practices.

When I came back to Johannesburg I teamed up with Dr Dennis Sifris and we got about 200 gay men together and examined them, took histories and stored their serum. When the first antibody test became available in 1985 we found that about 11% to 12% were already HIV-positive. Also at that time the first two Aids cases - patients who had died in 1982 - became known. They were diagnosed in retrospect.

And then the bubble burst.

We formed a little committee to look into the Aids scenario. Most doctors were scared. They didn't know what was causing the disease or whether they could become infected.

It was like running a race when you're the only competitor and you just had to win. And so it developed. You become a television and radio personality overnight.

People thought it was mainly a gay disease. Later on women became infected. I kept all the statistics. We used to phone doctors around the country and ask if they'd seen any cases. Through the laboratories, we had some idea of the number of infections. Now we have well over five million cases.

In 1986 we started a clinic at Johannesburg Hospital and set up an Aids advisory body to the government made up of my director, Professor Jack Metz, and myself. We did a lot of teaching. We ran around the country speaking at meetings.

It was devastating dealing with patients. We saw people dying in front of us and we could do very little. Aids, up until a few years ago, was a death sentence. And unlike the death penalty under apartheid, where you could always go to Bloemfontein and appeal, there was no such place.

So many wonderful people died and they taught me a hell of a lot - about humility, about not being judgmental. You felt impotent. Perhaps the most devastating thing was that they were young people, bright and talented.

The first time I pricked myself was in 1985. I sent some of my blood to the US to be tested. These things were a worry. In fact, I pricked myself three times and the last one I thought, third time lucky. I took some of these drugs and I'm still HIV-negative. But it's scary. You don't know what's going to happen.

I was really deep into this disease. It wasn't theoretical; it was practical. Then, unfortunately, as always, politics crept in. With the change of government there were different political alliances. So I withdrew.

For the past two and a half years I have been running a clinic that deals mainly with treating patients.

In 1996 protease inhibitors became available. For want of a better word, miracles started to happen. Now it became possible to treat a person, not to say, "Look I'm sorry. Go home. Put your will in order."

But in the meantime hundreds were becoming infected.

While we were achieving therapeutically we were failing on the frontier of changing sexual lifestyles.

We have failed on the education front, and we still don't have the answers.

Treatment is limited to those who can afford it. So, again, prejudice comes forward.

We were advisers to the [Nationalist] government and they never moved a step without phoning us. But what their feeling was - whether they said, "Good, it's going to get rid of the blacks one day" - we don't know. They weren't in favour of gays either. One gets the feeling they didn't really go out of their way. But neither has the ANC. In fact, they've done worse.

I've got a slide that talks about the three major disasters of the 20th century: the Holocaust under Nazi Germany, the atomic bomb and Aids. Now I have one for the 21st century - the attitude of the government towards Aids.

We know that 50% to 60% of admissions to medical wards are HIV-related. Absolute numbers aren't important. It's the trend that's important and it's going up and up.

We have been messing around too long. Everyone who needs antiretroviral treatment should get it, not only because it will improve quality of life and affect the economy but because it can reduce the national viral load and break the backbone of this epidemic.

I'm still here. I'm entering into my 20th year dealing with this disease. It was devastating for a doctor not to be able to do anything. Holding someone's hand is not the way to treat them but it was necessary.

These people have been turned into lepers. I give them a hug, make them feel like human beings, and they appreciate not being pushed away.

You can break barriers. It depends on the way you approach a situation.

Professor Sher was one of the first South African doctors to tackle Aids.

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