South Africa's early-warning "Mr. AIDS" dies
Published Friday, September 14, 2007

Dr. Reuben Sher, a South African immunologist whose 1983 warnings about a disease to be called AIDS were largely ignored both by the apartheid government and its successor, died Monday of surgical complications, the Cape Times reported.

Sher, then of the South African Institute for Medical Research, began his crusade after a trip to the U.S. Centers for Disease Control in late 1982.

What he heard from the centers' pioneering AIDS virologists prompted Sher to launch his own inquiries.

Only two South Africans were then known to have died of AIDS -- both young, white male flight attendants who traveled frequently to the United States and Europe.

"Everyone knew there was 'something' but no one knew what it was," said Dr. Dennis Sifris, a Johannesburg physician with a large gay practice whom Sher soon called for advice.

"About 200 patients agreed to come in and be tested," the Times quoted Sifris as saying. "Because there was no antibody test, we kept the blood samples locked up in a freezer."

When testing became available two years later, the pair found that nearly 12 percent of the men tested in 1983 were already HIV-positive.

Johannesburg General Hospital allowed the two in 1986 to start an AIDS clinic one day a week.

"I was looking for something to specialize in, and here was this new disease that involved a virus and immunity, both of my interests," Sher told Cape Town's Health-e news service in 2004. He soon found, though, that funding -- and compassion -- would be limited.

When AZT became accepted as an HIV treatment in 1987, Johannesburg health officials gave it to "blameless hemophiliacs but not to people (who) acquired HIV sexually, the implication being that it was their fault that they were infected," Sher told Health-e.

Also in 1987, Sher conducted the first AIDS study in a black population -- migrant mine workers from Malawi. Nearly 4 percent of them were HIV-positive, he found. Rather than treat the men, or grappling with the fact that they might have picked up HIV locally, the Chamber of Mines simply stopped recruiting workers from Malawi.

"First AIDS was seen as a gay disease, then a black disease," Sher said in 2004. "One got the feeling that the (apartheid) government didn't really go out of their way."

Today, more than 5.5 million South Africans are HIV-positive -- roughly 19 percent of the adult population. About 1,500 South Africans contract HIV every day, the Human Sciences Research Council reported in 2005. Every day, nearly 1,000 others die of AIDS.

Only 20 percent of those millions receive antiretroviral therapy. A five-year plan to boost that number to 80 percent is jeopardized by politics and lack of funding.

Sher retired after the fall of apartheid in 1994 -- he later complained that white AIDS doctors were "shunned" by the new government -- but continued to see AIDS patients in his private practice in Johannesburg.

Dr. Francois Venter, president of the HIV Clinicians Society, called him "a man who warned us all that HIV would decimate the country, was ignored, and was tragically proved right."

Barbara Wilcox, The Advocate