KHOPOTSO: Prof. Ruben Sher opens the door to welcome me into his spacious consultation room on the premises of a private hospital, in Johannesburg. He has aged a lot since I last saw him. But, as he recalls how he first came into contact with HIV/AIDS, it’s clear that at least his memories are still fresh.
Prof. RUBEN SHER: I’d just finished with my PhD at the South African Institute for Medical Research. I was looking for something to do. My one son became ill and I took him to America in December of 1982 when I started reading about this new disease in the newspapers, etc.
KHOPOTSO: What American media published at the time, says Sher, was that the condition had been identified among gay men, which made him fear for South Africa’s gay community.
Prof. RUBEN SHER: I went down to the CDC, the Centers for Disease Control and I met with some of the early virologists, the epidemiologists’¦ and I suggested that a lot of our gay men were flying to America and other places working for SA Airways and that we need to look into their situation, and they agreed and they’ve been most helpful throughout the years.
KHOPOTSO: The following year, in 1983 Prof. Sher teamed up with a fellow colleague, Dr Dennis Sifris ‘ a gay man himself – to research the presence of HIV among homosexual men in Johannesburg. The two had previously collaborated on some work on Hepatitis B.
Prof. RUBEN SHER: He brought about 250 gay men together. We bled them and we did certain tests. We kept them under observation. The test for the diagnosis of HIV wasn’t available, yet.
KHOPOTSO: How were you doing the tests at that time?
Prof. RUBEN SHER: We weren’t. We were only looking at their clinical condition. We could the CD 4 counts, but we couldn’t do an HIV test. That only became available in 1985.
KHOPOTSO: You could actually not do the HIV test, but then you could actually measure the CD 4 count. How does that work?
Prof. RUBEN SHER: If you look at the latest recommendations from the World Health Organisation, it deals with countries that can’t do CD 4 counts ‘ where they try and make a diagnosis on clinical grounds. And that’s all we had’¦ Things like weight-loss, previous infections such as syphilis, Hepatitis B. These are all indications.
KHOPOTSO: What did Professor Sher and Dr Sifris do with the blood?
Prof. RUBEN SHER: We stored their serum and when the test became available we went back and tested them’¦ You see, you never throw serum out. You freeze it’¦ Between 11 and 12% of them already were HIV-positive.
KHOPOTSO: Did that shock you?
Prof. RUBEN SHER: Yes and no’¦ Don’t forget that in 1982 two gay men had already died from this disease. The news only became known to us in 1983’¦ That was happening in America. It was predominantly a gay disease. We didn’t know what was happening in the rest of Africa to the north of South Africa. It was spreading, but nobody knew. The earliest was when people were diagnosed (with) Slim disease. Because of the severe weight-loss they called it Slim disease.
KHOPOTSO: In between long breaths and pauses, Sher says there was a real fear that HIV would become an epidemic in South Africa. And much work was done to sound the alarm bell, including knocking on the doors of the then apartheid government.
Prof. RUBEN SHER: We warned government. We warned corporations. We set up an AIDS advisory group’¦ But everybody thought we were trying to threaten people.
KHOPOTSO: And so, the apartheid government and then, later the first democratic government took little decisive action on AIDS. Corporate South Africa thought it was the duty of government to handle health issues, says Sher, so business also took no action. In the late 1980s the identity of HIV was to change from being a gay man’s disease.
Prof. RUBEN SHER: The first case of AIDS in the black community was only detected in 1987’¦ We were expecting it because we had immigrants here. We did a major study on the mines in 1986-87, which showed about 3.76% of Malawians working on the mines were positive. So, we’d anticipated there was going to be an epidemic’¦ We alerted people’¦ We had the evidence’¦
KHOPOTSO: However, the alerts fell on deaf ears. Sher has since retired from active involvement in AIDS issues. He continues, however, to see patients in his small AIDS practice in Johannesburg ‘ the result of an epidemic that could have been avoided.