Row upon row of colorfully clad women, pregnant or with babies in their arms, sat waiting for HIV treatment at the one-story Qoaling Filter Clinic in Maseru, the capital of this land-locked, mountain-ringed southern African country. Today, the majority of them receive comprehensive care for themselves and their children: a full range of antiretroviral drugs, testing for mothers and infants, and long-term follow-up and counseling. She is always more than willing to share responsibility for the good or the accomplishments.
Characteristically, she insists that accolades be directed to the local staff and medics. She was born into a family of physicians: Both her parents were doctors, and they imbued her with an ethos of public service.
As a newly minted doctor, she came to New York to study infectious diseases, believing that later she would return to Egypt. Her plans changed in , when AIDS began its cruel advance on the population of her adopted city. Many of them came from ruptured families, or families with more than one infected member—a spouse or a child. Some also were infected with tuberculosis TB ; others were drug-addicted. She formed teams of health care workers—including a doctor, nurse, nutritionist and social worker—who offered patients and their families psychotherapy and nutrition counseling, as well as assistance in finding housing, financial benefits, soup kitchens and drug treatment.
Bush in , which largely funds ICAP, the organization now can provide services that were unimaginable five years ago. In , fewer than people in Tanzania were being treated for HIV. Today, ICAP supports or provides care for 40, people at sites—hospitals, clinics or dispensaries—using the community-based model devised by El-Sadr. In addition to direct financial aid, Cunningham explains, ICAP provides training, on-site mentoring, financial management, counseling and testing to prevent mother-to-child transmission of HIV as well as lab equipment, solar panels, water supplies and even new buildings.
Nigeria, she says, is a country with more than three million people infected with HIV, and health care is often rudimentary. At first, ICAP teams often had to help clinics install lights, electricity and even water. She sees people, each person, each individual, each child. She also continues to conduct her own research: Most prominently, she was a lead investigator in the SMART trial, which found that breaks from antiretroviral treatments significantly increased the risks of opportunistic infections and death among HIV-infected patients.
