Monday 31 August 2015

Pour les autres

Some people seem to be put on the planet to serve humanity. They get up every morning, have breakfast and start the day's work and at the end of most days they've helped someone who was in a less fortunate position. They are the ones who stop the school bully, question authority or normality when they see a manifest injustice or just go out and clear drains because that will clearly help lots of people and nobody else seems to be doing it. I don't know what your experience of facing up to bullies is, it's not something I do and I don't see it happening very often, even among adults . . . even among scientists. And nobody, nowadays, cleans drains for a hobby.

These servants of humanity may have an ordinary or extraordinary life but their unspoken and probably unthinking baseline is looking out for other people. I think that Françoise Barré-Sinoussi is one such. I know nothing about her early years, so I can't say what she was like in school, except that it was in Paris, and that she went on to study in l'université de Paris and thereafter to work in the l'Institut Pasteur whence she obtained her doctorate in 1974.  It's possible that she might have motored along working in France's premier research institute on the study of viruses but she was in the right place at the right time when the Pasteur received a biopsy from a young man dying of AIDS in 1983. Because she had developed appropriate tools on her earlier virus projects, she was able within 15 days to show conclusively that the death of lymphocytes in the mystery sample was associated with the appearance of a virus. It took another 15 weeks to tie up the loose end and publish the paper and 25 years before the Nobel Prize appeared, but the discovery itself was "easy". I covered the HIV story a couple of weeks ago as a battle for prestige, priority and payola between a two big personalities and two world powers - the boy stuff.

A few months later, Barré-Sinoussi was in San Francisco for an academic conference about the new virus. It was an appropriate venue because it seemed at the time as if San Francisco was the epicentre of the epidemic - nobody had started counting the bodies in sub-Saharan Africa. One of the delegates asked if she'd like to meet someone who had the AIDS and she seems to have shrugged in a Gallic way before saying "Sure, why not?" It had a profound impact upon her: as she took the hand of the wasted, cadaverous, dying man in the hospital bed he mouthed "Thank you" in a barely audible croak.  When she asked why she was being thanked he said "Not for me, for the others". He knew he was fucked, but he saw that her scientific breakthrough was a source of hope for a cure. That benediction was almost the anonymous San Franciscan's last act - he died that night.

She spent the next 30+ years tied to and tied up in HIV and AIDS. Her then boss, Luc Montagnier, has moved onto very different things and they no longer collaborate. Significantly and usefully, Barré-Sinoussi has a total view of the HIV/AIDS and her whole life since 1983 has been focused on this one Big problem.  In this sense she is a Hedgehog "πόλλ' οἶδ' ἀλώπηξ, ἀλλ' ἐχῖνος ἓν μέγα" Archilochus; Multa novit vulpes, verum echinus unum magnum Erasmus; A fox knows many things, a hedgehog knows one great thing. Isaiah Berlin.  You can hear her speaking at the 2015 Lindau Conference [Lindau previously with Hans Rosling].

Antiretroviral treatment ART is fine but you have to a) take it regularly relentless forever b) get it to everyone: not just those who are rich.  Some countries do far better at this than others. The uptake of ART in Cambodia, a former French colony with which FB-S has worked for many years, is 80%.  In the USA the rate is a shameful 28% - poor black uninsured Americans with HIV just die. The incidence of HIV infection is higher at 3% in Washington DC than in Dakar, the capital of Senegal. It was one of the staggering successes of medical science, how it took about a dozen years from the formal identification of the syndrome to the launch of a successful therapy. Partly that was because a shed-load of money was thrown at the problem but it was also because of the solidarity between patients, clinicians, and scientists.

But it's much better if you don't get HIV in the first place, so Barré-Sinoussi has been a strong advocate for properly informed sex-education among the young . . . and not only in Senegal and Cambodia.  She finds that youngsters are plug-ignorant about the sources and consequences of HIV. After she got the Nobel Prize in 2008, she acquired the inevitable talking-head celebrity status that accrues to Nobellists and took it to The Pope the following year after the old man had said something demonstrably silly about the relationship between condoms and HIV transmission. Show me the evidence for your assertion, was the admirably scientific sense of her open letter to the Pontiff, which was never answered or acknowledged. She could also have asked about the compassion of his assertion or the economic and social consequences of his assertion and she does ask those questions in other forums.

She is also vocal in questioning the social, medical and economic sense of stigmatising homosexuality in Third World countries like Uganda and Cameroon where she has worked and where homosexual behaviour can result in a jail term.  Before we get too complacent, let's remember that Ireland only decriminalised homosexuality in 1993. Like the vocal Caitlin Moran expressing the anti-value of dismissing the contribution of women, Françoise Barré-Sinoussi has been talking seriously, to those who count, about the self-destructive social consequences of treating drug-users and homosexuals as untermenschen.

Today, the last day of August, Françoise Barré-Sinoussi will step down from her position in the Pasteur under the normal French compulsory retirement scheme. She is content to do so at least partly because a protegée of hers Dr Michaela Muller-Trutwin is going to be given her own lab as the old make way for new. In the Paris of the 1970s it was really hard for a young woman to get a start in science. Young Françoise had to use all her assertiveness and determination to find a lab that would accept her application. Her father and all the father-figures tried to discourage her from pursuing such an unsuitable career for a woman. She showed them! And she showed the world what a difference a woman can make . . . pour les autres. Bonnets bas!

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