On 9 March, I checked out of my hotel in Brazil. We had just finished a fascinating meeting on the integration of HIV with other health programmes and diseases. There was plenty of elbow-bumping and embarrassed smiles about the lack of embraces with Brazilian and global colleagues. We knew the wave must be coming, but the beaches still looked beautiful. We even really did drink Corona beer with supper.
I was excited and booked to go straight on to Boston for the 2020 edition of CROI, the conference on retroviruses and opportunistic infections. Apart from the consistently high quality of the science presented at CROI, I always love the corridors. There was always plenty of time to meet up with friends and colleagues, many of whom have been together over the past 25 years or more of the HIV pandemic. I saw Gita Ramjee at every meeting, and was looking forward to seeing her again.
Tragically, it was not to be. My phone pinged with an email announcing that the conference was no longer happening in Boston, but would be delivered virtually.
Gita was already in London on her way to the meeting from South Africa. Hearing that CROI was “virtualized”, Gita was delighted to stay on in London for a few more days. She was spending more time in London lately because she wanted to be with her sons and grandson, who live there. She visited the London School of Hygiene and Tropical Medicine, where she holds an honorary professorship for her work on HIV prevention trials. My colleagues there tell me that she was on her usual good form—kind, collaborative, straightforward and full of integrity and determination to make things happen. She flew back to South Africa that weekend and gave a talk at the London School remotely on 17 March. Two weeks later, she died, one of the first deaths from COVID-19 in South Africa.
Gita is an extraordinary testament to resilience and determination. She was born in Uganda and escaped from the Idi Amin regime. She continued her schooling in India and then went to university in the United Kingdom. There she met her future husband, a South African, also of Indian heritage. She moved to the Transvaal with him, but hated the segregated life, which contrasted so obviously with the more open society she had found in the United Kingdom. So they moved to Durban, which suited them better, and she began to build the two pillars of her life—her family and her career.
Her career as a strong leader of research on HIV prevention, specifically on women, particularly underprivileged women and sex-workers, has brought her global acclaim—lifetime scientific awards for excellence from South Africa, an Outstanding Female Scientist Award from the European Development Clinical Trials Partnerships, honorary degrees. To me, she was always a friendly face and someone to meet and talk to, not only about the science, but also about our sons and grandsons, London, Durban and beyond.
The COVID-19 wave is breaking over us now, and its power is awesome. Gita was a very early casualty of the African epidemic because she was a global superstar. Her death is a stark warning. Millions of poor people living in southern and eastern Africa, many of them living with HIV, are now facing a devastating challenge. The weak health and social systems, the dependence on piece work, the crowded housing, the lack of water and electricity all make it a horrible prospect. The death toll will rise steeply, in part because of direct infections with the virus, but even more so because of the impact on the overstretched health systems and weak social protection safety nets. How are the millions of scared people living in crowded, shared accommodation and dependent on their daily wages to buy food expected to maintain physical distance?
Gita believed in and fought for the rights and welfare of sex workers. Back in 2007, she told the Guardian newspaper, “The stories they used to tell us were horrific. That’s when I knew I wanted to be involved in the prevention of HIV infection in women.” I know that she would want us to step up and meet the challenge of COVID-19, not only as a public health crisis, but even more so as a challenge to inequity, poverty and lack of global solidarity.
Peter Godfrey-Faussett, Senior Science Adviser, UNAIDS
