In collaboration with colleagues from the region, I have conducted patient-oriented research related to HIV in southern Africa since 1996, primarily in Botswana. A major area of focus is maternal HIV treatment during pregnancy and breastfeeding to optimize maternal and child health and eliminate transmission of HIV to the infant, including through randomized trials of HIV treatment regimens in pregnancy. We demonstrated that perinatal HIV transmission can be reduced from 40% to <1%, even when mothers breastfeed. We holistically include maternal health outcomes (including mental health), pregnancy outcomes, and longer-term child growth, health and neurodevelopment in our pregnancy studies. Patients and caregivers deserve high-quality safety and efficacy evidence for drugs that they may need during pregnancy and breastfeeding. Hence in parallel, I co-lead an initiative with colleagues at the World Health Organization and numerous other stakeholders (including community advocates, bioethicists, regulators, pharmacologists, healthcare providers, researchers and industry) to tangibly advance the conduct of ethical, high-quality research on priority drugs during pregnancy and breastfeeding (with a focus HIV and other infections). I also help lead a range of HIV-focused research in Botswana unrelated to pregnancy, for example in HIV prevention and HIV service delivery (including a community-randomized trial of universal community-based HIV testing, linkage to HIV care, and rapid HIV treatment initiation, which collectively reduced community-wide HIV incidence). Our lab extended to COVID-19 in 2020, conducting more than a third of SARS-CoV2 testing and all genomic sequencing for Botswana (our research laboratory director, Dr. Sikhulile Moyo, was recently recognized as a TIME100 person of the year for discovery of the Omicron variant). We are currently conducting studies on the impact of HIV on long COVID and SARS-CoV2 evolution.
My other primary focus has been helping to establish and support the Botswana Harvard AIDS Institute Partnership (BHP), an internationally recognized health research collaboration with the Botswana Ministry of Health and Wellness. I am privileged to spend much of my time mentoring and supporting brilliant early career scientists from Botswana and the region.