The “grandfather” of AIDS in South Africa, Reuben Sher passed away on Monday morning following post surgery complications.
Sher, an immunologist who had been in semi-retirement the last few years, has been remembered by colleagues who he first introduced to the AIDS epidemic in South Africa in the early eighties.
Recognisable by his snow white beard, Sher became “Mr AIDS” in the eighties when he warned that HIV/AIDS could become a biological holocaust.
Dr Francois Venter, president of the HIV Clinicians Society, paid tribute to Sher as “a man who warned us all that HIV would decimate the country, was ignored, and was tragically proved right.”
“He was without a doubt the first person in the scientific and medical community who tackled AIDS head on,” recalls Dr Des Martin, another AIDS stalwart, who met Sher in the mid eighties.
“He became Mr AIDS, everyone was seeking his opinion and he was often in the media,” says Martin. “He was not scared to speak out even if it was politically sensitive,” says
Three years ago, Sher recalled in an interview with Health-e how he had contacted Dr Dennis Sifris, one of the country’s pioneering AIDS doctors, early in 1983 after an eye-opening trip to the US in late 1982 where he had met some of the pioneering AIDS virologists at the Centers for Disease Control.
At that stage, two South African were known to have died of AIDS. Both were young, white male cabin attendants for South African Airways who travelled frequently to the US and Europe.
“I was looking for something to specialise in and here was this new disease that involved a virus and immunity, both of my interests,” said Sher, who was working for the SA Institute for Medical Research (SAIMR) at the time.
When he returned to South Africa, Sher contacted Sifris, who had a big gay practice.
“I called my patients and spoke to them about AIDS,” Sifris told Health-e at the time. “Everyone knew there was ‘something’ but no one knew what it was. About 200 patients agreed to come in and be tested.”
Throughout 1983, Sifris and Sher took the men’s histories and blood samples. “Because there was no antibody test, we kept the blood samples locked up in a freezer. When the HIV test became available in 1985, we went back and tested the samples and found that 11 to 12% were already HIV positive,” said Sher.
The two doctors approached the Johannesburg General Hospital in 1986, and were given permission to start an AIDS clinic that initially operated once a week. They saw the majority of the early AIDS cases in the city.
“In the earlier cases, I saw many SAA cabin attendants who had been infected overseas. We saw some haemophiliacs who were infected by blood transfusions, but the sexually transmitted cases all involved white homosexuals until 1987 when the first two black South Africans were diagnosed,” said Sher.
“We were faced with young men whose parents didn’t even know they were gay. Now they were being called to see their sons dying of AIDS in hospitals. I learnt a lot from them about not being judgmental.
“It was very difficult dealing with young people who were dying and we could offer them nothing more than empathy.”
Around 1987, the drug AZT – initially a cancer treatment – was found to be effective in treating people with HIV. But, said Sher, the government was “not interested, as they felt their money could be better spent on other things”.
The Johannesburg Hospital’s administration decided to give AZT to “blameless haemophiliacs but not to people acquired HIV sexually, the implication being that it was their fault that they were infected”.
Between 1986 and 1987, Sher was involved in a major study with the Chamber of Mines in which about 30 000 mineworkers were tested for HIV.
“There was a lot of prejudice. First AIDS was seen as a gay disease, then a black disease. One got the feeling that the [apartheid] government didn’t really go out of their way. But the officials we dealt with were interested in the condition,” said Sher.
“I was the keeper of the statistics nationally,” he added. “I would contact doctors and laboratories all over the country, asking them whether they had seen any cases.”
He said there were “a lot of ethical problems” in the early days, involving doctors breaking patient confidentiality, mainly because doctors were scared of being infected.
“As one of the few people dealing with AIDS, I ran around all over the place giving talks about how it was transmitted.”
On the eve of World AIDS Day last year, Sher again reiterated in an interview with Health-e how he had tried to send out a warning. “We anticipated there was going to be an epidemic, we alerted people, we had the evidence.”
Despite retiring, Sher continued to see patients in his small AIDS practice in Johannesburg.