More than 11 million people around the globe are receiving medicine to treat the HIV/AIDS virus under the President’s Emergency Plan for AIDS Relief, a U.S. initiative that began in 2003 and has grown to become a major success.
One of the key players behind this ambitious program to save lives is Dr. Tedd Ellerbrock of the Centers for Disease Control and Prevention, who worked on scaling up the system to deliver the medicine to developing nations. He helped build international partnerships, expand the initiative and oversee evaluations in more than two dozen countries to identify gaps and recommend new solutions.
“We are where we are today because of Tedd Ellerbrock,” said Ambassador Deborah Birx, the State Department’s global AIDS coordinator. “He changed the course of the pandemic.”
“He did something that had never been done before,” said Dr. Shannon Hader, director of the CDC’s Division of Global HIV and Tuberculosis. “He figured out how to roll out safe and effective treatment programs in developing countries.”
Before the global push by the U.S., the number of people dying of AIDS was shocking. Up to 30 percent of people in some sub-Saharan African communities were succumbing to the disease, while fewer than 50,000 people in this region—the hardest hit part of the world—were receiving antiretroviral treatment when the program began, Birx said.
The goals of the U.S. program were to test and treat as many people as possible with antiretroviral medications and make sure the therapy was effective and ongoing so that patients could live longer, healthy lives. Because there is no vaccine for the disease, treatment is vital.
Ellerbrock, an OB-GYN-trained epidemiologist, immediately began working with international organizations and health authorities in affected countries to identify, test, counsel and provide medication to victims, and to train health care workers.
During the first years of the AIDS initiative, the program that Ellerbrock designed and led treated 1.4 million people at 1,300 facilities across 13 countries. This laid the foundation for expansion of the program worldwide. The number of people receiving antiretroviral therapy supported by the U.S. government today has grown to more than 11 million.
The CDC plays a major role in the global program, working at 11,000 sites in 26 countries supporting 6.6 million of the $11 million being treated.
Traveling constantly with colleagues to clinics around the globe, Ellerbrock asked doctors and nurses about how the program was doing, what was working and what was needed, and made the necessary adjustments to improve effectiveness.
“He’s a great listener. People can tell how much he cares,” said Dr. Mark Dybul, executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria.
In recent years, Ellerbrock and his team have evaluated the quality of care and treatment of patients throughout the world to identify gaps and recommend achievable solutions, said Dr. R.J. Simonds, an associate director at the CDC’s Center for Global Health.
Simonds said Ellerbrock’s work has included educating host governments, local leaders and citizens about HIV/AIDS, combating the stigma surrounding the disease, getting the drugs to clinics—including those in remote areas—and training health workers.
Ellerbrock and his colleagues had trouble selling the program to African leaders, in some instances, even though the disease was killing their people. They feared treatment centers might fail and they would be blamed, or that the U.S. would not be around for the long haul, said Hader, who traveled with Ellerbrock to Zimbabwe to start the HIV treatment program there.
Ellerbrock was instrumental in convincing officials in Zimbabwe to adopt the plan, she said. As a result, the number of people being treated mushroomed from about 400 to 40,000 in the first two years and to as many as 800,000 by the most recent count, Hader said.
In addition to the skepticism, Ellerbrock also had to deal with cultural barriers and differences between countries, and adapt the program’s approach to fit the situation. “We thought we could create a single plan that could be used everywhere, but then we realized how different countries were,” Birx said.
“Sometimes public health success requires sheer tenacity to overcome inevitable political, technical and operational barriers,” said former CDC Director Dr. Tom Frieden. “Tedd’s sustained leadership in the scale up of the program is a classic example of where such tenacity combined with a clear vision can have an incredible life-saving impact.”
Ellerbrock, who was a Peace Corps volunteer in the Philippines, came to the CDC in 1986, and soon after began examining low-income communities with high rates of HIV among women.
“Tedd did some groundbreaking work looking at HIV in marginalized communities in the South at a time when people didn’t really acknowledge that women were getting HIV in large numbers,” Hader said.
For his part, Ellerbrock said his work at the CDC, particularly overseas, has been an opportunity of a lifetime.
“If you took all those people off their medication, probably a third to half would be dead in two to three years. This is life-saving therapy,” he said. “So I and all the people I work with have the opportunity to make an enormous impact. It’s a privilege to spend my life doing that. I cannot tell you how proud I am of what I’ve been able to do and the joy I feel each day.”