Helen Rees: The prof leading SA’s Covid-19 drug trial
If one were to list all the titles and positions held by Prof Helen Rees, who is leading the SA part of a global trial to identify treatments for Covid-19, there would be no space to write anything else.
But, in a nutshell, the gynaecology professor has been involved in World Health Organisation (WHO) committees on vaccines and the elimination of polio; she is the head of SA’s medicine regulator and the scientific advisory chair of the Coalition for Epidemic Preparedness Innovations, an international group that prepares vaccine technology in expectation of epidemics such as Covid-19; and she is a scientific adviser to the US National Institutes of Health.
One of her many jobs is head of the Wits Reproductive Health & HIV Institute (Wits RHI), which she co-founded in 1994 to guide health policy in SA’s new democracy.
So how does she manage five jobs at once?
"I have a leadership team who have their own portfolios," she says. "They have a lot of independence. I don’t have to micromanage the work they do. They are talented leaders in their fields."
She says she’d be lost without her personal assistant, who helps schedule her day and phone calls, sometimes down to the minute.
Rees is tiny, but intimidating. She is well known as a tough boss who expects an enormous amount from the employees and scientists she leads. At a party to celebrate Wits RHI’s 20 years of existence, she told staff she felt pleased when she received their e-mails written at 2am, testimony to their intense work ethic and dedication.
Rees and infectious diseases doctor Jeremy Nel are leading the SA division of the Solidarity trial of four possible treatments for Covid-19. It is a global trial, she explains, and the great number of international sites is designed to speed up results. Usually a trial will have one or two testing sites and then expand to more countries, but that takes years. "We need to answer these questions in months."
Under investigation is the use of the antimalarial drug chloroquine, as well as remdesivir (which was designed to treat Ebola but had poor results), and an antiretroviral (ARV) drug combo, lopinavir and ritonavir, used with and without the drug interferon. Data from the trial is monitored in real time, which means medicines that are persistently failing can be removed.
Rees, an honorary professor at the London School of Hygiene & Tropical Medicine and the recipient of the Order of the British Empire in 2001 and the Order of the Baobab in 2015, is well versed in trials, including many that didn’t succeed. She has been involved in trials to test topical vaginal gels and ARV pills for women to prevent HIV transmission. HIV prevention trials in women is a field littered with failure. In the case of gels, trial after trial shows women don’t feel comfortable using them and thus they can’t be licensed for use.
Rees describes science as a "stepladder" of "failure" with incremental steps of success up the ladder. Science doesn’t stop when something doesn’t work, she says.
"In the science world, if you do it properly, the research that doesn’t work will inform the field as much as the research that does."
And she knows how to run multisite international trials. She most recently led the Echo trial that tested three different contraceptives in about 7,000 local, Kenyan and Zambian women to see if SA’s injectable contraceptive Depo Provera increased the risk of HIV transmission.
It is a trial many said couldn’t be done. But doctors needed to know if SA women were at risk and Rees lobbied for the trial and elusive funding for years. Last year, Rees and her colleagues revealed there is no added risk of HIV infection from the common contraceptive.
She is particularly well known for her skill at chairing of meetings.
Mitch Warren, head of HIV advocacy group AVAC, writing from New York (Rees advises that board too, of course) says: "Rees is the most effective meeting chair I have ever seen. She can guide discussions (no matter how heated), ensure all voices are heard, summarise the outcome precisely and identify exactly what has to happen next. This may be why she is asked to serve on – and chair – nearly every committee, board, advisory council or individual meeting.
"We all go to too many meetings, but a Helen Rees-chaired meeting is one not to miss."
So how does she do it? She listens and ensures "everyone’s views are equally respected", she says. "When you reflect back, it is extremely important that people can hear that their view is acknowledged and taken into account."
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