Got Tang? A Blog Post to Honor David Stanton

David Stanton in Kangemi, Kenya, where the International AIDS Vaccine Initiative has a clinical research center.
David Stanton in Kangemi, Kenya, where the International AIDS Vaccine Initiative has a clinical research center and was beginning a vaccine trial.

 

By OHA’s Research Division

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The Research Division is leading the way in cultivating strategic partnerships to implement HIV and AIDS research and technology development programs, designing and managing biomedical and implementation research, disseminating research findings and supporting their programmatic and policy applications, and supporting sustainable capacity building for HIV and AIDS research, while always driven by the local context and ultimately being of service to the most vulnerable.

Legend has it that the soft drink Tang came about as a result of research conducted by National Aeronautics and Space Administration (NASA), the U.S. Space program. A few years back, this bit of lore was dismissed after it was revealed that although Tang was enjoyed by astronauts, it was initially invented for common consumers. NASA’s research did, in fact, contribute to the creation of smartphone cameras and baby formula, among many other key discoveries.

Despite the myth-busting, the Tang metaphor has long been used to make the point that while on the way to discovering one desired product or outcome, another one that really matters may emerge. This is often referred to as “serendipity in science.” David Stanton, who formerly led the U.S. Agency for International Development’s (USAID’s) Office of HIV/AIDS (OHA) research efforts, often referred to this phenomenon while imploring: “Look what we’ve gained while getting men to the moon!”

Under David’s leadership, first while growing OHA’s research expertise and then as Office Director for the past four years, much has been accomplished in the research arena. Several key discoveries have resulted from David’s unwavering support of research in the pursuit of new biomedical tools to prevent HIV, as well as his keen insights into what data would be necessary to influence policy and programs to stop HIV and the searing suffering it creates.  

David is a champion for the critical need for funding the discovery of new global health technologies to ensure a sustainable response to tackling our toughest health and development challenges, particularly for new HIV prevention tools. He consistently sees the wisdom in funding innovative ways to optimize the implementation of evidence-based programs capable of achieving an AIDS-free generation through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). David emphasizes the necessity of focusing this complex research agenda on the most vulnerable people and the importance of conducting clinical research with African research centers and laboratories.

It seems fitting, as David transitions from OHA’s Director to its Scientific Leader, to highlight a few examples of “home-runs” in OHA’s research portfolio as a direct result of David’s vision, leadership and mentoring:

A microbicide for women: In 2010, the landmark CAPRISA 004 trial provided proof of concept that a microbicide could significantly reduce a woman’s risk of HIV infection. The HIV prevention field faced both the satisfaction of a positive result and having to ask, “Which way do we go now?” It was a time to pull everyone together, shift gears, and explore a plan for product introduction and future access, while advancing innovative research. With his genuine affability and remarkably broad foresight, David led the conceptualization of next steps and furthered solid commitments among our USAID partners, implementers, donors, and key stakeholders around the world. David’s “shared vision” approach was the definition of exceptional leadership and of true development, while paving the path that, to this day, is still guiding the field.

The long-term goal of a safe and globally-effective HIV Vaccine: In 2009, USAID’s partner, the International AIDS Vaccine Initiative (IAVI), discovered a few broadly neutralizing antibodies (bnAbs) capable of blocking HIV. These powerful proteins were the most potent antibodies known to date and the first to be isolated from a study volunteer in a developing country. David recognized it as a landmark discovery and immediately orchestrated a USAID press release. Since then, many researchers the world over, including at the National Institutes of Health, have identified multiple new bnAbs against HIV, which may lead to a viable vaccine.

For years, scientists have sought to induce potent protective immunity against the many subtypes of HIV, and many have depended on samples from IAVI’s Protocol C [PDF, 570KB]. This USAID-supported work, which David encouraged despite the absence of an actual candidate vaccine being tested, is a highly-recognized and valued study that enrolled more than 600 volunteers from Kenya, Rwanda, South Africa, Uganda, and Zambia and collected more than 23,000 samples from volunteers at the early stages of HIV infection. This work continues to leverage key partnerships, yielding unprecedented insights into both early HIV transmission and the progression of infection over time.

Implementation Science: David led multiple initiatives over the years to foster operations research and Implementation Science, generating evidence and data to guide HIV programs. From leading USAID’s first flagship mechanisms dedicated to HIV operations research, HORIZONS, to making investments in evaluating new interventions, such as voluntary medical male circumcision and Option B+ to offer lifetime antiretroviral treatment for pregnant women living with HIV. David has led USAID in innovation and has effectively prioritized measuring impact through Implementation Science.

For some, it might be enough to cite these discoveries that have catapulted HIV biomedical prevention and implementation science into successful territory, but David has never shown signs of resting on his laurels. In fact, he shows no signs of resting at all until this pandemic is beaten, carrying on with a bright and optimistic demeanor, a steady hand, and an eye on the prize. Even on a really rough day, when asked how he’s doing, the worst anyone can get out of him is: “Medium” – in tandem with a generous smile.

Reflections

OHA Research team has memorable stories to narrate about David and his influence on us. David often asks difficult questions, not to get necessarily the right answer but to have a better and deeper understanding of the issue, to clear common misconceptions, and to challenge us on our narrow and limited thought process. He pushes us to look beyond point estimates and p values to real world programmatic messages hiding behind those numbers. He always looks at things through a programmatic lens. Borrowing David’s own words, “Neither the elegance of the science nor the strength of the effect predicts the ease of implementation.” --Dr. Benny Kottiri, Research Division Chief

David has great stories to tell about how OHA has grown; a favorite is from the early days of the Office when it required a newly dedicated research team and portfolio. David was asked by a senior Agency staff: “Tell me again why we should fund research? I thought you knew what you were doing!” This may not have been the easiest starting point for a discussion, but David effectively made the case to those who were uncertain by patiently explaining the benefits of biomedical research and why it should be led by OHA. His argument emphasized that OHA’s research would be done decidedly through a development lens. The result was the establishment of an enviable, well-respected research portfolio, which has resulted in seminal discoveries, with many more still to come.

The good news is: We do indeed know what we’re doing. We’re doing sound, invaluable global health research because that’s what informs the most effective and impactful programs and results in transformational new tools to reach David’s vision and our collective goal: to end HIV and AIDS.

OHA’s version of reaching the moon is creating an AIDS free Generation – what you’ve taught us is to value the discoveries made along the way. Thank you, David, most sincerely, for moving us all forward.

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