Global Health Chronicles

Dr. Alan Greenberg

David J. Sencer CDC Museum, Global Health Chronicles
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2:00 - Background and Education

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Partial Transcript: But let’s begin with your background. Tell me about where you grew up, your early family life, and where you ended up going to college.

Segment Synopsis: Dr. Greenberg talks about upbringing in New York and his first experience with a healthcare environment and what influenced him to become a physician. Greenberg also describes his internship experience in Côte d’Ivoire and his residency in New York City hospitals where he recalls seeing his first Pneumocystis patient.

Keywords: Abidjan; Bronx, New York; Dabou; fall of 1981; Greenwich Village; Health; influence; J. Millar; limited career choice; medical school; psychiatric; Shakespeare; social justice; sub-internship; table tennis; veteran; volunteer

Subjects: Amherst College; Côte d’Ivoire; EIS; Epidemic Intelligence Service; George Washington Medical School; Hospital; Ivory Coast; Lenox Hill Hospital; malaria; Pneumocystis Pneumonia; Saint Vincent’s Catholic Medical Center; VA; Veteran Affairs; Vietnam War

10:48 - The Early Epidemic

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Partial Transcript: So during your training, your internships and residency, you must have seen a lot of these patients. Can you tell us a little about that?

Segment Synopsis: Dr. Greenberg describes his experience with early HIV patients, his admiration for nurses and hospital staff who were working during this time were constantly being exposed to unknown risks and the courage of the patients. Greenberg explains how he was introduced to the Epidemic Intelligence Service and CDC through a senior physician and a New York Times article.

Keywords: antiretrovirals; Atlanta, Georgia; beginning; Belgians; bodily fluids; career; Central Africa; chief resident; clinical; courage; field station; first hemophiliac; frustration; G. Bolan; ground zero; HIV epidemic; ID; infectious disease fellowship; inspirational; internship; J. Kislak; L.A. [Los Angeles]; mistake; New York; residency; San Francisco; young 20’s

Subjects: Africa; CDC; Congo; Epidemic Intelligence Service; gay-related immune deficiency; GRID; HIV; New York Times; Zaire Ministry of Health

19:52 - Malaria Branch

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Partial Transcript: Tell us about your EIS training a little bit. Where were you assigned and did you begin working on AIDS early on?

Segment Synopsis: Dr. Greenberg describes how through the EIS program and his desire to work internationally led him to CDC’s malaria branch. His experience within the malaria branch as an EIS officer and how one patient’s case of malaria in Texas led him to work on HIV in Zaire.

Keywords: C. Clinton; children; Chloroquine-resistant malaria; drug resistance; EIS officer; field station; French West Africa; H. Francis; H. Jaffe; HIV infected; J. Curran; J. Mann; K. Campbell; K. Miller; Kinshasa; M. Laga; malaria branch; match process; medical base; mentor; P. Nguyen-Dinh; P. Piot; Pediatric Ward; prevalence; R. Colebunders; San Antonio, Texas; soldier; T. Quinn

Subjects: Africa; AIDS; CDC; East Africa; Haiti; HTLV-3 [Human T-Cell Lymphotropic Virus Type 3]; Mama Yemo Hospital; National Institutes of Health; NIH; Projet SIDA; Southeast Asia; tropical diseases; United States of America; US Government; Wilford Hall Ambulatory Surgical Center; Zaire

29:19 - Jonathan Mann

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Partial Transcript: Well, tell us a little bit about Jonathan Mann.

Segment Synopsis: Dr. Greenberg describes what is was like to work with Dr. Jonathan Mann, and how Mann’s vision and productivity was inspirational.

Keywords: Cambridge; communication; crisis; details; Francois-Xavier Bagnoud Center for Health and Human Rights; FXB Center; Geneva; HIV epidemic; inspirational; International AIDS Conferences; J. Curran; J. Mann; K. Campbell; kind; mentor; mentors; P. Nguyen-Dinh; publish; respected; social justice perspective; Toblerone; visionary

Subjects: Côte d’Ivoire; Harvard School of Public Health; International AIDS Conference; Projet SIDA

34:05 - Zaire Projects

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Partial Transcript: Do you want to mention a few of the projects that you were doing at that time in Zaire?

Segment Synopsis: Dr. Greenberg describes a couple studies he worked on as an EIS officer regarding the association of HIV with malaria and blood transfusions and a sub-study of parasitemia in children with HIV.

Keywords: 1984; 6-year-old boy; blood donors; blood smears; blood transfusion; children; Chloroquine resistance; cohort; EIS conference; EIS officer; H. Francis; HIV negative; HIV positive; HIV seropositivity; HIV testing; J. Curran; J. Mann; J. McCormick; K. Bila; K. Campbell; K. DeCock; Kinshasa; mother-child transmission study; mothers; origins of HIV; P. Piot; pediatric malaria patients; R. Colebunders; R. Ryder; rural Zaire; seroprevalence; sub-study; Viral Special Pathogens branch; Washington D.C.

Subjects: Belgium; CDC; Central Africa; HIV; International AIDS Conference; JAMA [Journal of the American Medical Association]; Mama Yemo [Hospital]; New England Journal of Medicine; NIH; NPR [National Public Radio]; Projet SIDA; the Institute of Tropical Medicine; WHO [World Health Organization]

43:25 - NYC Department of Health

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Partial Transcript: Then you moved on, a big drastic shift from Central Africa to the New York City Department of Health, Office of AIDS surveillance.

Segment Synopsis: Dr. Greenberg describes how he was assigned by CDC to the New York City Department of Health and the people he worked with. Greenberg also shares a few stories on what it was like to work at the Health Department while there was quite a lot of activism about the HIV epidemic and a fair amount directed at the Health Department.

Keywords: ACT-UP members; activism; AIDS case reporting; airmail; angry; AZT monotherapy; B. N’galy; Brooklyn; case definition; case reports; CDC assignee; CDC forms; Commissioner of Health; Director of Surveillance; Epi branch; fax machine; Florence AIDS conference; four H’s; H. Jaffe; Haitian community; HIV epidemic; I. Weisfuse; J. Curran; local public health authorities; M. Rogers; Mann-N'galy Lecture; N. Nzilambi; P. Thomas; reporting hospitals; S. Joseph; S. Schultz; spectrum of HIV disease; stigma; technical assistance; technology

Subjects: ACT-UP; AIDS Coalition to Unleash Power; azidothymidine; AZT; Beth Israel Medical Center; CDC; Conference on Retroviruses and Opportunistic Infections; CROI; JAMA; Ministry of Health; New York; New York City Department of Health; RETRO-CI; Zaire

53:20 - Projet RETRO-CI/ TB & HIV

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Partial Transcript: So maybe let’s move on to your time in Côte d’Ivoire as Director of Projet RETRO-CI, which was from 1993 to 1997.

Segment Synopsis: Dr. Greenberg discusses his time in Abidjan as Director of Projet RETRO-CI and the preventive strategies the project approached. Greenberg also shares the issue of testing for HIV in TB clinics and the stigmatic issues this posed.

Keywords: A. Grant; Abidjan; AZT trials; Bactrim prophylaxis; C. Issa-Malick; epidemiologist; ethicists; G. Djomand; HIV-tuberculosis [TB] patients; Ivorians; J. Nkengasong; K. DeCock; leadership; leadership roles; local buy-in; management; manager of science; Ministry of Health institutional review board; mother-to-child transmission; opportunistic illness; P. Ghys; P. Piot; post hoc consultation; pre-antiretroviral era; Professor Kadio; S. Wiktor; The Lancet; tribal leaders

Subjects: Africa; Africa CDC; CAT; Centres Anti-Tuberculeux; Côte d’Ivoire; EIS; Institute of Tropical Medicine; London School [London School of Hygiene & Tropical Medicine]; Ministry of Health; PEPFAR; President’s Emergency Plan for AIDS Relief; Projet RETRO-CI; TB; The Joint United Nations Programme on HIV and AIDS; Treichville [Centre hospitalier universitaire de Treichville]; UNAIDS

77:40 - Management

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Partial Transcript: What were some of the most pressing management issues you had to deal with?

Segment Synopsis: Dr. Greenberg describes the professional support he had while in Côte d’Ivoire and how his career has shifted towards more responsibility in management.

Keywords: 1997; A. Ghys; Abidjan; AIDS Epidemiology Branch; cerebral malaria; culture; cultures; DHAP; diversity; Division of HIV/AIDS Prevention; F. Houphouet-Boigny; field station; fiscal; food-related enteric illnesses; French West Africa; H. Gayle; health concerns; HIV Prevention Trials Network; hospitalized; HR; Human Resources; International AIDS Branch; Ivoirian food; J. McCormick; Kinshasa; M. Laga; P. Ghys; P. Nieburg; P. Whitaker; personal protection; policy-wise; Professor Kadio; R. Katz; respect; responsibility; scientifically; T. Dondero; U. S. Ambassador; Washington D.C.; widespread conflict

Subjects: CDC; Center for AIDS Research; CFAR; Commisssion Corps; Côte d’Ivoire; George Washington University; GW; Harvard School of Public Health; Lassa fever; NIH; PEPFAR; PMI [President’s Malaria Initiative]; State Department; Thailand; United States Embassy; West Africa

95:48 - Closing Remarks

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Partial Transcript: Before we conclude, any general thoughts on your work for CDC and in the various settings and the various topics you’ve covered?

Segment Synopsis: Dr. Greenberg concludes his interview by reiterating how impressive the work that CDC does with the little amount of money appropriated to the institution and how the people who he’s worked with have shaped his life.

Keywords: advisory boards; D. Birx; Hepatitis C; Institutional lessons; J. Man; J. Nkengasong; K. Campbell, J. Bremen, J. Curran; K. De Cock; leader; M. Diallo; mentor; P. Ghys; P. Nguyen; P. Piot; P. Thomas; privilege; public health; R. Ekpini; R. Ryder; responsive; S. Hader; S. Wiktor; surveillance; T. Frieden; transformative

Subjects: AJPH; American Journal of Public Health; sexually transmitted disease; STD; UNICEF; World Health Organization