Global Health Chronicles

Dr. Nathan Shaffer

David J. Sencer CDC Museum, Global Health Chronicles
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2:09 - Background/Early Career

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Partial Transcript: Would you tell me about where you grew up and your early family life?

Segment Synopsis: Dr. Shaffer talks about his early life, education and residency years.

Keywords: behavioral; Boston City Hospital; cases; clinical; college; drugs; follow up; GI; Harlem Hospital; health; humanities; immigrants; jobs; justice; Kaposi’s sarcoma; lymphadenopathy; medical; men; New York City; pneumocystis; pneumonia; premed; primary care; public; residency; risks; San Francisco General Hospital; service; social; student; TB

Subjects: AIDS; CDC; Columbia College School of Medicine; Connecticut; HIV; New York; Yale University

8:11 - Public Health and the CDC

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Partial Transcript: So then how did you get interested in public health?

Segment Synopsis: Dr. Shaffer discusses his introduction into public health through EIS and his work at the CDC.

Keywords: A. Reingold; African Malaria Vaccine Testing Network. Meeting; AIDS; Boston, Massachusetts; botulism; cholera; clinical; community; Diarrheal Diseases Bacterial Branch; disease; Enteric Diseases Branch; field station; global; health centers; HIV; immigrant; infectious; inner-city; international; J. Mann; Kinshasa; laboratory; malaria; methodologies; mosquitos; outbreak; primary care; Project SIDA; public health; R. Ryder; residency; Salmonella; sexually transmitted; Shigella; surveillance

Subjects: Africa; Alaska; CDC; Centers for Disease Control and Prevention (U.S.).; Centers for Disease Control and Prevention (U.S.). Epidemic Intelligence Service; Congo; EIS; Guinea Bissau; Indian Health Services; Mexico; South America; Zaire

15:57 - Early HIV Efforts

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Partial Transcript: You were looking at pediatric HIV if I recall in Zaire. Can you tell us a little about what the scene was like? Were there dying babies, what was the scenario when you were there?

Segment Synopsis: Dr. Shaffer talks about his experience working with the HIV/AIDS effort domestically and internationally.

Keywords: A. Greenberg; antibody; Atlanta, Georgia; baby; blood; breastfeeding; C. Ou; CD4; civil; cohort; disease; domestic; epidemiologist; family; groups; guidelines; health department; HIV-1; HIV-2; incidence; infants; infection; K. De Cock; Kinshasa; laboratory; M. Oxtoby; M. Rogers; malaria; medical; mother-to-child; P. Thomas; PCR; pediatric; pregnant; prevalence; Project SIDA; public health; risk factors; samples; screening; severity; studies; study; transmission; vertical transmission; viral load; women

Subjects: Africa; AIDS; CDC; Congo; Emory University Hospital; Grady Memorial Hospital (Atlanta, Ga.); HIV; Ivory Coast; Malaria; New Jersey; New York; NIH; PEPFAR; Project RETRO-CI; U.S.; U.S. Public Health Service; Zaire

26:57 - HIV Cohort Study

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Partial Transcript: How did CDC and NIH work together during these relatively early years?

Segment Synopsis: Dr. Shaffer describes his continued work with HIV in the United States and Thailand.

Keywords: adventure; AZT; B. Weniger; baby; Bangkok, Thailand; clinical issues; clinical trial; cohort; domestically; drugs; epidemic; epidemiologist; guidelines; infection; interventions; intravenous; M. Oxtoby; mother; pollution; prevalence; public health; relationship; risk; smog; strains; study; subtypes; subway; traffic; transmission; work

Subjects: ACTG-076; AIDS Clinical Trials Group; Asia; CDC; HIV; National Institutes of Health; NIH; Thailand; U.S.

33:38 - Thailand and CDC Study Partnership

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Partial Transcript: So, what were the terms of reference for this assignment, and who was your boss?

Segment Synopsis: Dr. Shaffer introduces his experience of the study and the CDC’s relationship with Thailand.

Keywords: ACTG; ACTG-076; Atlanta; AZT; B. Weniger; Bangkok, Thailand; births; clinical; cohort; counseling; doctors; epidemiology; ethical; FETP; field sites; hospital; laboratory; leaders; ministry; MTCT; natural history; office; PEPFAR; placebo; pregnant; prenatal care; private; protocol; research; results; screening; sector; study; T. Mastro; team; Thai; training; university; upcountry; urban; wards; women

Subjects: Bangkok Children's Hospital; CDC; Côte d'Ivoire; HIV; IRB; Ministry of Health; NGOs; Rajvithi Hospital; Siriraj Hospital, Mahidol University; Thailand; UN

47:20 - Global AIDS Initiative

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Partial Transcript: Can you tell us a little bit about this initiative? This was the beginning of something very large that was coming to you and your colleagues.

Segment Synopsis: Dr. Shaffer discusses the CDC sponsorship and partnership with countries to eliminate HIV.

Keywords: 100; 1999; 500; AIDS; antenatal care; AZT; Bush; Clinton; COP; counseling; countries; Country Operation Plan; curriculum; drugs; focus; funding; global; government; HIV; hospitals; infrastructure; intervention; lab; language; M. Dybul; MCH; MCTC; million; monitoring; mother-to-child; Nevirapine; organizational; PEPFAR; PMTCT; policies; political; politics; practice; President; prevalence; prophylaxis; routine; statement; study; syphilis; T. Creek; testing; Thai; training; transmission; treatment; trials; Washington; women

Subjects: Africa; Botswana; Caribbean; CDC; EIS; Global Fund; HIV; Ivory Coast; Leadership and Investment in Fighting an Epidemic; LIFE Initiative; Ministry of Health; NIH; PEPFAR; Thailand; U.S.; Uganda; United States Agency for International Development; USAID; White House

59:38 - HIV Program Implementation

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Partial Transcript: How was CDC viewed as you were doing the beginning of this initiative?

Segment Synopsis: Dr. Shaffer shares lessons that the CDC learned in the implementation of guidelines and protocols in different countries.

Keywords: AZT; breastfeeding; care; communities; confidentiality; cooperative agreement; cost; counsels; countries; credibility; curriculum; data; deliveries; disclosure; drugs; facility; focus; follow up; funded; guidelines; hospitals; information; infrastructure; intervention; investigator; laboratory; managers; ministry of health; moms; Nevirapine; nurses; obstetricians; office; partners; portable cabins; pregnancy; prevalence; program; public health; research; retraining; risk period; rural; support; T. Kenyon; task-shifting; TBA; testing; theories; Traditional Birth Attendants; training; transmission; turnover; workers; world

Subjects: CDC; Columbia; Côte d'Ivoire; EGPAF Program; HIV; MCH; MTCT Plus Program; NGOs; PEPFAR; SOPs; South Africa; Standard Operating Procedure; WHO; Zimbabwe

75:38 - PEPFAR and Beyond

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Partial Transcript: You mentioned that PEPFAR we know was the interagency, multiagency project and USAID played a big role in PMTCT as well. How did you and CDC people interact with USAID in-country? How did that go?

Segment Synopsis: Dr. Shaffer talks about the impact of PEPFAR and the global challenges of treating HIV.

Keywords: advocates; agencies; AIDS; antiretrovirals; ART; ARVs; baby; breastfeeding; budgets; calls; capacity; CD4; child; clinical; community; cost; country; decentralized; different; drugs; education; Efavirenz; evidence; funding; guidelines; health care; HIV; interagency; interventions; level; local; maternal; Maternal Child Health; money; mother; Mother to Mother Program; Nevirapine; partners; patient; patients; pregnant; research; roles; safety; stigma; superagency; support; TB; treatment; women; workers

Subjects: Africa; Asia; CDC; HRSA; MCH; MTCT; NGO; NIH; PEPFAR; PMTCT; U.S.: South Africa; USAID; WHO

92:57 - Evolution of WHO Guidelines

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Partial Transcript: Can you tell us a little bit about your position there, and what were some of the key advances and changes in guidelines concerning PMTCT?

Segment Synopsis: Dr. Shaffer concludes with remarks on the progression of WHO guidelines and HIV treatment standards.

Keywords: B Plus; benchmarks; CD4; committee; Consolidated Guideline; cost; countries; eradication; evidence; feasibility; framework; funding; Geneva; guidelines; history; HIV; infections; intervention; lifelong; mother; mother-to-child; Path to Elimination; people; placebo; pregnant; prevalence; progress; protocols; safety; studies; tool; transmissions; treatment; viral load; women

Subjects: Asia; CDC; Elimination of mother-to-child Transmission; EMTCT; Global Fund; Malawi; MCTC; PEPFAR; PMTCT; Switerzland; Thailand; WHO