Twenty-four hours in India

By Myron S. Cohen, MD

India—nearly one-fifth of the world’s population lives in this sprawling and complicated country. While I have traveled to most parts of the world in my career, I made my first trip to India in January 2012 to fulfill a promise.

The HPTN 052 study team in Chennai, India

More than a decade ago I had the idea for a massive, multinational clinical trial to prove that treating HIV infection prevents transmission. As I started planning the study, known as HPTN 052, I knew that we should have a study site in India. I recruited the passionate Suniti Solomon and her young colleague Kumar Kumarasamy, who had just established a new AIDS research center in Chennai, India, as partners.

All these years later our hypothesis was not only proven, but was also declared the 2011 “Breakthrough of the Year” by Science magazine. In the very beginning, I promised Dr. Solomon that I would visit India when the study reached a conclusion. It is because of this promise that I found myself in the city of Chennai, in the state of Tamal Jadju, on the east coast of India.

I was in India for just one day, and this brief report is but a sketch of my impressions from that experience.

Chennai is full of people out on the bustling streets at all times of the day and night. Cars are everywhere and operate under no obvious rules. Sudden U-turns are the preferred method of changing direction. I suspect the number one concern of my hosts was to prevent me from being run over.

Most of my time was spent at YRG Care, the research center established by Dr. Solomon and Dr. Kumarasamy. What began in 1993 as a single place for HIV care has developed into a multi-center organization with a comprehensive response to the HIV/AIDS epidemic featuring: prevention initiatives; laboratory services; medical care and support programs, including a labor and delivery room for pregnant women with HIV infection and their babies.

On the surface, YRG Care is no different than so many other sites in the HPTN 052 study network. But two experiences clearly emphasized the differences.

First, was lunch. My one lunch in India was a delicious tray of rice, lentils and curry that had been prepared off-site by the YRG Kitchen. That’s right, I said the YRG Kitchen. In partnership with a large Indian food company, the entrepreneurs at YRG have started a business to make these meals at cost. The center’s HIV patients sell the lunches to businesses and out of carts on the street. India’s indomitable entrepreneurial spirit—a notion that dominates discussions at every business school in America—was on full display here, even in an AIDS research and care organization.

A second notable experience came on the night of my departure. By happenstance, I was able to attend an event in honor of Dr. Solomon and her work. Held at a beautiful hotel in Chennai, the celebration included donors, colleagues and friends. Her grammar school teacher, surely well into his 90s, was there and even gave a speech! Full of affection and reference, everyone called Dr. Solomon either “Madame,” if a colleague, or “Auntie,” if a friend or student. I feel that I truly got to see what respect looks like in India.

And at the end of the party, I left to catch my 2:00 a.m. flight, and the roads were still crowded and the airport was packed.

Most months, Dr. Cohen writes a “Global Health Update” column for the UNC Global Newsletter. We reprint the item here.

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