Online catalogue of Peter Piot's archives now available

The archive collection of Professor Baron Peter Piot is now available online on the archive catalogue. The papers held at the School reflect his career in fighting epidemic disease not only through his epidemiological work on the Ebola virus and HIV/AIDS but also his role as Executive-Director of UNAIDS (1995-2008).



Peter Piot 

Baron Professor Peter Karcl Piot, was born on the 17th February 1949 in Louvain, Belgium. He studied medicine at the University of Ghent (achieving his M.D. in 1974) and after graduation moved to the Institute of Tropical Medicine, Antwerp, to work under Dr S. R. Pattyn. In 1976, he and his colleague, Guido van der Groen, were chosen from the School to join the WHO International Commission investigating the then unknown Ebola virus in Zaire (now Democratic Republic of Congo), having been part of the team that had isolated the virus.

In 1980 he received his PhD in microbiology and became Associate Professor of Microbiology and Head of the Division of Microbiology at the Institute. Based in Antwerp, he set up a number of international projects in Africa chiefly looking at the spread of the HIV/AIDS on the continent. In 1983, he helped establish the international project based in Kinshasa, known as Projet SIDA that was the initial source of epidemiological work on HIV/AIDS in Africa. Between 1986-1987 he became an Associate Professor, Department of Medical Microbiology at the University of Nairobi, Kenya.

The following year, he became chair of the Steering Committee on Epidemiology and Surveillance of WHO's Global Programme on AIDS. In 1991 he was elected President of the International AIDS Society and then left his position in Antwerp to move to Geneva to become an Associate Director of the Global Programme on AIDS, World Health Organisation. In 1995, he was elected Executive-Director of  the Joint United Nations Programme on HIV/AIDS (UNAIDS) and served in this position for thirteen years before leaving in 2008 to become Professor of Global Health, Imperial College London. In 2010, he was appointed Director of the London School of Hygiene and Tropical Medicine.


Archives

The papers held at the School reflect his career in fighting disease with fieldwork based on his epidemiological work on the Ebola virus and HIV/AIDS in Kinshasa. Correspondence files from his time as Professor of Microbiology in Antwerp provide an insight on the international network of medical experts working on the AIDS pandemic in the 1980's with conference papers on notable meetings such as the first African meeting on AIDS in Bangui, 1985. 

The majority of the papers in the collection relate to his tenure of Executive-Director of UNAIDS. The papers incorporate material relating to the establishment and governance of the organisation and also the working life of the Executive-Director through his speeches; correspondence; conferences; meeting notes; travel documents and also hold a rich source of working papers on significant developments in his tenure such as the South African AIDS epidemic; the formation of the Global Fund against AIDS, Tuberculosis and Malaria and the United State's
President's Emergency Plan for AIDS Relief (PEPFAR). Papers also include collected articles, newspaper articles and reports relating to Piot's career and various topics relating to the global strategy for the prevention of HIV/AIDS.

The collection can be viewed by appointment by contacting the archive service by email at the following address, Archives@lshtm.ac.uk.

World AIDS Day Events at LSHTM Archives

For this year's World AIDS Day the London School of Hygiene and Tropical Medicine archives will be hosting two events on the 2nd December 2013.

World AIDS Day: Global Visions

Monday 2^rd December, 6pm-7pm, Manson Lecture Theatre, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT

Evening seminar presenting the HIV/AIDS poster collections held by the London School of Hygiene and Tropical Medicine archive and the Wellcome Library.  The Wellcome Library holds one of the world’s largest digitised AIDS poster collections, with over 3000 posters. The LSHTM archives holds sizable collection of its own along with collected campaign ephemera and collected papers. Through the combined archives we shall explore changing attitudes to the disease and the dramatically contrasting cultural attitudes to sex from across the globe.

This joint event organised by the Wellcome Library and the LSHTM Archive will explore the digital and physical poster series of both collections and explore the key themes and contexts of these poster collections through our speakers, Professor Kay Wellings, Professor of Sexual & Reproductive Health Research at LSHTM and donor of the LSHTM poster collection and Julia Nurse, Content Officer at the Wellcome Library and cataloguer of the Wellcome AIDS poster collection.

This event is free though booking is required. http://www.wellcomecollection.org/whats-on/events/world-aids-day-global-visions.aspx

World AIDS Day: Gems of the HIV/AIDS Collection

Monday 2nd December, 12-2pm, Manson Lecture Foyer, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT

The archives and rare book collections will showcase a display of library and archive material from our extensive HIV/AIDS collections. This includes posters, badges, condoms and other ephemera from the Centre for Sexual and Reproductive Health (CSRH) collection; UK HIV/AIDS campaign material from the AIDS Social History Programme (1988-1994) and the archives of LSHTM Director, Peter Piot, whose archives reflect his the twenty five year experience in combating HIV/AIDS epidemic as both an epidemiologist and then as Executive-Director of UNAIDS, 1996-2008. 

The event is free and open to all. For more information about the World AIDS Day events or the HIV/AIDS archive collection please contact us, archive@lshtm.ac.uk

Selection of ephemera from the Centre for Sexual and Reproductive Health collection

  

Peter Piot and the Ebola outbreak in the Yambuku in 1976

Within the archives of Peter Piot, surrounded by decades of material surrounding HIV/AIDS was a small box file, simply entailed, ‘Ebola’. Within it were papers relating to his work with the International Medical Commission in Zaire (now Democratic Republic of Congo) to investigate an unknown hemorrhagic fever that erupted spontaneously in 1976. The disease infected 318 people, killing 280 people in a two month period. It’s lethalness was only rivalled by that of rabies and spread widespread fear across the region. As a junior member of the Department of Microbiology Department at the Institute of Tropical Medicine, Antwerp, Peter Piot’s life and career was dramatically affected by the emergence of this terrifying epidemic.

Newspaper cutting of the ITM team with Guido van der Groen, Peter Piot and Dr Stefaan Pattyn

The story of Piot’s involvement is comprehensively told in his memoir, No Time to Lose, but his archives convey the scope of his epidemiological work within the Yambuku region. Piot became a member of the International Medical Commission after the he and his colleagues at the ITM had identified a new virus from the blood samples taken from the Flemish nun who had caught the disease. What is truly terrifying about the account is the lack of precautions that were taken with the highly infectious blood from it turning up, semi-thawed in a thermos couriered on a passenger airline to the almost accidental contamination of one of his colleagues when a test tube of the virus smashed onto the floor and covered the shoes of his colleague, Rene Delgadillo. 

Electron microscope image of the Ebola virus

 

 

The alarming reports from Zaire along with the identifying a lethal new virus caused the World Health Organisation to mobilise an International Commission to investigate and contain the outbreak. Members of the ITM were drafted in to go to Kinshasa and Piot was one of them. He was a relative novice at the time and had not been to Africa nor even had a valid passport (having cut out the picture for a squash membership card). However, he leapt at the opportunity to go and reached Kinshasa on October 18th. President Mobutu Sese Seko had ordered the entire Bamba region to be quarantined and there was no information from the region regarding the severity of the epidemic. It was agreed that a small expeditionary team would go in and investigate; Peter Piot volunteered to be on it.

The archives note the epidemiological procedures the expeditionary party took during this period. Using they’re airlifted land rovers to visit local hospital and affected villages the team same came to some preliminary conclusions about the epidemic. Firstly, the peak of the epidemic had already been reached and the team could not identify any new cases; the main source of transmission was hypothesized and later proved to be the Yambuku hospital ran by the Flemish nuns, unwittingly the hospital staff had passed on the infection to a host of people through the re-use of syringes; whilst other cases seemed to be skin to skin transmission especially through preparation of the dead, the initial vector of the disease was not identified.

 

Map of the villages visited in the Yambuku region (1976)

On hearing the news, the international commission departed to the region to carry out more extensive epidemiological search and be certain that the disease was no longer a threat. Despite killing 88% of its victims the disease magnitude was deceased thanks to village elders imposing their own cordon sanitaire measures to prevent the spread of disease to surrounding areas and local people realising that the hospitals were the major source of the infection.

The experience with the Ebola virus had quite a transformative effect on Peter Piot’s life. Along with being grateful to being alive, he felt vindicated in his decision to pursue epidemic disease and eager to advance in his profession and shortly afterwards moved to America.

Cataloguing the paper of Dr Peter Piot: the archives of Projet SIDA (1983-1992)

Having finished repackaging the archives of Peter Piot for the past couple of weeks I have been cataloguing this collection. Cataloguing often requires a degree of familiarity with the contents in order to make accurate and informed descriptions and therefore it necessitates background reading of the subject or individual. Fortunately, for this collection I have the interesting and compelling account by the man himself in the form of his memoir, No Time to Lose (2012). The chapters that really stick out are his fieldwork in Africa on both the Ebola Virus and HIV/AIDS as they resonate the thrill and the horror of studying a new infectious disease in the middle of an epidemic. The archives mirrors the book with significant holdings on both diseases. In this post, I would like to concentrate on Projet SIDA, the Zairean-American-Belgium AIDS research project that ran from 1984 to 1992. 

 

Clinical definition of AIDS (c.1983)

In No Time To Lose, Peter Piot recalled how a number of the patients he attended at the Institute of Tropical Medicine, Antwerp exhibited AIDS-like symptom. The significance at the time was these patients were not the previously identified risk groups (the virus had only recently been named as acquired immunodeficiency syndrome was coined, the virus was previously known as the '4 H' virus after the confirmed communities affected: homosexuals, heroin users, hemophiliacs and Haitans) but all had ties or had spent time in Zaire. He knew he needed to go to the country to find out what was going on and was fortunate to encounter two US epidemiologists with the same assessment. Dr Tom Quinn and Dr Richard Krause, of the U.S National Institute of Health (NIH), they had both noticed the link with Zaire when investigating the AIDS outbreak in Haiti and in a cafe in Geneva, the three agreed to launch an investigation in the country. They were joined by Joseph McCormick, of the U.S. Centre for Disease Control (CDC) and arrived in Kinshasa, then Zaire in October 1983. 

When they arrived in Memo Yamba Hospital the epidemic was worse than they could imagine. Piot noted that the team saw fifty people alone on the first morning with AIDS symptoms which was a huge number for 1983 with only 2000 reported cases, many of them retrospectively. The team began to collect and examine blood samples from the patients and sent the samples to the team headed by Professor Luc Montagnier of the Pasteur Institute in Paris.The results of the tests confirmed the presence of AIDS with 97% positive results from the original sample. With this information the team and the other epidemiological and clinical information gathered the team produced an article that was published in the Lancet in 14th July 1984 confirming the first heterosexual HIV/AIDS cases in Africa. 

Manuscript note by Dr Piot relating to the LAV test results of Dr Montagnier for patients from the Memo Yamba Hospital

On the back of this preliminary investigation, it was decided that a major international project should be launched that would be known as Projet SIDA. The US health agencies, CDC and NIH provided the bulk of the funding with the third partner being the ITM, led by Piot. The project began in 1984 with it's first director being Dr Jonathan Mann, who would later become the Director of the World Health Organisation's Global Programme on AIDS, the precursor to UNAIDS. In it's time Projet SIDA employed over three hundred people, a number of them being Zairean doctors and hospital staff who former director, Dr Robin Ryder, described as the 'backbone' of the project. The project produced over 120 publications over the course of it's duration and was cited in thousand abstracts. It ended in 1992 as both the Belgium and US governments withdrew it's nationals in the face of the escalating nature of the Ugandan civil war. 



The archive of Projet SIDA provides a glimpse of the clinical work of the ITM during the breadth of the project. This includes material collected from the preliminary study in 1983 and later reports, blank medical questionnaires and project documentation along with numerous correspondence between Piot and project staff members and project partners, notably the former directors such as Jonathan Mann, Dr Robin Ryder and Dr William Heyward. 



To read more about the project there is an excellent article, by Joe Cohen, entitled, 'The Rise and Fall of Projet SIDA', published in Science is available online (and where a number of my references are from) at the following: http://www.sciencemag.org/content/278/5343/1565.full