Paying tribute to Late Dr. Suniti Solomon on her 78th birth anniversary: A PlexusMD Exclusive

The lady who discovered Indias first case of HIV in 1986 This year, the government of India honored the contribution of Dr. Suniti Solomon the lady who pioneered the research for HIV/AIDS in India with a posthumous Padma Shri.

The lady who discovered India’s first case of HIV in 1986

In the 1980s when the world was putting together pieces of a life-threatening disease, India refused to believe it’s existence in its people. In times like these, one lady microbiologist from Chennai stepped forward to not only discover India’s first case of HIV, but through her findings made the nation sit up and take notice about the impending epidemic. Experts from around the world predicted that India with its menacing mix of poverty, illiteracy and population would face a devastation like no other. But the crisis never came! Thanks to the efforts of Dr. Suniti Solomon.

This year, the government of India honored the contribution of Dr. Suniti Solomon the lady who pioneered the research for HIV/AIDS in India with a posthumous Padma Shri.

As a part of our 'Doctors of India' series, PlexusMD pays homage to Dr. Suniti Solomon for being the torchbearer in the fight against HIV/AIDs till her last breath and salutes her entire team at YRG Care for taking her legacy forward.

We bring to you excerpts from our conversation with Dr. Kumarasamy, Chief Medical Officer at YRG Care:

Three decades ago, Dr. Suniti Solomon woke India up to the HIV threat. Can you take us back to who she was and how it all began?

Dr. Suniti Solomon was a well renowned microbiologist. She studied Medicine at Madras Medical College (MMC) and later trained in Clinical Pathology in the UK, US and Australia. In 1973, she returned to Chennai with her husband Dr. Victor Solomon - a Cardiac Surgeon, and pursued MD in Microbiology, mainly because it included the sub-specialty of immunology and she believed it would prove useful in our battle against infectious diseases.

Post her MD, Dr. Suniti Solomon continued working in the Microbiology Department at MMC as a Professor. This was the time when she realized a dire need to determine the presence of HIV in India, as most international journals were writing about its effects in other countries. Dr. Solomon who read these articles regularly, persuaded one of her Postgraduate students to take this up as her PhD subject.

Her team collected blood samples from ¬100 sex-workers in remand homes. Six samples came back positive for HIV. She also sent the samples to be independently tested at Johns Hopkins University, Baltimore, USA. Hopkins reconfirmed her findings. Dr Solomon had diagnosed India's first HIV Case! Till then, HIV was an issue that was often ducked by the medical fraternity but when the findings were read out in the state assembly, officials were forced to take notice.

Source: YRG Care Foundation

While the government started training camps for medical and paramedical professionals on HIV infection, Dr. Solomon set up India’s first voluntary HIV Testing and Counseling Centre at Madras Medical College. This was a first-of-its kind facility for HIV- specific counseling and testing with no precedents in either the public or the private sector. In 1993, she took voluntary retirement from the government and established the Y.R. Gaitonde Centre for AIDS Research and Education, popularly known today as YRG Care.

Today, since the first documentation in 1986, almost 2.1 million people have been diagnosed with HIV.

YRG Care had a very strong and inspiring mentor in Dr. Suniti Solomon. How did you move past the vacuum that was created and take the vision forward?

She was our Champion Figure. It is true that she left behind a huge vacuum. But, I think the most wonderful thing that she did was that she inspired and created the next cadre of individuals in each department at YRG Care who work towards the same vision as her with an equal passion. We as a team continue to offer the same kind of support to Persons Living with HIV (PLHIV), conduct awareness campaigns in the community and the research like in the past, continues to grow. Today, Dr. Sunil Solomon, her son, heads the organization and along with the entire team at YRG Care, carries Dr. Sunita Solomon’s legacy forward.

Dr. Sunil Suhas Solomon, son of Dr. Suniti Solomon, accepting the posthumous Padma Shri on behalf of his mother in January 2017

You had known Dr. Suniti Solomon for a long time. What was she like?

She was a legend.

I was her student at Madras Medical College and later we worked together as colleagues in research and at YRG Care. She was always full of energy and charm. Her real passion for teaching could be seen in the exceptional teacher that she was, no doubts about that. But, she was also an excellent mentor, a great leader, a wonderful colleague and most importantly, an outstanding doctor to her patients. She was always so kind to them. In fact, her strength came from her bond with her patients. To all those who were reluctant in dealing with HIV lest they get infected, she would often say “..listen to their stories and you wouldn’t say the same thing.”

When it came to her staff, she was always very supportive and encouraging. She believed in science, and encouraged us to do the same. She bravely fought a battle that most were even reluctant to step into, and for that she was a gem of a human being, a true fighter.

Dr. Suniti Solomon with Dr. N. Kumarasamy (CMO, YRG Care) at an International symposium at Chennai

Dr. Solomon established YRG Care in 1993. What are the services that you provide now at YRG care?

This was when YRG Care became the first in India to establish an HIV Care Centre that accepted patients who were cast aside by other hospitals. Located inside a dedicated facility of VHS Hospital Chennai, YRG Care has now become a nucleus for HIV and STI testing, community and educational outreach services, a walk-in clinic for PLHIV or for those with risk factors. Along with these, we also provide a variety of supportive counselling such as pre-test and post-test counselling, couple counselling, family counselling, nutritional support, adherence support, etc.

Every day, approximately 60 to 80 patients come to our out-patient clinic. We also have a specialized infectious disease laboratory to conduct a variety of tests from a simple Haemoglobin test to tests for opportunistic infectious diseases like TB. The facility also includes testing for CD4 cell counts, viral loads, HIV drug-resistance testing and the entire gamut of investigations required for an HIV infected patient. We also have a pharmacy where patients can get medicines for their Anti-Retroviral Therapy (ART).

“It has now become a one-stop shop for people living with HIV and their families. Till now, we have registered more than twenty-two thousand patients for HIV Care at our Centre.”

That’s a big number! From having to go to remand homes to test people, to now having 60-80 patients walking in everyday, how do you think the perception of HIV changed?

In 1986, a diagnosis of HIV meant a death sentence. The minute someone said they were HIV positive, the word which cropped up in most people’s mind was ‘immoral’. Because of this stigma, people would not even come forward for testing. Beyond the basic few prevention methods like the use of condoms, safe sex and abstinence, we too could do very little.

Today the scenario is very different. As per our research at YRG Care, if today people living with HIV start ART early, their viral levels drop and the risk of transmission to partners is negligible. So now, all our campaigns are majorly about spreading awareness about the treatment available. Our focus has changed from talking about prevention methods, to identifying people and putting them on ART.

To fight the HIV stigma, Dr. Solomon would often play the role of a matchmaker for her patients where she would not just match by religion, education and income; but also match by CD4 counts and viral loads. Source: http://lovesickthefilm.com/

“Matching CD4s in people who are HIV+ is like matching stars in the horoscope. In short, you can say CD4 is our astrology.” – Dr. Suniti Solomon

Do you collaborate with the government to address this issue?

Yes, we have a good rapport with the government. We have worked together in many aspects, especially after our research in 1997 - 2003, which showed that ART was effective in reducing morbidity and mortality in PLHIV. This prompted the government to start free ART clinics. Today the government has 400+ such clinics and they have given free treatment to approximately 1.1 million people.

We also work very closely with the National AIDS Control Organization (NACO) in drafting guidelines and in their care and support program. We further engage in scientific advocacy with NACO for any new research findings that can be implemented in India so that those benefits go to the community as well the people living with HIV.

Do you conduct this research at your facility?

We do. We have a research centre called CART i.e. Chennai Antiretroviral Research and Treatment that is funded by the US National Institute of Health (NIH) for a variety of clinical research and trials. We try and understand the HIV disease in India and more importantly, find out what happened to those infected over a period of time. We have further been approved by the Drug Control of India to study Phase I, II, III, and IV clinical trials of various new medications that are coming up.

Together the YRG Team has authored more than 350 papers that have been published in leading medical journals.

Wow! That’s a significant number. Would you like to comment on the scope for research in India?

I think there is plenty of scope for research in India, not just in HIV, but in various disciplines in medicine. We tend to follow western literature when we ourselves have a lot of expertise in the country as well as abundant clinical material and unpublished data.

I believe every doctor should take up some type of research during their time as a doctor. The research doesn’t have to be a Nobel Prize-winning research, but it can be a simple research of documenting their patients, presentations and publications. This can tell us what is happening to our Indian patients over a period of time – common disease patterns, trends, any improvements on the usage of a certain medication over time etc. For instance, documenting common side effects in our patients can help us develop a data on drug toxicities in Indian patients. This is something that most textbooks or international books will not provide. Besides, research is something that helps you acquire more knowledge. It gives you plenty of opportunity to read more and travel more.

“My experience says that it makes you a better doctor, a better person of science, and of course a better individual.” – Dr. Kumarasamy

Any pointers for doctors on how can they tackle HIV in their regular practice?

We often say that it is the stigma that is killing the people, not the disease. If all doctors can scientifically take care of their patients without discriminating and follow the key guidelines, it will be a big help to the people living with HIV and those fighting the stigma. Also, doctors can counsel them to accept ART.

For you, what’s the best part about being a doctor?

I think it’s awesome that I am a medical doctor who is treating patients as well as an avid researcher, because I get to apply a lot of what I research into clinical practice. This way, my patients get some of the best scientific care. It keeps my interest going!

In what capacities can someone get associated with YRG Care?

For people who are seeking services, apart from HIV Care we also take care of people with Hepatitis B and Hepatitis C. We also have a significant number of students and Professors who collaborate with us for research. You can send us your research questions and we’ll try to assist you with the same. For doctors who want to get involved in HIV Care, we have training programs where you may get enrolled and work with us.

At 76, Late Dr. Suniti Solomon lost her life to Cancer in 2015. We at PlexusMD salute Dr. Solomon for giving an endless fight towards the care of HIV patients and for playing a pivotal role in the lives of so many.

'Doctors of India' is an initiative by PlexusMD to bring forth inspiring stories from the medical fraternity.

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