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Face to Face with Professor Nigel Rollins
Republished courtesy of Public Affairs and Corporate Communications, University of KwaZulu-Natal
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Professor Nigel Rollins believes that the value of good nutrition should not be lost in the fray over antiretroviral drugs
When Professor Nigel Rollins packed his bags in Belfast and jetted to Durban in 1994, little did he realise that he would end up at the coal face of the struggle against HIV/AIDS in KwaZulu-Natal.
Eleven years later his intensive work on breastfeeding and HIV transmission is set to bear fruit. Later this year the rural project he has been involved with since 1998 will release the findings of a seven-year study that will provide crucial new guidelines on this subject.
It was a meeting with a prominent Paediatrics professor and HIV/AIDS research specialist that pointed Rollins in his current direction. Professor Hoosen ?“Jerry?” Coovadia was on hand to welcome Rollins to Durban with a traditional dinner of Indian cuisine and gave him a cogent overview of the dynamics of the virus in KwaZulu-Natal. Almost 1,2 million South African children are infected with HIV/AIDS. At UKZN?’s Nelson R Mandela School of Medicine, Coovadia has spent years raising the public profile and awareness of mother-to-child transmission through breastfeeding. Rollins got onto a good footing in the Department of Paediatrics, working closely alongside Coovadia. Their work took them to some of the impoverished rural belts of the province and provided a face-to-face encounter with the scourge if HIV/AIDS.
Rollins was appointed principal medical officer at King Edward VIII Hospital?’s Nutrition and Diarrhea Unit. Four years later he was handed the project leadership of the Vertical Transmission Study at the Africa Centre for Health and Population Studies until 2002. later he returned as senior lecturer and was appointed associate professor and then Head of Maternal and Child Health at UKZN?’s Medical School.
At the World Health Organisation (WHO)?’s first international consultation on nutrition and HIV in Durban earlier this year, Rollins was appointed Chairperson of the WHO Technical Advisory Group on Nutrition and HIV/AIDS.
The controversy in South Africa surrounding the most appropriate treatment for AIDS (the ?‘antiretroviral vs good nutrition?’ argument) has made scientists wary of tackling the question of AIDS and nutrition.
A father of four, Rollins knows the value of good nutrition for growing children. He also believes strongly that good nutrition can help to fight HIV/AIDS, particularly children infected with the virus, but is not a substitute for ARV?’s.
?“Relatively few research studies have been conducted to learn the positive, negative or no benefit that nutritional interventions such as food supplements or vitamins might have. General guidelines exist that are based on what is known about the effects of malnutrition in other conditions, but not what is known in people with HIV
?“Claims for various nutritional products and immune boosters have proliferated in this vacuum of information. Mothers, fathers brothers and sisters are investing hope and money they do not have on claims that vitamins and supplements alone will cure their disease?”
His regular ward rounds at King Edward VIII?’s Hospital indelible memories. ?“When I go to work I get angry to see these children repeatedly coming through the door. It?’s offensive and diabolical to see them suffer the way they do. But when they do keep coming, then we, individually and collectively, need to use everything we have, muster every ounce of knowledge and influence at our disposal to make that difference.
Rollins recalls an experience with students at the hospitals paediatric outpatients department: ?“A two year old child was lying in bed, emaciated and with diarrhea for three weeks. The mother was also there, looking at the wall, disconnected, seemingly dispassionate about the child she had given birth to.
A medical student presented the child?’s history of diarrhea and described her findings: ?‘the child is very neglected.?’ But the student didn?’t see the mother?’s fear. This story is repeated over and over again at clinics and hospitals.?”
Rollins is also linked to the United Nations UNICEF programme on micro-nutrients in maternal and child health. Following the Durban Consultation, he joined an influential international group of 30 experts with research expertise in micronutrients at the UNICEF Innocenti Research Centre in Florence, Italy.
?“The WHO Consultation and the Florence meeting made me realise that it is absolutely essential for people working in South Africa and the Southern African Development Community to bring insights and experience to discussions that can be otherwise academic and detached from some of the realities. These recent interactions have confirmed my choice to be part of the research, clinical work and advocacy that is integral to academic life at UKZN.
?“Everybody talks about nutrition as being important and is still often seen as a slightly soft area of work within medicine. The WHO Consultation has elevated nutrition from just being an optional extra to being central and part of mainstream care.
?“The connection between HIV-AIDS and Nutrition has been obvious for years. Good nutrition does not kill the virus, but where there is chronic malnutrition and poverty, you will never achieve the optimal benefit of interventions like antiretroviral drugs (ARVs) unless you ensure that adults and children are getting adequate and good quality food. Anti-retroviral drugs certainly help, but food and good nutrition can also make a difference that should not be lost in the fray. The challenge is how to deliver this in an effective and equitable way where the health system is struggling itself and where other people without HIV infection are also poor and hungry.?”
In his advocacy work, Rollins, lends his voice to Treatment Action Campaign, a powerful NGO lobby battling government to provide free ARVs. |
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