Hutch News Stories

A 'hard sell' for minority health

Counts returns to center with toughest teaching job yet: underscoring importance of public in AIDS vaccine research
Dr. George Counts
"Deep down, I'm a teacher who just happened to like research and take care of sick people," says Dr. George Counts, who has returned to the center to educate the public of the importance of government-sponsored AIDS vaccine research. Photo by Todd McNaught

George Counts watches as an untrained undergraduate student tries to view bac- teria through a microscope. As Counts waits, the student shifts a slide forward and back, searching a bleary haze for the elusive microorganisms.

Suddenly, as the invisible snaps into sharp focus, a look of amazement floods the student's face. Savoring the gratification of teaching, Counts, too, feels his own face light up.

That was 40 years ago. Today, Dr. Counts, a physician and infectious-diseases researcher, reaps the same satisfaction whether he is delivering a community lecture on health-care disparity or mentoring a pre-med undergraduate student.

He's back at Fred Hutchinson after 13 years to tackle what may be his toughest teaching assignment yet - educating a wary public, particularly minorities, of the importance of government-sponsored AIDS vaccine research.

"Deep down, I'm a teacher who just happened to like research and take care of sick people," said Counts, senior adviser on special populations for the HIV Vaccine Trials Network.

"When I finished school, I realized that whatever path my career took, education would always be a part of what I did."

The lessons he will teach have high stakes for the future of public health. It's his job to lead the creation of strategies to ensure maximum participation of traditionally underserved populations in AIDS vaccine trials.

These populations are groups at disproportionate risk for HIV infection that may have encountered historical abuses in medical research.

"It's a hard sell," he said. "We're going out to find uninfected people to agree to participate in a government-sponsored study that will inject them with a vaccine against the virus that causes AIDS.

"For populations that already have grounds for suspicion of government research, such as African-Americans who remember the Tuskegee syphilis study, we'll need to overcome barriers by first building community relationships."

Track record

Counts has an extensive track record in breaking down barriers in health-care disparity.

For the past two years, he served as coordinator for the U.S. Centers for Disease Control's National Plan to Eliminate Syphilis, where he helped to effect a significant reduction in congenital syphilis and among adults, especially in minority populations.

Before that, he established and directed the Office of Research on Minority and Women's Health at the National Institute of Allergy and Infectious Diseases (NIAID), to ensure that the institute's research properly focused on diseases and conditions important to women and minorities. An additional goal was to encourage minority students to pursue careers in biomedical research.

He's already known to many at the center for his expertise in infectious diseases. From 1982 until 1989, Counts directed Fred Hutchinson's clinical microbiology program and laboratory, which served as a diagnostic laboratory and conducted research on the myriad infections that can plague bone-marrow transplant recipients.

Dr. Larry Corey, principal investigator of the HIV Vaccine Trials Network and head of the infectious-diseases program, said he recruited Counts for the advisory position for his unique blend of policy and research background.

"George has a wealth of experience and an international stature, both in the field of infectious diseases as well as in the recruitment and involvement of undeserved populations in clinical research," he said. "His presence and advice are of great necessity for modern clinical-research programs."

Dr. Judith Wassherheit, director of the network and Counts' colleague on the CDC syphilis-eradication project, echoed the praise.

"George brings to the network's community-outreach efforts a wonderful combination of credibility as an extremely knowledgeable professor of medicine, the wisdom of years of working at both local and national levels to improve minority health and the passion of a man who cares very deeply about these issues."

Corey and other leaders of the network, whose mission is to develop and test preventive vaccines at 25 clinical sites around the world, founded the international effort on the premise that community members would be crucial partners in the research effort.

Without them, even the most promising vaccine in the laboratory would have no opportunity to be tested.

While sub-Saharan Africa has been hit hardest by the AIDS pandemic, HIV infection continues to spread in the United States, particularly among disadvantaged African-Americans in the Southeast and along the East Coast.

Like tuberculosis and other sexually transmitted diseases, the spread of HIV infection in the United States is related to social conditions, with educated and affluent groups gaining first access to interventions.

Career choices

These and other examples of health-care disparity have fueled Counts' career choices over the past decade.

In his first position at NIAID, where he directed the office responsible for oversight of national AIDS clinical trials, he became frustrated with inadequate recruitment of women and minorities to research studies, prompting him to establish an office dedicated to addressing these issues.

At the time, Congress had just passed the NIH Revitalization Act of 1993, which mandates the inclusion of women and minorities in human-subjects research.

"That should have solved the problem, but it hasn't," he said. "In the seven fiscal years following passage of the act, there have been only slight increases in minority recruitment to clinical trials."

In addition to his efforts to bridge the health-care divide in AIDS research at the network, where he will work closely with Steven Wakefield, associate director for community relations and education, Counts serves as informal adviser to the center as it expands efforts to increase minority participation in treatment and prevention trials for cancer and other diseases (see related story).

Counts views these activities as part of a larger effort.

"I see this as a much bigger issue than just making sure we comply with NIH requirements," he said. "We should strive to have diverse communities look upon Fred Hutchinson as a world-class resource and partner that has their best interests at heart."

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