Photo by Robert Hood / Fred Hutch
Many paths led Dr. Jim Kublin to where he is today: executive director of the HIV Vaccine Trials Network (HVTN), based at Fred Hutchinson Cancer Research Center. A good place to start is the 16 days he spent struggling to finish the 1,000-mile Yukon Quest sled-dog race — the lesser known and more demanding cousin to Alaska’s Iditarod.
“You talk about the long haul, and the incredible patience that’s required to really see it through to the finish, and the perseverance,” he said recently. Kublin was recalling the 1992 race from Fairbanks, Alaska, to Whitehorse, Yukon, when he was 30 years old. But he could have been talking about leading the world’s largest clinical trials network in the marathon quest to develop and test an HIV vaccine.
Kublin grew up in a Michigan mining town. The son of an ophthalmologist, he found work and role models in the town’s iron-ore mine warehouse and foundry during high school. “I was surrounded by people who hadn’t had a lot of advantages growing up,” he said. “It just gave me an appreciation of the struggles that many people experience in this country."
After two years at Georgetown University in Washington, D.C., he dropped out to work in Nicaragua on a malaria-eradication campaign — only to come down with the disease himself.
“That’s when I first learned about malaria,” he said, “and became fascinated by just the elegance and biology of this parasite’s life cycle.”
It became a lifelong love affair. In addition to his work heading the HVTN, today Kublin is medical director of the Malaria Clinical Trials Center at Seattle Biomed.
Nicaragua proved a turning point. Kublin returned to Georgetown to focus on biology and pre-med and went from uninspired student to the dean’s list. He was in his first year of medical school at Georgetown in 1984, the year HIV was found to cause AIDS.
Photo courtesy of Kari René Hall
From malaria to HIV
Kublin’s internship at New York’s St. Vincent’s Hospital in 1988 put him in the AIDS epidemic’s West Village epicenter. The hospital was filled to capacity, with gurneys in hallways.
But even that did not prepare him for sub-Saharan Africa. He and his wife, Zara, and their young sons, Gus and Henno, moved to Malawi in 1998, where he ran a research program and worked as scientific coordinator for a malaria initiative. He found whole villages decimated by HIV, with no one left but elders and orphans.
Antiretroviral treatment, by now resurrecting patients from near death in developed countries, was not yet available in Africa. So Kublin started doing what other U.S. and European workers were doing — getting colleagues back home to send expired but still usable drugs. Then came wrenching decisions on who should get his tiny stash of pills. The drugs were no match for the immensity of HIV in Malawi. The hospital morgue overflowed daily.
Like Nicaragua, Malawi was transformative for Kublin. Having come to work on malaria, he left with a passion to help find an HIV vaccine.
Staying the course on the road to a vaccine
In 2004, after a three-year stint working on an HIV vaccine at Merck Research Labs, Kublin was lured by Dr. Larry Corey, a world-renowned virologist and now Fred Hutch’s president and director, to coordinate operations across the HVTN.
The HVTN conducts all phases of clinical trials, from evaluating experimental vaccines for safety and the ability to stimulate immune responses to testing vaccine efficacy. A model for collaborative global research, its trial units are located at research institutions in more than 30 cities on five continents.
The road to an HIV vaccine has proved challenging. One of the deepest disappointments came in 2007, just before Kublin took over as executive director. A major trial had to be halted when it was found that the vaccine neither prevented HIV infection nor reduced the amount of virus in the blood among vaccine recipients who became infected with HIV. In some cases, it could make the recipient more susceptible to the virus.
Kublin was devastated. When he told his children what had happened, his then 9-year-old-son, Gus, after a pause, replied, “But you’re not going to give up, are you? It’s too important.”
The next day, Kublin called the team together and told them what Gus had said.
“He conveyed that to us to keep us going,” said Niles Eaton, HVTN director of site operations. “We needed to hear that.”
Photo courtesy of Andy Gregg
For his 50th birthday three years ago, Kublin’s colleagues made a word cloud of phrases used to describe him. Renaissance man topped the list, though “brilliant” and “approachable”— traits not always seen together — were not far behind. So was “steady leadership.”
“In science, an experiment doesn’t fail, it informs us. He reminds us of that,” said HVTN project manager Sue Ferguson, Kublin’s assistant. “There have been rough waters, but he’s a phenomenal leader. He gives you so much room to bring your best every day.”
Last October, the HVTN opened a state-of-the-art laboratory in South Africa, which has the highest rates of HIV/AIDS in the world. Next year the network will launch a series of clinical trials there. One will test a modified version of a vaccine that prevented about 32 percent of new infections in a six-year trial involving more than 16,000 adult volunteers in Thailand. The study, published in 2009, was the first to show that a safe and effective HIV vaccine is possible.
A vaccine may be the prize at the end of the marathon, but the man described as driven to make a difference savors interim victories as well. The huge effort that goes into setting up trials provides humanitarian benefits that often go unrecognized.
“Large trials require formidable infrastructure and training and raise standards of clinical care — a lasting resource,” he said.
Write to Mary Engel at firstname.lastname@example.org.