The legacy of BIPAI at 20

Through the Lens, a specially curated photography exhibit and event, was held Sept. 26 to highlight and celebrate 20 years of the Baylor International Pediatric AIDS Initiative at Texas Children’s Hospital. The event showcased the work of BIPAI through the work of Pulitzer Prize-winning photojournalist Smiley N. Pool and allowed guests an immersive look in to the people and places that BIPAI has served.

BIPAI was born in 1996, when Dr. Mark Kline, now chair of pediatrics at Baylor College of Medicine and physician-in-chief at Texas Children’s, spent a week in Romania touring hospitals, clinics and orphanages where he saw children with HIV/AIDS dying in droves at a time when new antiretroviral drugs were revolutionizing treatment of the disease in the Western world.

Read Dr. Kline’s first-hand reflections on BIPAI and the strides that have been made over the last two decades in caring for some of the world’s most vulnerable people. This article originally appeared in the Texas Children’s Blog.

In 1996, I was on a return flight home following a week touring hospitals, clinics and orphanages in Romania. What I had seen on that trip shocked me. Children with HIV/AIDS were dying in droves at a time when new antiretroviral drugs were revolutionizing treatment of the disease in the Western world.

I spent a lot of time thinking through how to address this discrepancy in care and survival. It was on that flight home – scribbling ideas down on a legal pad – that the concept of what would later become the Baylor International Pediatric AIDS Initiative at Texas Children’s began to crystallize.

In 2001 – with initial financial support from Houston’s Sisters of Charity of the Incarnate Word and Abbott Fund, along with drugs donated by Abbott Fund and AmeriCares – the Romania clinic I envisioned became a reality.

As a result of the hard work of many dedicated individuals who worked at this clinic and those from Texas Children’s and Baylor who helped make the clinic a reality, deaths among children in Romania declined from 15% to less than 1% per year, in just two years. Children were living instead of dying. This work offered some of the first proof of concept for providing effective HIV treatment to children in limited-resource settings worldwide.

Not long after we began our work in Romania, Bristol-Myers Squibb Foundation announced its Secure the Future program to support HIV treatment in Africa. BIPAI was one of the first organizations tapped to fight HIV/AIDS in this hardest-hit region of the world. In Botswana, at the epicenter of the AIDS pandemic, former President Festus Mogae declared that his people were “faced with extinction.” Botswana’s Ministry of Health donated a plot of land where we would build Africa’s first-ever standalone pediatric AIDS clinic.

In the first year, our Botswana-Baylor Children’s Clinical Centre of Excellence tested more than 4,000 children for HIV and began more than 1,200 children on lifesaving antiretroviral treatment. Over the next few years, with additional funding from Abbott Fund, Bristol-Myers Squibb Foundation and President Bush’s Emergency Plan for AIDS Relief (PEPFAR), we built a network of centers of excellence throughout sub-Saharan Africa.

This expansion exposed another disparity and challenge – the critical shortage of pediatricians in sub-Saharan Africa. In response, we launched the Pediatric AIDS Corps (now known as the Global Health Corps). The Corps sent more than 200 physicians to Africa over the ensuing years to help expand the care and treatment of HIV-infected children and families and train African health professionals to provide such care. Eventually, the Corps expanded its scope beyond HIV/AIDS to include other diseases and conditions impacting child and maternal health and survival globally such as tuberculosis, malaria, malnutrition, perinatal conditions, cancer, and sickle cell anemia.

We didn’t stop there. In 2014, Chevron approached us with an opportunity to expand the model of care, treatment and capacity building we created to Latin America – first in Colombia and soon after in Argentina – addressing gaps in maternal and child health care in underserved populations. Read more about BIPAI in Latin America.

Now, 20 years after those first children were treated for HIV/AIDS in Romania, BIPAI provides HIV/AIDS treatment to more than 350,000 children, more than any other organization worldwide.

Looking back, I’m grateful to have had the opportunity to work with amazing medical and nursing colleagues from Texas Children’s to impact the lives of some of the world’s poorest and least fortunate children. I’m proud of the centers we created and how they have become beacons of hope for entire communities and focal points for excellence in health care, medical education and research. I hope that over the years ahead we will reinforce our commitment to a global community of healthy children by finding new and better ways to deliver care to children who need us most.

Dr. Mark Kline is a medical specialist in pediatric infectious diseases, HIV/AIDS and global child health and the J.S. Abercrombie Professor and Chair of the Department of Pediatrics at Baylor College of Medicine (BCM) and the Ralph D. Feigin Chair and Physician-in-Chief of Texas Children’s Hospital.