User:Lf266/Roy Mugerwa

Roy D. Mugerwa (January 2, 1942 – April 19, 2019) was a Ugandan physician, cardiologist and researcher. His legacy in the world of academics include being a Professor Emeritus at Makerere University College of Health Sciences in Kampala, contributing to the development of cardiology in Uganda, researching HIV/AIDS and tuberculosis, and his efforts to find an effective HIV vaccine, such as conducting the first clinical trial in Africa.

Background and education
Dr. Mugerwa was born on January 2, 1942 to Yowana Ziryawula and Maria Namatovu. He pursued his education at St. Mary's College Kisubi for both the O-Level and A-Level and was at the top of his class for all six years. Upon graduation, he admitted to Makerere University, Uganda's oldest and largest public university, and completed both undergraduate and masters programs. He received training in medicine and cardiology at Mulago Hospital and also pursued higher level instruction in the United States, United Kingdom, and the Netherlands. Despite having the opportunity to establish himself as an academic abroad, he returned to Uganda and developed a career in Kampala, serving as faculty at both Mulago Hospital and Makerere University.

Career
Dr. Mugerwa's initial specialization was cardiology, and this is what he pursued in the early stages of his career. By 1972, he was one of the first five research fellows to be trained at Mulago Cardiac Clinic, which is the precursor of the present-day Uganda Heart Institute (UHI). Not only did Dr. Mugerwa have a significant role in founding UHI, but he also served as both Executive Director and Director. Among his other contributions to the world of cardiac health in Uganda are introducing the practice of echocardiography, founding the country's first hypertension clinic, and establishing the Uganda Heart Association.

His career would take a turn away from cardiology during the 1980s after the discovery of the presence of HIV/AIDS in Uganda. When scientist Wilson Carswell first confirmed there were HIV positive patients in Mulago Hospital in 1984, Dr. Mugerwa was part of a team that joined him as they went Masaka and Rakai and ascertained that the virus had spread there too. They published their findings in 1985, believing these Ugandans suffered from a manifestation of AIDS called Slim Disease, although it would later be known that they truly were dying of AIDS. In October 1985, shortly after their Slim Disease publication, Dr. Mugerwa attended a Workshop on AIDS in Central Africa, which was put on by the World Health Organization (WHO). The workshop discussed the establishment of an AIDS Surveillance System in every African country, which would be charged with confirming the presence of AIDS and collecting data. Dr. Mugerwa, along with two other colleagues, was appointed to Uganda's AIDS Surveillance Sub-Committee as recommended by the WHO, and by 1986 they had succeeded in implementing public health efforts such as educational programs, supplying condoms, and screening potentially infected blood donors. They also emphasized mutual monogamy, openly disclosing one's status, and increasing the number of available HIV tests.

While HIV/AIDS continued to spread in Uganda throughout the 1980s, Dr. Mugerwa was the Director of Medicine at Mulago Hospital, which had a large number of AIDS patients - the patient prevalence reaching 40% during 1988. During this time, he struggled with the challenge of deciding to tell patients they were dying of AIDS as well as the stigma and shame surrounding the disease. Furthering his career outside the realm of hospital work, he was one of the founding members of the Uganda-Case Western Reserve University Research Collaboration and held the position of lead principal investigator for twenty years. The main focus of this collaboration was HIV/AIDS and coinfection of tuberculosis in HIV-positive individuals, and this was conducted mainly through clinical studies, providing care to patients, and investigating treatment and prevention methods. Founded in 1988, the collaboration continues to this day. At its 20th anniversary celebration, it was stated that the collaboration had provided over fifty Ugandans with upper level degrees, published over two-hundred articles in peer-reviewed journals, and presented at over five-hundred conferences. Dr. Mugerwa was also a member of the Academic Alliance for AIDS Care and Prevention in Africa. Established in 2001, the Alliance succeeded in providing treatment to patients with HIV/AIDS, training medical providers about HIV/AIDS care, installing programs to increase outreach and prevention efforts, and providing comprehensive lab resources. The Infectious Disease Institute at Makerere University broke ground in 2003 to help carry out these efforts.

Around this time, suspicions that questioned if HIV truly causes AIDS were circulating, and these were supported by South Africa's president Thabo Mbeki quite vocally. In 2000, over five-thousand scientists signed the Durban Declaration, a document in direct opposition to these denialist claims that aimed to unequivocally state that HIV leads to AIDS as proven by multiple studies. Dr. Mugerwa demonstrated his support for the Durban Declaration's stance by being on its Organizing Committee.

Dr. Mugerwa was also involved in the search for an HIV vaccine, and one way he contributed to this was conducting the first clinical trial of an HIV vaccine in Africa. The prospect of testing a vaccine in Uganda, however, was not without controversy. There were fears concerning the vaccine's scientific merit, vaccine recipients falsely testing positive for HIV, and the use of Ugandans as guinea pigs for risky experiments that would only benefit the West. It wasn't until Dr. Mugerwa and his colleagues obtained approval from various governmental agencies could they overcome these barriers and begin to find volunteers. There were concerns about the safety of the volunteers that were eventually recruited, but the normal ethics requirements were waived due to the need for a vaccine as quickly as possible. Uganda had an HIV prevalence of around 20% in 1998, and most citizens could not afford the life-saving antiretrovirals needed to prevent the development of AIDS. Spanning from 1999 to 2002, the vaccine (named ALVAC 205) was tested on forty HIV-negative Ugandans, but was stopped in phase I after newer vaccines started to receive more attention. While the trial was not carried out to completion, there were still encouraging findings from it. There was doubt about whether the different subtypes of HIV would need different vaccines, but volunteers that received the ALVAC 205 vaccine (designed to fight subtype B) produced blood samples that showed resistance to subtypes A and D as well. This demonstrated that a single HIV vaccine could potentially be effective against every HIV subtype, and Dr. Mugerwa described this as a landmark achievement.

Personal life
Dr. Mugerwa was married to Rosemary Kibulo Mugerwa, a physical therapist, and they had eleven children together. Many of them followed their parents' example and also pursued careers in the medical field. Outside of his profession, Dr. Mugerwa was both a businessman and a farmer. His wife preceded him in death in November 2018.

Death
Dr. Mugerwa died on April 19, 2019 at Nakasero Hospital in Kampala. At the time of his death, he was a Professor Emeritus at Makerere University, where he had also gone to school and conducted research programs. He was said to be suffering from depression, which led to an onset of other illnesses. He was buried on April 27, 2019 at Meru Village in Southwestern Uganda.