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nTÍTTTOTíTI news
he way to really stop the spread
of HIV is to shut the ham door.
And the way to do that is with
a vaccine,” says Margaret John-
ston, who admits that seems
like an obvious conclusion for a research immu­
nologist to reach.
Yet it didn’t completely hit home until John­
ston looked beyond U .S. borders to a world
where HIV affects more than 30 million peo­
ple— a number that grows each day.
Her epiphany eventually led her to become
head of the U .S. effort to develop a vaccine
against HIV. Johnston is assistant director for
A ID S vaccines at the National Institute of
Allergies and Infectious Diseases. The programs
she oversees stretch far beyond the National
Institutes of Health to research laboratories
across the country and into the far comers of
Asia and Africa.
J
ohnston’s office is bigger than most, but there
is no mahogany desk, just a standard worksta­
tion and a circular meeting table that would
be at home in a breakfast nook.
She is dressed casually in a charcoal-colored
blouse and purple slacks. A t 48 she still has the
powerful, compact physique of a soccer player.
Her voice is warm, friendly and self-confident.
Johnston says that while growing up she
always felt she was different— just like so many
gay kids.
“But it took a long time to really associate
the word homosexual or lesbian with those feel­
ings,” she explains, adding that she came to
accept her sexual orientation in her 20s and
shared her realization with her family.
Meanwhile, there weren’t many professional
women as role models for bright young girls
growing up in the early 1960s, especially in the
Rust Belt decay that surrounded Pittsburgh.
Nonetheless, Johnston’s aspiration of becom­
ing a gym teacher changed in the ninth grade
when a guidance counselor noted: “You’re too
smart for that. You should go into science.”
Johnston took it to heart, eventually study­
ing at Camegie-Mellon University and Tufts
University, where she received a doctorate.
i s
1AKING THE
I n it ia t iv e
Researcher Margaret Johnston—
formerly with the International
AIDS Vaccine Initiative— is leading
the U.S. effort to vanquish HIV
by B o b R oeh r
Next she went to the NIH for post-doctoral
work. A t each step along the way, she was
encouraged by mentors who shared their love of
biochemistry.
Johnston focused on interferon, a key pro­
tein that cells produce when exposed to a virus.
She had her own lab and an established career
at the Uniformed Services University of the
Health Sciences, the U .S. military’s crown jewel
of research and training that sits across the street
from NIH.
And then A ID S hit. In 1986 Johnston
decided to join 22 people in what was then
called the A ID S program at the National Insti­
tutes of Health. She closed down her own lab,
leaving daily bench work behind to become a
scientist and administrator.
The first paper she wrote at the National
Institute of Allergies and Infectious Diseases
pushed for development of protease inhibitors
and combination therapy.
Johnston kept getting promoted in the rapid­
ly expanding A ID S program, ultimately becom­
ing its deputy director. But after a decade she
was ready for a new challenge, which came in
the form of the International A ID S Vaccine Ini­
tiative and her epiphany concerning vaccines.
In 1996, Johnston became I AVI’s scientific
director (and its first employee).
“I had seen the influence that people outside
of government could have on the government,”
Johnston says. “Nobody was paying attention to
vaccines.”
So she set out to change the situation. Much
of her time was spent outside the United States
trying to increase awareness of and advocacy for
a vaccine “from the people who most need it,
those in developing countries," she explains.
Adds Johnston: “ ‘Silence equals death’ is just
as applicable overseas as it is here. The leader of
a country has got to admit there is a problem
and be willing to do something about it, or else
nothing will happen. That is what leadership is
all about.”
Nearly three years with IAVI has taught
Johnston the political, ethical and logistical
complexities associated with international
research.
“It can’t be anything other than a full part­
nership (with the developing countries) or it just
won’t work,” she says.
She’s also come to appreciate that a certain
amount of chaos allows creativity to flourish.
“ If everything is in a box and everything is
too much rules and regulations, people will do
the rules and regulations,” she says. “But they
won’t think about what they are doing. They
won’t be creative or innovative. You need a cer­
tain amount of chaos to do that.”
A t IAVI, Johnston says, “I was the one trying
to put the box around the chaos. I realized after
a while that for me it’s a lot more fun to be in the
box and to be pushing, knocking the walls
down.”
Johnston returned to the walls of N IAID in
1998, in part because she had “gotten a little too
far away from the science.”
‘*T p rev en tio n is undervalued in our society,”
I she says. “We need to find a way to give
value to preventing something from happen-
_ »1
mg.
Johnston admits that developing a preven­
tive vaccine for A ID S poses a greater challenge
than with most diseases. A main reason is that
few people have recovered from AIDS, so
researchers don’t have a good handle on what
parts of the immune system need to be stimulat­
ed with a vaccine to bring about protection.
“We have some intellectual guesses about
what it might take, but we don’t know,” she says.
A few commercial sex workers and spouses
have been repeatedly exposed to HIV and either
have not become infected, or their bodies seem
to be holding the virus in check. Thus Johnston
believes there are answers to be found, and HIV
vaccine trials underway in the United States
and abroad will perhaps shed light on the mat­
ter.
Johnston cautions that a “successful" vaccine
may look very different from what the industri­
alized world has come to expect— i.e., virtually
100 percent protection from infection with little
risk.
Instead, a vaccine that works only half the
time may be useful in helping to reduce the
spread of HIV in places with very high rates of
infection, such as southern Africa.
Though it may take a while, Johnston is opti­
mistic an A ID S vaccine will be developed.
“We have more bright people thinking about
it now than we did two to three years ago,” she
says.
■ B ob ROEHR is a free-lance reporter based m
Washington, D .C .
i |jii m.
John
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