[MUSIC] The truth is some time after I started graduate school, so not when I started grad school. I think grad school was more exploratory for me. It was sort of like am I going to enjoy this? I don't know, I did some research in undergrad that honestly I was not in love with. But when I got to grad school, I was very lucky. I started in a lab right around the time that HIV was discovered. So I was starting my PhD in 1984. And so that turned out to be a very exciting time to be involved with a completely new virus that people knew very little about. And so that opportunity was really life changing, as the phrase goes. The mission of the CFAR, that's the Center for AIDS Research, it's one of 18 centers of its kind in the country, so relatively small group of these centers nationally. And it really reflects the high quality of AIDS research that we have here at the University of Rochester. And so the goal of that is really to better support those researchers and add to that group of people. So the idea that NIH is very interested in is sort of how do we bring in people who don't already work on HIV and maybe interest them in something that relates to the work they do? So, for example, people in cardiovascular research. That's a very relevant area because people with HIV have a much elevated incidence of cardiovascular related disease that Is not well understood. And it's not necessarily related to the medications they're taking but more to inflammatory effects of the viral infection in the first place. Another example would be people in the field of aging. If you look at population of HIV infected individuals in the U.S. right now, they're of course aging because the antiretroviral meds have really been an absolute literal life saver for hundreds of thousands of people in this country. So they've really transformed the disease in the US. And really, in fact, in most, much of the world, not everywhere, but a surprisingly large part of the world. And they've transformed that then into a chronic disease that is manageable. But with that come diseases associated with aging, and they're superimposed on individuals who suffer from at least some level of chronic inflammatory state, we think, that accelerates the ageing process in some regards. So that, again, is another very relevant area where people are already working on ageing, but getting them interested in HIV. It becomes a very important issue in terms of increasing the quality of care over time. And earlier than that, understanding the sort of underlying biology and the underling nature of what's actually going on in the disease. Again, with HIV, it was that chance to be really on the ground floor of something new so that there's a lot of complicated reasons why HIV was compelling to me. So there's the scientist part, right? And that's sort of like this is a complete black box. And that's very unusual. Right now, Zika is a little bit of a black box. Not to the same degree that HIV was, I think. So there was a piece of that that was just intrinsically appealing to any scientist. There's a piece of the sort of societal value, that HIV remains a very stigmatized condition. And back in the early '80s it was even more stigmatized, a lot more stigmatized than it is now. And so there was a sense of sort of being Being in that line of work almost felt like it was connected to social justice in some sense, and that was important to me. Then sort of looking at creating a center to focus on AIDS research here at the U of R, there's a couple of reasons for that. One was the idea that you sort of want to bring people together. So one of the things that's really worked well has been to bring people together across the campus and to bring people together from clinical and basics. So it's really built some very effective relationships between our basic scientists and our clinical scientists. And that would not have happened without the CFAR. It's brought new people into the field who weren't working on HIV before. And so those things have really been enormous positives. I think for myself, many years ago when I was a junior faculty member, I was very interested in studying a CFAR and I went to talk to the high ups at the time. Not the Dean, but people who were high up in our infectious disease division. And they were clearly not interested in doing this at the time. And I remember feeling very frustrated about that. And so, when things changed later and I found myself more in the position where I could make this sort of thing happen, I didn't want to lose the opportunity to do it. So that's a piece of it too. It's sort of like there's an opportunity to be able to bring people together in this way. And I would say that the other piece has been that it's actually been, it's a surprising amount of fun to bring people together. You sort of think about new projects, you think about what it is we want to maybe do that we couldn't otherwise do. And so, for example, we have a project with Martin Zand right now that really is trying to apply data science to improve the quality of care for people living with HIV. But approaching that initially as a research question and really getting into that space. We don't have anybody really applying data science to HIV in that regard in clinical care or related aspects. And so that's something that we can do with the CFAR that we couldn't do otherwise. We have another project right not that's, I would never have imagined taking on. We have an artist in residence. So she's going to be working for six months with the CFAR actually creating portraits of people, and getting those out in the community, really engaging with the community, and engaging even with the community across the campus here with some of the groups over on river campus with psychiatry, with medical humanities. So a whole range of groups coming together that, again, we would never have thought of doing had we not had the CFAR and the ability to sort of draw things together. At some level, I guess I see it as obviously work that falls somewhere in that interface between basic and clinical. And so it can be work that really may be basic in nature, but is very much has as its end goal doing something of clinical relevance. So, for example, if you were developing a new drug for some aspect of HIV related illness, and a couple of our faculty are actually doing that. Then the early stage of that work might be basic science. You might be unraveling the pathways that are relevant to pathogenesis or relevant to some underlying condition. Once you've identified the pathway, then intervening in that pathway, developing a small molecule inhibitor or some other approach. That, to me, is a transitional space because you've moved past the basic science. You understand the mechanism involved. Now you're trying to target the mechanism and figure out can you manipulate that? And if you can, can you develop something with therapeutic potential? And then you sort of move over into the clinical space once you do have something that is able to be clinically evaluated. But there's a whole lot of things that are either in a translational or a pre-clinical space. For example, if you're going to do drug development, you have to do a lot of preclinical safety tox testing. That's certainly not basic science. It's somewhere in a translational space. It's not clinical because it's on the path to get to clinical, but it's a do not pass go. So you have to do the safety tox testing, you have to get an IND. And you, in fact, there's also another piece in there that you, if you're really serious about developing a new small molecule or new device or anything like that, you also have to probably start a company. License your IP if you're not starting a company. And get some kind of investment, either partnering with a larger company, but most likely you're trying to draw investment in your own small startup company initially because that's kind of the way that many things have developed these days. So it puts you in a very interesting space, some of the time in an academic setting, but some of the time actually outside of an academic setting or partnered. An academic setting partnered with a more entrepreneurial, small business-type entity. [MUSIC]
