October 2017

Stephen Lee, M.D.: “Our Patients Are Not Just Statistics”

Stephen Lee, M.D., often thinks about John, an HIV-positive patient whom he admitted to the Emergency Room at the Santa Clara Valley Medical Center in San José, Calif. Now the vice president of Program Implementation and Country Management for the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Lee was a medical resident when he treated John in the early 1990s.

“John was really sick. He had pneumocystis pneumonia,” says Lee. In my course of taking care of him, not only did he become my patient in the hospital—he ended up becoming my friend. Knowing John really solidified my desire about what I wanted to do. I wanted to be an HIV doc.

Lee first heard the whispers of a mysterious, fatal illness when he was a young adolescent growing up in Kingston, Jamaica. “This was before we had even coined the term AIDS or had identified HIV as the virus that causes the disease,” says Lee. “It was called GRID, gay-related immune deficiency.

“It was in medical school, in the late 1980s, that I was first exposed to HIV patients,” says Lee. “I remember being on the medical wards, and half— if not more than half—of our patients were HIV-infected young men. I remember feeling profoundly touched at that time that these were men my own age who were dying of an incurable disease.

“I was a resident when AZT [the first effective antiretroviral treatment] came out. I remember being very gung-ho and very interested in my patients doing well, calling patients in the middle of the night, reminding them to take their medication because we were dosing them so frequently throughout the day.”

“Just as I finished my residency training in the mid-1990s, the three-drug cocktail became recognized as the way to treat and manage HIV. So I saw, from my days as a medical student, patients dying from their illness or from an opportunistic infection—to people who got started on this three-drug cocktail and literally getting up and walking out of the hospital or getting up and walking out of their homes. We called it the Lazarus Effect.”

Despite the breakthroughs, some people could not be saved.

“John died in about 2000,” says Lee, soberly. “He was one of those patients who had cycled through various drugs, various regimens, and ultimately nothing would work for him anymore. I had other patients who passed away, but what made John’s passing harder is that he had become a friend. I knew his mom and sisters—so it was much more close to home.”

In 2003, after having worked as a clinician for ten years, Lee decided that it was time to take on a more global role. “I always knew that I wanted to do some kind of international work,” says Lee. “When you are a clinician you are impacting individual lives, and that is really great. But I transitioned to international public health and development for the opportunity to make a broader impact. That’s where my heart is to this day.”

Lee became a fellow with U.S. Agency for International Development (USAID), just after the President’s Emergency Plan for AIDS Relief (PEPFAR) was authorized. He started working in the Europe and Eurasia bureaus among most-at-risk populations, but with his clinical background, he was soon transitioned as a care and treatment advisor—predominantly working in sub-Saharan Africa, which was hit particularly hard by the pandemic. As his fellowship came to an end three years later, Lee found that EGPAF provided the best outlet for his skills and passion.

“I decided that I wanted to spend some time working as an implementing partner to get a closer-to-the-ground experience of managing HIV in developing countries,” says Lee.

“EGPAF alone has touched the lives of 27 million pregnant women in terms of getting them access to prevention of mother-to-child HIV transmission services and antenatal services. We are testing more people, so more people know their HIV status and are on treatment and they are not dying. People are living and working and contributing to their families and their communities and their national economy.

“Our patients are not just statistics,” emphasizes Lee. “These are individuals who have dreams and hopes and desires and goals for their lives. One reason I do this work is my belief that all lives are of value. And I like to think that as a citizen of the world, I have been lucky to have a relatively successful life—and I think that it would be selfish of me to not share that opportunity with others.”

Lee relates an experience he had a few years back in Mozambique.

“A young woman came into the office and asked to see our country director. She was HIV-positive, but she had delivered a baby that was HIV-negative, thanks to the support of EGPAF. She was just profoundly grateful to our team and came to the office to express her gratitude the country director personally. That is one of those experiences of why I do this work. I love going to the field, and I love visiting our country programs is to see the hands-on work and the hands-on opportunities, and the hands-on successes of our colleagues.

“A lot has been accomplished in terms of preventing and treating HIV, but there’s a lot more that needs to be done,” says Lee.

“I don’t want to see us take our foot off the gas pedal. Actually, I think that we need to really be pushing our foot harder on the gas pedal to really accelerate access to treatment, really accelerate enrollment in care and treatment services, and accelerate the support that we give to patients to make sure that they are maintaining their medication and improving the quality of their lives.