SR researcher Susan Schader discusses the future of HIV treatment
August 29, 2018
Prolific, dedicated HIV researcher Susan Schader, Ph.D., believes that a cure for HIV cannot be pursued without first defining the concept of “cure.”
“There are many things that go into ‘curing,’” she said. “Are we curing the world, or are we curing the human? And that’s where I challenge the scientists I work with. You’re telling me that you’re working toward a cure? How are you curing HIV? In an individual, let’s just start there, or even a cell. Tell me how you’re curing it.”
That big-picture view—what are you working toward? What are you working for?—has largely defined Susan M. Schader’s career as a scientist. Recently promoted to principle investigator, she guides a project focused on new viral targets and novel therapeutics in the face of this constantly mutating virus. When she joined Southern Research three years ago, she immediately felt at home at the institution that has touched nearly every HIV drug that’s come to market since the epidemic began in the 1980s, turning a death sentence into a treatable disease.
Schader’s mindset goes back to her early work in the lab of Dr. Robin Shattock at St. George’s Hospital Medical School, studying the effect of TMC120 (later dapivirine) and tenofovir on HIV replication. “He was the perfect mentor. We called him the Prince of Microbicides,” Schader said. “He was always big picture-focused. Although he didn’t say, ‘Susan, you must be big picture-focused,’ he was. And you saw this side of humanity, and what you were doing in the lab meant something.”
That broad perspective would prove to be a common thread among the other mentors who had the most impact on her during her early career. Dr. John Moore, who reminded her, when she got caught up in the technical details, to “keep the big picture in mind.” Dr. Mark Wainberg, under whom she received her doctorate and who recognized her knowledge and experience and gave her the freedom to work, to lead, even to sit in his place on steering committees and at conferences—gave her a new perspective on where her work fit into the global effort against HIV.
Schader recounts a story from a visit to the International AIDS Symposium after she’d left Shattock’s lab. The TMC120 she’d been studying was in testing as part of a silicone vaginal ring that women would be able to use for protection from HIV—an important advancement for women in developing countries who might have neither access to medical treatment nor the personal agency to negotiate sexual contact.
Both researchers and workers on the front line of the AIDS epidemic attended the symposium, and it was a group of the latter, healthcare workers in Africa, who approached Schader. “They said, ‘We’ve heard about this ring. Can we see it? Can we touch it?’” she said. “And it was an aha moment for me. It’s the human connection— this is a good concept, but if you really want to get it adopted, you have to be able to say, ‘Here. Touch it. Feel it. What are your thoughts on it?’ We could have done a better job as scientists to help the people on the front lines understand where we were going. And it was those women who brought it to my attention, who said, ‘We really want this product.’”
SMALL SCALE, BIG DISCOVERIES
Over a decade later, Schader is working in a world facing a $7 billion funding gap, per the UN, between our current reality and the goal of eradicating HIV by 2030. “That to me just says, it’s got to stop being about a country,” she said. “It’s got to stop being about the person. You can treat an individual, but we also have to look longer term.”
“What I can do in the lab is on a very small scale,” Schader said. “But I know by bringing everyone together at Southern Research, it’s the biggest
gift I’ve ever been given in my career, because the scientists I work with have the capacity to do what no other research lab can do or would attempt. The scientists here are dedicated, and they want to stay here. I learn something new every day here, and we’ve already discovered things that, hopefully by the end of the year, we can get some funding to help us carry on research.”
Schader believes the biggest thing standing between science and a cure—a cure by any definition—is funding. A constant struggle for a share of limited grant money pits scientists against each other, she said, and impedes collaboration. That, combined with lack of access to new technology, resources and brainpower, hinders potential advances.
Teams have had to innovate new technology using their own research funds, or just go without. “Struggling for two days with something when you can buy a piece of equipment that will let you do it in 30 seconds or less—just those processes can make us less frustrated and more productive,” she said. “What we’ve accomplished over the past year, we could have accomplished a lot faster.”
Those accomplishments are significant. What other labs are unable to do, Schader’s team specializes in doing—developing ways to detect HIV in active replication, to test drugs, to design novel, clinically relevant assays. Her lab is the first in the world to produce protein from HIV in a particular bacteria. That discovery can mean the difference between the therapies that were effective decades ago and the ones that are changing the world now. “We just need the funding to be able to sit down and say, ‘OK, let’s work together.’”
THE BIG PICTURE, FULL CIRCLE
While her team works toward the future, a project from Schader’s past has reappeared. While pursuing her doctorate, Schader was awarded nearly a quarter of a million dollars from the International Partnership of Microbicides to study the drugs they wanted to test in combination—research that led to the silicone ring that had made waves at the IAS. Now, she’s been approached directly—this time to supply preclinical data because the dapivirine ring is a reality, has been tested in Africa and is up for regulatory approval in Europe. “I was involved at the beginning, and now I get to see and help bring it to people under the European regulatory agency,” she said. “And it’s at Southern Research that we’re doing it.”
Seeing it come full circle isn’t just a thrill for Schader—it’s also educational and encouraging for her team, she said. “To actually say we’re helping women on a worldwide scale, it really makes people look up from their bench and go, ‘Yeah, what I do means something.’”
“I think we can do it,” Schader said. “I think we can cure HIV. We just need to know what a cure looks like.”
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