KwaZulu-Natal, Durban | McCord Hospital

As Walker wades into the crowded wing of St. Mary's that houses iThemba, an HIV-positive woman—she was one of the first patients to receive ARVs there and is now working as an iThemba program counselor—rushes over to hug him. She says that patients are staying with their ARV regimens, even though compliance was anticipated to be a difficult challenge in much of Africa, and that the drugs are helping. "The St. Mary's adherence program became a template for the national ARV rollout in South Africa," says Walker, who worked with the Clinton Foundation in helping the South African government draft that plan.

Later that morning, Walker visits with HIV-infected infants and children enrolled in another program at St. Mary's, the Pediatric HIV Treatment Study. Recently, staffers gathered about 50 of those children with their mothers and siblings for a party to celebrate their progress. "It's inspiring to see a room full of mothers and children who would not be alive if the program did not exist," says Douglas Ross, the hospital's chief executive.

At McCord Hospital, a clinical research program that Walker helped establish at the modernized Hope House clinic sees about 450 outpatients every four months as part of a longitudinal study of HIV-infected persons. "So far, these population-based studies have provided tremendous insights into what the key mutations are that arise in the virus and enable it to escape detection by the immune system," says Walker. "By understanding these pathways, we are trying to devise vaccine strategies to block them."

While important data are being collected from those effective clinical programs, Walker's scientific pride and joy in South Africa is the HIV Pathogenesis Program (HPP), housed in a wing of the University of KwaZulu-Natal's Nelson R. Mandela School of Medicine that Walker helped create.

When Goulder, then a postdoc with Walker at Harvard, first visited the medical school in Durban in 1998, he observed that the prospects for research there were promising but that the infrastructure was deficient. Joined by fellow researchers Hoosen Coovadia and Photini Kiepiela, Goulder set up a tiny lab, and later he and Walker worked to interest major philanthropies in modernizing it. Encouraged by Walker, the Doris Duke Charitable Foundation, together with the university, agreed to fund a whole new research wing.

Since the new building was opened in 2003, Walker has expanded his involvement there. The HPP has become a major center of HIV/AIDS research in Africa, attracting high-quality researchers who are already publishing papers in Nature and other top-flight journals and are helping to train a new generation of African scientists. "Within four years, we established an excellent lab," says Kiepiela, who directs HPP and credits Walker for the progress. "Bruce has a heart for Africa and its people. He sees the devastation and wants to help at the human level. He mentors our Ph.D. students and sets high standards for basic science research."

"HPP has grown from strength to strength," says Coovadia, now chairman of HIV/AIDS research at the medical school. He too credits Walker, as well as Goulder, with helping to initiate a sea change in research at the school, which as a non-white institution during the apartheid era had been grossly underfunded.

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