In Memoriam: John G. Bartlett, MD
By Richard E. Chaisson, MD
Dr. John Bartlett, an iconic and visionary leader in infectious diseases and HIV/AIDS died on January 19, 2021, at the age of 83. Dr. Bartlett was an original principal investigator in what became the AIDS Clinical Trials Group and a legendary scientist, clinician, teacher, and writer who made major contributions to an astonishingly wide range of infectious disease threats. In addition to his leadership within the ACTG, Dr. Bartlett played a pivotal role in leading numerous other professional and public health entities, including co-chairing the Department of Health and Human Services HIV Guidelines Panel, serving as president of the Infectious Diseases Society of America, and chairing the board of directors of Baltimore’s Health Education Resources Organization (HERO), one of the earliest AIDS advocacy groups in the country.
Born in upstate New York, John studied medicine at SUNY Syracuse, was an intern at the Peter Bent Brigham Hospital in Boston, and a resident at the University of Alabama, Birmingham, where he planned to become a cardiologist. He was drafted into the US Army in 1965 and sent to Vietnam where he helped run a hospital that cared for soldiers with a variety of infections. Returning to the US, he decided to study infectious diseases because “you can look in the microscope and see the enemy.” He began studying anaerobic infections and helped elucidate the causes of both pulmonary and abdominal infections caused by anaerobes, publishing a number of seminal papers on the subject. He then focused his attention on antibiotic-associated colitis, and discovered the toxin produced by Clostridium difficile (C. diff) that caused the disease. His landmark study of C. diff colitis, published in the New England Journal of Medicine, led to the development of diagnostic tests and treatments for this extremely common and debilitating disease.
John was recruited to Johns Hopkins School of Medicine in 1980 to lead the Infectious Disease division and over the next 26 years built it into a global leader across the entire spectrum of infectious diseases. In 1982, his interests shifted to the AIDS epidemic and he and his colleague Frank Polk mobilized resources within the institution to both care for patients and better understand the disease. He created the second dedicated inpatient AIDS ward in the world, after San Francisco General Hospital, and recruited a multidisciplinary team of clinicians to provide care and develop treatments.
Over the next 30+ years he became an internationally renowned expert in HIV therapeutics, always driven by his own direct involvement in caring for patients. John maintained a busy clinic caring for people with HIV and other infections, taught on the inpatient wards, and always attended on the AIDS Ward on Christmas, giving gifts to every patient while wearing a Santa hat. He befriended Garey Lambert, a prominent local AIDS activist who had written highly critical articles about the medical community’s response to the epidemic. John and Garey became close friends; Garey relied on John’s insights into HIV research, and John brought Garey to scientific meetings, including ACTG meetings, to both learn and provide community perspective to researchers and clinicians. Following Garey’s death, the Hopkins HIV Research Clinic was named in his honor, and a large portrait of Garey hung over John’s desk for the remainder of his career.
John was one of the most sought-after speakers on HIV and infectious diseases. He lectured around the world with an absolutely brilliant ability to synthesize data, explain it to scientists, clinicians, and laypeople, and look into the future to predict what would come next. John’s Top Ten lists of advances in HIV and Infectious Diseases were extremely popular talks at conferences and have been emulated by many. He was an early adopter of internet tools, establishing an HIV website, conducting online clinical conferences for clinicians in Ethiopia, Uganda, and India, and pioneering telemedicine for inmates in the Maryland state prison system. His teaching in the classroom and at the bedside was equally awe-inspiring, with his encyclopedic knowledge and insightful interpretation. He wrote prodigiously, producing dozens of books, including his Pocket Guide to HIV Infection and The Medical Management of HIV Infection, now in their 19th and 17th editions, respectively. In addition to HIV, he was a leader in areas as diverse as bioterrorism, emerging infections, community-acquired pneumonia, and antimicrobial resistance.
John was famed for his extraordinary work ethic, maintaining a schedule that made most people weary just to think about. He arrived at his office in the wee hours of the morning and worked for 15 hours, but still managed to be home for dinner and spend the evening with his wife Jean and their three children, Valerie, Josh, and Scott. He explained his secret to me once when he returned from a two-week vacation with Jean in Australia and showed me the hand-written manuscript he had produced while they were there, the first edition of his Pocket Guide to HIV/AIDS. I scolded him and told him he was supposed to have been on vacation, and he responded, “Yes, but you have to understand that Jean sleeps at night.” In addition to time spent with his family, John was a talented artist, and he once took a sabbatical to Paris to paint.
Following his retirement in 2014, John and Jean moved to Tupelo, Mississippi, where he continued to write, read, lecture, and serve on committees, but he was able to spend even more time with friends and family. John’s beloved wife Jean Bartlett died in October, 2020.
In 2016 the Johns Hopkins HIV and viral hepatitis clinics were merged in a magnificent new facility named The John G. Bartlett Specialty Practice. The clinic continues the work that John began 36 years ago, caring for people from all walks of life with HIV infection.
John’s death is a huge loss to the HIV and medical communities. He commented at his retirement, “It would be difficult to find another discipline in medicine that has such extraordinary diversity, surprises, value in patient care, and clinical relevance for both domestic and international applications.”1 It would be difficult to name another individual who contributed more to our understanding of, provided better care for, or helped educate more practitioners to combat the diverse spectrum of microbes that threaten human health and happiness than John Bartlett.
1 Bartlett JG. Why infectious diseases. Clin Infect Dis. 2014, 59(suppl 2):S85–S92,
AIDS Action Baltimore forces Moderna and Pfizer to include people in their COVID-19 Vaccine Trials
COVID-19 Vaccine Trial Advocacy Letter to Moderna
COVID-19 Vaccine Trial Advocacy Letter to Pfizer
AIDS Action Baltimore (AAB) has been providing essential services to people with HIV/AIDS since 1987. Thanks to your generosity, we’re still standing. We know only too well that times are still tough, but as we commemorate our 33nd year of service, we hope we can count on your continued support which will help us maintain our many HIV/AIDS programs. We still desperately need your help to keep our doors open and continue to provide our many essential services to the Baltimore HIV/AIDS community. We hope you will remember us and continue your loyal support. Please help us in any way you can. Your donations will enable us to continue our marvelous record of benevolence and compassion with only a rate of 6.1% overhead in 2019. The amount of work we accomplish and
the effect we have had on the war against HIV with only four employees is truly amazing!
Although HIV disease is becoming a chronic manageable disease, here is w hy we still need your help now more than ever: In the latest Centers for Disease Control (CDC) data reported in 2019, Maryland was ranked 6th among U.S. states and territories in adult/adolescent HIV diagnosis rates (per 100,000) in 2018, tied with Mississippi. At year-end 2018, 1,173,900 persons in the United States aged 13+ were living with diagnosed or undiagnosed HIV infection. At year end 2019, there were 31,630 people aged 13+ livingwith diagnosed HIV in Maryland. It is estimated that 3,830 people with HIV in Maryland in 2019 remain undiagnosed.
COVID-19 is eating a large percentage of US funding. We are in danger of losing all our hard won treatment and prevention gains.
AAB has been instrumental again this year in the effort to reduce HIV infections in Baltimore. We are currently administering two HIV
prevention programs, one for transgender women and one for gay men. All our prevention programs provide outreach, prevention education, testing assistance, healthcare linkages and adherence support. Our PrEP UP program promotes PrEP (pre-exposureprophylaxis) use in interested gay men and transgender women. PrEP is a one pill once a day prevention regimen that has proven tobe 99% effective in reducing HIV transmission risk. So far, our PrEP efforts have been extremely successful. New Horizons, our stigmareducing, empowerment prevention program for black gay men has also been very effective. The CDC tells us that black gay men have a 1 in 2 chance of becoming HIV infected in their lifetimes. Our new program seeks to educate black gay men about this exorbitant risk
and to help them build networks of support to combat the many social obstacles they encounter which contribute to their risk of becoming
HIV infected. We are very excited about these new programs which have had excellent HIV prevention and treatment adherence results. We have developed even more community partnerships, including a collaboration with FreeState Justice. We recently worked successfully with FreeState Justice taking the lead to help pass new legislation to allow minors to obtain HIV prevention drug accesswithout obtaining parental consent, and conducting outreach to trans women.
We have been educating people about Treatment as Prevention (TasP), known as U = U (Undetectable HIV = Untransmittable HIV) as well as the latest in HIV treatment. We will continue to link people to care providers and help them to stay on their PrEP and HIVmedications. We are very excited about our very successful support and education programs which have helped to decrease the numberof people who become HIV infected and positive people who are unable to sexually transmit HIV because their virus is undetectableand thus untransmittable (U=U).
AAB still provides financial assistance to many needy people with HIV/AIDS. AAB has provided this support to over 8,600 peoplesince 1987 and $3,100,000 in assistance for items such as rent and utilities, and direct programs to people with HIV/AIDS and theirfamilies in our community. We firmly believe we must continue our invaluable financial assistance program which provides a safety netto people with HIV/AIDS experiencing an emergency financial crisis.
The Trump Administration promised to End the HIV Epidemic, but Trump proposed a cut in other HIV spending while the rate of HIV cases
in Baltimore is still raging. Although the Trump Administration will soon be gone, he has left the country with the largest public health crisis
in 100 years which has also resulted in a shattered economy. We need your help more than ever so that we can continue the fight tosave our community from the devastation of HIV disease and the ravages of COVID-19. AAB successfully advocated for increased NIH
research funding this year and will continue to advocate for budget increases to NIH research funding and continued funding for the Ryan
White Care Act for the care and support of people with HIV. HIV policy gets more complicated every year. Because of COVID-19, it is
much harder to obtain the money we need to fight HIV. We are working very closely with the Baltimore City Health Department (BCHD)
on their End the HIV Epidemic Initiative. We had two Town Halls in conjunction with the BCHD in 2019, to discuss community strategies
to end HIV transmission in Baltimore, one featuring the Director of the NIH Office of AIDS (OAR) Research Dr. Maureen Goodenow in2019, to provide input on federal research priorities. Innovative events like this do not happen w ithout AIDS Action Baltimore.
Our work affects all who are touched by HIV/AIDS. Eventually many people with HIV/AIDS will need new drug cocktails when theirold drugs are no longer working or because some are causing life-threatening side effects. AAB continues to work on manygovernment and industry Community Advisory Boards (CABs). We are working with industry to continually change the standard of careby ensuring that their new drug pipelines remain robust, and by replacing older more toxic drugs with more effective, better tolerateddrugs and exciting new long acting drugs that will require only daily, weekly or monthly dosing. This is the wave of the future.
We are very excited that scientists have begun to work on HIV “cure related” research. AAB is working with government and industry
and the national HIV community to make a “cure” for HIV or what we are now calling “HIV remission” or “durable HIV suppression”a reality. Even though this will take years to come to fruition, we have to start somewhere. AAB is a member of the Martin DelaneyCure Research Collaboratories (DARE) and amfAR CABs. AAB is also working with DARE researchers to bring additional resourcesto Baltimore for local cure research projects. We held three HIV Cure Research Forums in 2019 and 2020, and will hold more in 2021.
AAB has been instrumental in the formation of the Drug Development Committee of the AIDS Treatment Activists Coalition, a national
organization that interacts with the pharmaceutical industry, pressuring companies to study drugs expeditiously and ethically and toinclude the HIV affected community in all aspects of research and development. AAB is also a leading member of the national Fair PricingCoalition (FPC), pressuring “big pharma” to price HIV and HCV drugs reasonably, limit price increases, cap ongoing drug prices forgovernment programs like AIDS Drug Assistance Programs and to initiate co-pay programs for patients with private insurance. We haveconvinced every HIV and Hepatitis C drug company to create programs that will cover all the outrageously expensive co-pays and
other out of pocket (OOP) costs for people with private insurance. Our work directly affects Marylanders with ever increasing OOPprescription costs. We are also working very hard to ensure that people in Maryland and across the country who cannot afford theirmedications get their drugs for free from “big pharma” through Patient Assistance Programs (PAPs). Our work is way ahead of the curve. This type of advocacy does not happen in any other disease community. These OOP co-pay programs are now in danger of being discontinued by insurance providers. AAB is working in collaboration with numerous national organizations and the insurance
industry to preserve co-pay programs.
We are still doing our best to help ourselves. Thanks to the many of you who attended our fabulous 2019 Tea at Cedarcroft event raised over $48,000. Unfortunately, we were unable to have our 2020 Tea Dance on September 20, at the Clifton Mansion, the restored Italian style mansion which was the residence of Johns Hopkins. So, we need your help now more than ever.
For more information on our events and the latest in HIV treatment and research as well as PrEP for HIV prevention or financial assistance and prescription drug access program information, please see our web site at www.aidsactionbaltimore.org and Facebook https://www.facebook.com/prep.up.7 and https://www.facebook.com/newhorizonsbmore/
Please help us to continue our emergency financial assistance programs and our vital local and national research and treatment advocacy. We greatly appreciate your continued support in these tough economic times. Thank you in advance for your contribution and for your past generosity. We know you are called on to make many contributions. We very much appreciate your continued confidence in our work. Your donation will help us to save lives. We are forever grateful for your trust and loyal support. Remember, now more than ever, without people like you, there would be no AIDS Action Baltimore! We hope you and yours remain safe and well.
Sincerely, Lynda Dee & the AAB Board
Merle McCann, M.D., Chair
Jake Boone, III
Cameron Wolf, Ph.D., M.P.H.
Our current financial statement is available upon request by contacting AIDS Action Baltimore at 14 East Eager Street, Baltimore, MD 21202 or (410)837-2437. Documents and information submitted to the State of Maryland under the Maryland Charitable Solicitations Act are available from the Office of the Secretary of State, State House, Annapolis, MD 21401 for the cost of copying and postage.
COVID-19 and People Living with HIV
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