“They asked me, ‘Doc, can’t you do anything? Can’t you save me?’ But all I could say is, ‘I’m sorry. There is no medication.’”
That was Dr. Robert Jeffrey Edwards, BSc’83, working on the front lines of patient care in the earliest days of the AIDS epidemic.
“I treated them for opportunistic infections, but every one of these patients died of AIDS,” Edwards said.
“I got very close to them because they shared their most intimate stories with me as they were dying. I felt so bad, and I thought, ‘I must find a way to help these people.’ That’s what drove me.”
That drive was guided by compassion without moral judgment. Desperately ill people kept coming to Edwards at the only place in the Republic of Trinidad and Tobago that provided care for them in the early 90s.
Dr. Robert Jeffrey Edwards graduated with honours from Western in 1983, the year AIDS was first diagnosed in his home country of Trinidad and Tobago. He didn’t know it then, but that pivotal diagnosis would tie into his future career as a leading physician and researcher in HIV care. (Submitted)
“Stigma and fear surrounding these patients were widespread in those days. Because so many people were dying and there was no treatment, everyone was scared, but patients could approach me freely. They asked me to make them comfortable so they could die with some dignity.”
The despair of relentless fatalities gave way to hope and promising medical discoveries. Edwards was part of the transformation in care that turned HIV, the virus that causes AIDS, into a manageable chronic condition with less stigma than it once carried. He could not have imagined this path when he left Trinidad to study at Western in 1979.
In residence at Saugeen-Maitland Hall, Edwards found fellow students welcoming. Some offered to help him with his math and science courses. They would soon be coming to him for help instead.
“Most of the Canadian students had never met anyone from a Caribbean island before,” Edwards said. “We were from different cultures, but they discovered I was just like them in so many ways, and just as academic.”
Edwards graduated with a bachelor of science in biochemistry in 1983, the year AIDS was first diagnosed in the Republic of Trinidad and Tobago. He returned to the Caribbean to complete a medical degree at the University of the West Indies, where he met a professor of medicine and leading-edge researcher who would shape the rest of his life.
Inspiring mentor, Dr. Courtenay Bartholomew
During his internship, Edwards worked under the supervision of the late Dr. Courtenay Bartholomew, the Trinidadian physician and researcher who made the unprecedented diagnoses of the first cases of AIDS in the English-speaking Caribbean.
“Professor Bartholomew was leading clinical trials on HIV vaccines and retroviruses in partnership with institutions in the United States,” Edwards said. “He invited me to join his research team. That was a real kickstart for me.”
As a member of the research team, Edwards began seeing patients in 1991 at a facility Bartholomew founded, the Medical Research Foundation of Trinidad and Tobago (MRFTT). As the epidemic grew more dire, a new population of patients was emerging – children born with HIV whose parents had died of AIDS.
The Society of St. Vincent de Paul established the Cyril Ross Home to care for these children, where Dr. David John was the home’s first physician. Edwards later volunteered to work alongside John to care for children living with HIV.
“At the height of the epidemic, we had 25 children in the home. Luckily now, we don’t have many.”
To this day, Edwards provides care for the children there free of charge.
In 1997, the MRFTT worked with the country’s Ministry of Health to implement a Prevention of Mother-to-Child Transmission program, providing the first available anti-retroviral (ARV) medication to pregnant women living with HIV. The program was later expanded to treat newborns.
“Some of those children are now in their 20s and 30s, thanks to ARV treatment,” Edwards said.
Anti-retroviral drugs life saving for people living with HIV
Throughout the 90s, the number of new HIV cases kept climbing.
“In response to so many people dying, the prime minister of the country asked professor Bartholomew to open a clinic to start treating people with HIV.”
As the director of the Medical Research Foundation of Trinidad and Tobago, Dr. Robert Jeffrey Edwards oversees the care of more than 5,000 patients at the largest HIV treatment and care centre in the English-speaking Caribbean. (Submitted)
The MRFTT became the lead clinical site for treatment and care of adults living with HIV in 2002. That year, treatment became widely available in Trinidad and Tobago because the government had negotiated with pharmaceutical companies for a reduction in the cost of ARV drugs. At the time, Edwards was one of only a few clinicians in Trinidad and Tobago with expertise in using them. With treatment came a steady decline in HIV-related deaths.
“After we treat our patients, their viral load is undetectable. That means they do not transmit HIV sexually to their partners. That is huge, because they live normal lives, with a typical life expectancy,” Edwards said.
Following Bartholomew’s retirement from MRFTT in 2017, Edwards succeeded him as director. He continued to advance forward-thinking approaches to reduce barriers to treatment, with programs tailored to the specific needs of women, men and youth.
“There’s still a lot of stigma and discrimination against men who have sex with men, so we have a support group for those men.”
Recognizing that patients who leave clinical care are unlikely to adhere to their anti-retroviral treatment, Edwards hired social workers to contact patients not in active treatment. Persuading them to return them to care ensured they had no detectable level of HIV in their blood.
“We have to continually work with these patients because people don’t like taking pills. When HIV treatment began, it required 15 or 20 pills a day. Now, it’s just one pill at night, though we still must help patients to ensure they take it regularly.”
Edwards says caring for all patients, regardless of their circumstances, is not only compassionate, it’s effective health-care policy. His team tries to reach even the most stigmatized patients.
By 2019, more than 23,000 people who’d fled the humanitarian crisis in nearby Venezuela were living in Trinidad and Tobago. Edwards supported a government program registering undocumented migrants, giving them limited access to the public health-care system. The strategy led to 40 per cent of undocumented migrants being tested for HIV.
“Some tested positive, and if you don’t identify and treat all infected people, the virus will most certainly spread.” Edwards said. “We hired Spanish-speaking doctors and nurses for the Venezuelan patients.”
Edwards receives Chaconia Gold Medal
As a clinician, leader and researcher in public health and dermatology over four decades, Edwards has advanced the understanding of HIV and other sexually transmitted infections and promoted life-saving public health policies. He also lectured at the University of the West Indies and currently oversees the care of more than 5,000 patients at MRFTT.
Dr. Robert Jeffrey Edwards received the Chaconia Gold national award at Trinidad and Tobago’s 48th Republic Day celebrations in September 2024. (Facebook/The Office of the Prime Minister of Trinidad and Tobago)
Edwards was formally recognized for his accomplishments at Trinidad and Tobago’s 48th Republic Day celebrations in September 2024. The Office of the President presented him with the Chaconia Gold Medal for “long and meritorious service” promoting national welfare. The award is the second-highest national honour.
Edwards was quick to point out his mentor earned the most prestigious honour.
“Professor Bartholomew was awarded the Order of the Republic of Trinidad. That’s the country’s highest honour. He worked at this clinic until he was 85 years old.”
While appreciating the recognition, Edwards remains humble.
“It’s not about me. It’s about the patients and ensuring they can live long and healthy lives.”
Today, the opportunity to restore vitality is what drives him.
“I see patients who are very sick, even close to death, and then we put them on medication and four or five months later, they go back to work. It’s really a dramatic turnaround. I’m so happy to see people reclaim their lives again.”
