Communication was Dr. Manasseh Phiri's prescription for infectious diseases

Dr. Manasseh Phiri was working at the Centre for Infectious Disease Research in Zambia when I met him 10 years ago, although his days as a practicing physician were well behind him by then. Dispirited by the unrelenting toll of AIDS in his country over the decades before life-saving treatment made it there, when locals wryly referred to the local hospital as "the departure lounge," with no medicine to dispense, he said, he had years earlier begun, instead, to dispense information. He had since then served as a liaison between science and communities, explaining advances, dispelling rumors with facts, and urging frank dialogue on sex, stigmas, sickness and risks. Dr. Phiri, physician, researcher, educator, journalist, broadcaster, teacher, mentor, advocate and friend to anyone working to tell stories about health, died of prostate cancer this week. Having found his calling as a disseminator of lifesaving knowledge, he never stopped, and, to the end, spread word of the importance of screening and treatment for the disease that took his life.

Dr. Manasseh Phiri By the time I met Manasseh Phiri, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President's Emergency Plan for AIDS Relief had five years earlier begun to expand access to the antiretroviral medicines that had been saving lives and stemming the tides of transmission for more than a decade in wealthy countries. Research had proven the value of medical circumcision in protecting men from the virus. A clinical trial of a vaginal microbicide that was hoped to protect women from the virus was underway locally. A new, affordable, accessible visual screening measure rolled out by CIDRZ was enabling early detection and treatment of cervical cancer, which, fueled by the HIV epidemic, had become the number one cancer killer of women in Zambia. But people in their 20s, 30s, 40s, 50s continued to die with no cause of death mentioned. New HIV infection rates held steady, year after year. The realities of sexual risks remained largely unspoken, and, following years when medicine had remained out of reach in the countries where it was needed most, suspicion of the science now abounded most in the places where its advances were needed most. Amid these frustrations, Manasseh continued his work, quietly, persistently, painstakingly, breaking silences wherever he found them. He extolled those who were open about their HIV status. He persuaded leaders of communities who had never practiced traditional circumcision to embrace the medical version of the intervention. He argued that couples counseling and testing, as an accepted standard of care, should be integrated into research protocols. Elephants figured into his metaphors, in descriptions of ones that walked quietly through your garden at night until it was destroyed, and stories of how "when ants are well organized, they can kill an elephant." And in his gentle, pleasant voice and slightly clipped accent, he talked specifically about how HIV is spread. I met Manasseh Phiri because I was working with local journalists on health reporting projects. "He'll want to meet you!" one of his colleagues said, smiling at the understatement. Manasseh had his own radio show and a column in the one nongovernment newspaper then, but he loved chances to further amplify his messages through other journalists. He talked one into getting screened for cervical cancer, and then writing about it. He talked another into getting circumcised. He offered tips on studies with results of local importance, that might otherwise have gone unnoticed,  including one showing that donor-funded HIV testing efforts weren't attuned to local needs. In all the myths he tackled, the policies he questioned, the etiquette he ignored, and through the progress he promoted that brought him closer to the day he could envision his grandchildren living in a world free from HIV, his message remained consistent. Whatever stands in the way of honest communication, he told us, stands in the way of health.