Global Pathologist Pioneer Reaps International Acclaim
Thursday, April 11, 2013
As a medical resident in Los Angeles during the early 1980s, Ann Marie Nelson, MD, FASCP, heard acclaimed infectious disease pathologist Daniel H. Connor, MD, describe his groundbreaking work in tropical pathology in Uganda from 1960 to 1963.
“Dr. Nelson has had the greatest presence in global pathology of any U.S. pathologist during the past 25 years. Not only has she contributed to research into AIDS pathology and infectious diseases pathology in general, but she has led the efforts to improve pathology capacity in Africa.”
—Michael L. Wilson, MD, FASCP
“I said, ‘That’s what I want to do!’ ” recalls Dr. Nelson, Senior Staff Pathologist of Infectious Disease at the Joint Pathology Center, Bethesda, Md. From that point forward, her interest in infectious diseases (which started during medical school in Guadalajara, Mexico) led to a lifelong journey to practice medicine in Africa.
She has been devoted to the global fight against HIV/AIDS, particularly for patients in sub-Saharan Africa. For her pioneering work to improve health care, especially in resource-limited countries, Dr. Nelson was recently awarded the Gold Medal Award by the International Academy of Pathology.
“Dr. Nelson has had the greatest presence in global pathology of any U.S. pathologist during the past 25 years,” says her colleague Michael L. Wilson, MD, FASCP, Editor-in-Chief of ASCP’s American Journal of Clinical Pathology and Professor and Vice-Chair in the Department of Pathology at the University of Colorado School of Medicine, Denver. “Not only has she contributed to research into AIDS pathology and infectious diseases pathology in general, but she has led the efforts to improve pathology capacity in Africa.”
Early in her career, Dr. Nelson obtained a position at the Armed Forces Institute for Pathology (AFIP) and worked for Dr. Connor, whose work had inspired her. In 1986, she traveled to Zaire (now, the Democratic Republic of Congo) to work for several months at a mission hospital that had a longstanding association with the AFIP. She returned to Zaire later that year to set up a pathology laboratory at the University of Kinshasa, in Kinshasa, Zaire, as part of Projet SIDA, the first international HIV/AIDS research project in Africa.
Just as Dr. Connor had conducted autopsies and field studies on infectious and other diseases in Uganda, Dr. Nelson set up a laboratory to conduct autopsies on individuals to identify those who had died of complications related to AIDS.
“During the first decade, we were really discovering the extent of the disease and what it looked like in people who were dying of it,” Dr. Nelson says. “By 1996, when clinicians started treating patients with combination antiretroviral therapy, the challenge was to document the pathology related to the drugs themselves such as liver damage, skin rashes, and other complications related to the restoration of the immune system.”
Today HIV/AIDS is a chronic, but treatable disease, not a death sentence. Yet clinicians now see patients managing the virus but succumbing to other illnesses, such as melanoma, lung cancer, and cervical cancer.
“The pathology of the disease has evolved over the years,” she says.
Additionally, Dr. Nelson has been active with ASCP for many years, serving on the Global Institute Advisory Committee, which initiated the Society’s participation in the President’s Emergency Plan for AIDS Relief (PEPFAR) in resource-limited countries. She praised ASCP for its contribution to expanding the capacity of pathology and laboratory medicine and improving the training of laboratory professionals worldwide.