KEYWORDS: AIDS, HIV, Microbiology, Pharmacy, Pasteur Institute, “Say No! to a used syringe”
SHE THOUGHT IT
Maria Odette Santos Ferreira was a scientist and pioneer in the fight against AIDS, playing a crucial role in the identification of the Human Immunodeficiency Virus Type 2 (HIV-2). She graduated in Pharmacy in 1970, obtained her doctoral degree at the University of Paris-Sud in 1977 and was Full Professor in Microbiology at the Faculty of Pharmacy of the University of Lisbon. She was responsible for the diagnosis of the first cases of AIDS in Portugal, including that of António Variações, a famous Portuguese singer and songwriter.
As the 1980s were marked by the appearance of AIDS, Odette Ferreira heard about the decease in a conference in Lausanne, Switzerland. In 1984, during an internship at Pasteur Institute with Luc Montaigner, from the Unité d’Oncologie Virale, and Leon de Minor, from the Service des Enterobacteries, she learned how to identify the LAV (Lymphadenopathy Associated Virus), one of the etiological agents of HIV.
At the same time, she was working with Dr. José Luís Champalimaud’s team at Hospital Egas Moniz in Lisbon and trying to solve the mystery of a group of patients from Guinea-Bissau that presented very similar symptoms to HIV positive victims but did not test positive to the immunofluorescence test. In 1985, in order to discover what was killing those patients, she asked an intern of the Infectious and Parasitic Diseases Unit of the Egas Moniz Hospital, Kamal Mansinho, to collect and bring her blood samples of those patients to the Lisbon Airport. She took them with her to Paris so they could be tested at the Pasteur Institute. The samples traveled hidden inside her coat, as to remain at 37 degrees Celsius and to pass airport security without problems.
She learned to isolate the LAV with Denise Guetard and was able to do it from the samples collected at the Egas Moniz Hospital. After the isolation, genetic studies were able to prove that it was indeed a new type of virus, named “MIR” by the Portuguese team as a tribute to the patient from whom the sample was collected. Later on, the name was changed to “LAV-2” and the results of the investigation were published in prestigious scientific magazines, such as Scienceand TheNew England Journal of Medicine. In the aftermath of this discovery, Odette Ferreira and José Luís Champalimaud were invited to assume the provisory position of consultants at the World Health Organization AIDS Program.
She also coordinated the Portuguese Fight Against AIDS National Committee. In 1993, she created the first program of syringe exchange in Portugal called “Say No! to a used syringe”, thus contributing significantly to the prevention of the transmission of HIV and other common diseases among injecting drug users, such as hepatitis B and C. The program consisted in the distribution, in exchange for a used syringe, of a kit containing condoms, disinfectant wipes and sterile syringes, and involved not only medical institutions, but also pharmacies. Odette Ferreira’s insight of combining medical and pharmaceutical agencies in the implementation of the program was one of the main reasons of its success. Since the pharmacies were spread all over the country, they were able to reach a great number of people. According to the ANF (Associação Nacional de Farmácias – National Pharmacies Association), between 1993 and 2008 the program was responsible for collecting more than 43 million syringes. The “Say No! to a used syringe” program had important national and international repercussions, having been recognized by the European Commission for its innovative character and the effectiveness of its application in the national territory, drastically reducing the cases of seropositive in the country.
Born in Lisbon on June 4th, 1925, Maria Odette Santos Ferreira, also known as Professor Odette Ferreira, was a pioneer scientist in the fight against AIDS and a crucial figure in identifying the Human Immunodeficiency Virus Type 2 (HIV-2). She was born in a family of pharmacists. Her grandfather, Cândido Augusto da Encarnação Santos, was the owner of the first drugstore in Bolama, in the Bijagós Archipelago in Guinea-Bissau. Her father, Manuel Cruz Ferreira, was a civil servant and her mother, Lydia Ferreira, was a housewife, taking care of their home and their two children, Maria Odette and Rui Álvaro.
Odette Ferreira was born in Portugal and moved to the island of Bolama when she was only three months old. She spent her childhood between Lisbon and Africa, visiting Portugal every four years. In Bolama, she attended the official school and, according to her biographer, Sandra Nobre, hated the quilting classes, offering food to whoever would do needlework in her place1. She received a very strict education from her father and, at the same time, grew up with an independence only possible thanks to her life in Africa, which led Sandra Nobre to assert that Odette Ferreira “grew up with eyes of Africa”2.
Back in Portugal at the age of 10, she attended Colégio Moderno in Lisbon with her brother and lived with her family in Avenida Barbosa du Bocage until moving with her husband, Manuel António, also a pharmacist, and his two daughters, Maria da Graça and Maria Manuela, to a house in Largo Hintze Ribeiro.
When the time came for her to enroll in a University, she considered Medicine, Agronomy and Pharmacy. Since her grandfather and uncles were pharmacists, she opted for the latter, which was also considered best suited for a girl3. After obtaining her bachelor’s degree, Odette Ferreira had to leave her academic training on hold. The Faculty of Pharmacy of Lisbon had been closed since 1932, and the only institution able to grant the Pharmacy degree was the College of Pharmacy in Porto. Her father, however, did not consider it appropriate for a woman to leave home alone to study. In 1968, nevertheless, the status of the College of Pharmacy was reinstated in Lisbon, and she decided to finish what she had started.
At around this same time, taking advantage of a loophole in the legislation, Odette Ferreira became the first pharmacist to open a laboratory without having a medical degree. She graduated in 1970 and was invited to assume the position of assistant professor in that same College, becoming responsible for the practical instruction in the courses of Microbiology, Bacteriology, and Virology. Having started a belated career in academia, Professor Odette Ferreira was building her academic path together with her students. As she was doing her doctoral program in Paris, she was encouraging her students to do the same and follow her example. As a Professor, she always thought her pupils to have not only a theoretical, but also a practical approach to the subjects she was teaching, asserting that “it was very important that they [the students] had eyes and hands”4.
After being invited by the cultural attachéof the French Embassy in Portugal, Dr. Piet, to apply for a three-month internship scholarship from the Cultural Service of that same Embassy, she went to Paris, leaving her husband and their two daughters in Lisbon. At Pasteur Institute, she was mainly interested in learning more about the techniques being used in clinical analysis. She attended the Cours de Microbiologie Systématique, learning techniques of isolating, identifying and typifying bacteria and viruses at the Centre Hospitalière Universitaire Kremlin – Bicêtre. After the end of the internship, she started her Ph.D. under supervision of Jean-François Vieu. Odette Ferreira chose to investigate a subjected that could be useful in her home country, Portugal, opting for the field of Epidemiology. More specifically, her research was concerned with the causes of hospital infections.
After presenting a paper in the 1973 meeting of the Société Française de Microbiologie and the Association Belge d’Hygiène et de Médicine Social, she was able to sign a contract with a Japanese Laboratory in order to investigate the resistance of bacteria to certain antibiotics.
Back in Lisbon, she became the only person in Portugal capable of identifying the causes of hospital-acquired infections and worked at Dr. Fernando Teixeira’s Diagnostics Clinic while still teaching and collaborating with different hospitals. She was then nominated director of the course of Microbiology and of the specialization course in Chemical-Biological Analysis at the College of Pharmacy of Lisbon. After the Carnation Revolution (April 25th, 1974), she held different positions in the reorganization of that institution, as member of the Board of Directors and of the Pedagogical Council.
In 1977, she completed her doctoral program, receiving the title of Docteur d’Etat en Sciences Pharmaceutiques – Microbiologiefrom the Université Paris-Sud XI with the thesis entitled Marqueurs Epidemiologiques de Pseudomonas Aeroginosa – Leur Application à L’Étude des Infections Hospitaliéres au Portugal. In the next year, on February 11th, she lost her husband. Later on, she would reflect that she needed to be alone in order to be a leader, with no distractions5.
During the following years, she would work at the Pasteur Institute once again, and, together with Dr. José Luís Champalimaud’s team at Hospital Egas Moniz, in Lisbon, and Luc Montagnier’s team, in Paris, she would isolate and identity the LAV-2, discovering another type of virus as one of the etiological agents of HIV.
In 1986, Odette Ferreira would become a Full Professor at the College of Pharmacy of the University of Lisbon, being one of the most active figures in the creation of the Microbiology Laboratory of that same institution. She was also responsible for identifying the first cases of AIDS in Portugal, including that of António Variações, a famous Portuguese singer and songwriter.
The discovery of the LAV-2 came together with the discovery of the underworld of sex workers and drug users, and she became very active in the fight against AIDS in Portugal. From 1992 to 2000, she led the CNLCS (Comissão Nacional de Luta contra a SIDA – National Fight Against AIDS Commission), becoming the first pharmacist to assume this position, usually exclusive to medical professionals. As coordinator of the CNLCS, Odette Ferreira was responsible for the creation of the first program of syringe exchange in Portugal called “Say No! to a used syringe”, contributing significantly to the prevention of HIV transmission.
She died in 2018 at the age of 93. Until the very end, inspired by Rita Levi-Montalcini, Nobel Prize winner, she believed that only life itself counts, not the years one has lived.
SCIENTIFIC COLLABORATION AND RECOGNITION
Maria Odette Santos Ferreira played a crucial role in one of the greatest AIDS related discoveries in the 1980s. Together with Dr. José Luís Champalimaud’s team at Hospital Egas Moniz, in Lisbon, and Luc Montagnier’s team, in Paris, she would isolate and identity the LAV-2, discovering another type of virus as one of the etiological agents of HIV.
She also made a great contribution to Portuguese science, not only because of her discovery and countless papers published in renowned scientific magazines and presented in important conferences throughout the world, but also for her successful effort in improving research facilities in the country, culminating with the creation of the Laboratory of Microbiology at the College of Pharmacy of the University of Lisbon.
Her work also had a great social impact, especially through the program “Say No! to a used syringe”, responsible for a drastic decrease in the number of new AIDS infections.
SHE SAID IT
I feel that throughout my life I have helped to draw attention to AIDS, not only through research but also by educating the population, improving the treatment conditions of infected people and the quality of life of patients.
Odette Ferreira in an interview to Revista Mulher Portuguesa.
The years don’t matter, only life counts.
Odette Ferreira in an interview to Farmacêutico News (2016).
I’m not stubborn, I am determined, and I don’t back down before a good a idea, provided it is necessary.
Odette Ferreira in an interview to Farmacêutico News (2016).
In truth, the body may grow old and we have no control over that process, but the aging of the brain may be controlled by ourselves!
Odette Ferreira in an interview to Farmacêutico News (2016).
THEY SAID IT
Because of this discovery, she is the most important pharmaceutical person in science nationwide.
Taveira, Nuno, cited in Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto.
Considering Edmund Burke, that in the 18th century, taught us that “The only thing necessary for the triumph of evil is for good men to do nothing”; if there were more people like Professor Odette Ferreira, who didn’t hesitate to engage, with a strong voice and through committed action, in activism at the service of some of the most stigmatized, our world could surely be better and more considerate than what it is.
Maria de Belém Roseira, cited in Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto.
She always looked at the test tubes as if they were people, a piece of life in her hands.
Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto.
If a minister dared to fail a project in which she believed, she wouldn’t leave his office until he changed his view. She was a force to be reckoned with.
Cordeiro, João, cited in Nobre, Sandra (2014) Uma luta, uma vida: Nem precisava de tanto.
PRIZES, ACHIEVEMENTS, HONOURS
1979: Chevalier dans l’Ordre des Palmes Académiques
1987: Chevalier de L’Ordre National de la Légion d’Honneur
1988: Grau de Comendador da Ordem Militar de Sant’Iago da Espada
1989: Medalha de Honra da Ordem dos Farmacêuticos.
1995: Medalha de Honra da Universidad Complutense de Madrid.
1996: Prémio Almofariz “Figura do Ano”, Portugal.
1996: Prémio Dr. José Luís Champalimaud, Portugal.
1996: Medalha de Honra do Colégio Moderno, Portugal.
1999: Cosmopolitan Magazine: One of the 100 women of the century.
2007: Prémio Carreira Universidade de Lisboa.
2007: Medalha de Honra da Faculdade de Farmácia da Universidade de Lisboa.
2010: Prémio de Investigação científica Professora Doutora Maria Odette Santos-Ferreira (criado em 2010 pela Ordem dos Farmacêuticos)
2012: Prémio Dra. Raquel Ribeiro Envelhecer com Arte e Engenho, Portugal.
2017: Grau de Grã-Cruz da Ordem da Instrução Pública.
Exhibition Odette Ferreira – Construir Futuros, Museu da Farmácia, Lisbon
Exhibition And Yet, They Move! Women and Science [E contudo, elas movem-se! Mulheres e Ciência], Rectorate of the University of Porto, Portugal, 10-29 september, 2019. [an illustration of Odette Ferreira by Miguel Praça is displayed at the exhibition]
E contudo, elas movem-se! Mulheres e Ciência (com poemas) (2019), Org. Ana Luísa Amaral e Marinela Freitas. Porto: U.Porto Edições [the book contains a short bio on Odette Ferreira, as well as an illustration by Miguel Praça].
WORKS BY ODETTE FERREIRA
Santos-Ferreira M.O. (1977), Marqueurs épidémiologiques de Pseudomonas aeruginosa, leur application à l’étude des infections hospitalières ou Portugal. Thèse Doctorat (Pharmacie), Paris (no. E. 69).
Calado, M., P. Matoso, Q. Santos-Costa, M. Espirito-Santo, J. Machado, L. Rosado, F. Antunes, K. Mansinho, M. M. Lopes, F. Maltez, M. O. Santos-Ferreira, and J. M. Azevedo-Pereira (2019), “Coreceptor usage by HIV-1 and HIV-2 primary isolates: the relevance of CCR8 chemokine receptor as an alternative coreceptor”. Virology 408: 174-82.
Cavaco-Silva, P., N. C. Taveira, M. H. Lourenco, M. O. Santos Ferreira, and R. S. Daniels (1997), “Vertical transmission of HIV-2”. Lancet 349: 177-8.
Cavaco-Silva, P., N. C. Taveira, L. Rosado, M. H. Lourenco, J. Moniz-Pereira, N. W. Douglas, R. S. Daniels, and M. O. Santos-Ferreira (1998). “Virological and molecular demonstration of human immunodeficiency virus type 2 vertical transmission”. J Virol 72: 3418-3422.
Clavel, François, Denise Guétard, Françoise Brun-Vézinet, Sophie Chamaret, Marie-Anne Rey, M. O. Santos-Ferreira, Anne G. Laurent, Charles Dauguet, Christine Katlama, Christine Rouzioux, David Klatzmann, J. L. Champalimaud, and Luc Montagnier (1986), “Isolation of a New Human Retrovirus from West African Patients with AIDS”, Science 233, no. 4761: 343-46.
Clavel, F, Mansinho, K, Chamaret, S, Guetard, D, Favier, V, Nina, J, Santos- -Ferreira, MO, Champalimaud, JL, and Montagnier, L (1987), “Human immunodeficiency virus type 2 infection associated with AIDS in West Africa”, The New England Journal of Medicine 316, 1180-1185.
Nobre, Sandra (2015), Uma Luta, Uma Vida: Nem Precisava de Tanto, Parede, Sopa de Letras.
1. Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto, Parede, Sopa de Letras, 13.
2. Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto, Parede, Sopa de Letras, 13.
3. Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto, Parede, Sopa de Letras, 27.
4. Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto, Parede, Sopa de Letras, 32.
5. Nobre, Sandra (2014), Uma luta, uma vida: Nem precisava de tanto, Parede, Sopa de Letras, 50.