James Hildreth, president of Meharry Medical College, hopes the coronavirus vaccine under investigation by his historically Black institution in Nashville will help bring an end to a virus that is disproportionately killing Black Americans.
His goal is to enroll at least 500 participants in a clinical trial of the drug, many of them Black. But first, he has to convince them it's safe. Black people have been underrepresented in U.S. coronavirus clinical trials to date, an imbalance researchers attribute to a deep-seated suspicion of the medical establishment stemming from past abuses.
So when vaccine trials get underway this month, Hildreth will be one of the first to roll up his sleeve.
As coronavirus cases again climb in many states, several HBCUs, like Meharry, are playing a pivotal role in responding to the disease. They are studying potential vaccines, developing treatments, and testing students and members of their communities for the virus. Hildreth argues it's imperative HBCUs rise to the occasion.
"There is an inherent trust that has been engendered by those institutions over a long period of time," he said. "There is also a cultural sensitivity."
But their well-intentioned efforts haven't always been well-received. When the presidents of Dillard and Xavier Universities — small, private HBCUs in New Orleans — encouraged their students, faculty, staff and alumni to enroll in a vaccine trial, as they had, they were accused of coercion.
Black Americans have been hit particularly hard by the pandemic, becoming infected at a rate more than twice that of White Americans, according to the Centers for Disease Control and Prevention. They are nearly five times more likely to be hospitalized, and twice as likely to die of the disease.
The CDC attributes these disparities to "long-standing systemic health and social inequities" that include unequal access to health care and overcrowded housing. Education gaps are a factor, too. Because Black students have one of the lowest college graduation rates across racial and ethnic groups, they're more often limited to low-wage jobs that require close contact with other workers and the public.
Support flows to HBCUs
For HBCU leaders, the fact that many of their students come from homes headed by people who are at high-risk for the virus or who are more likely to be unemployed made reopening their campuses this fall critical, said Harry Williams, the president of the Thurgood Marshall College Fund, which represents 47 public HBCUs and predominantly Black institutions. More than 90% of Williams' member colleges have in-person or hybrid learning this term, he said.
"Campuses are a place of refuge and a place of safety," Williams said. "Students have been itching to get back to campus, to a place that creates a sense of normalcy for them."
In a survey conducted by UNCF in June, nearly a quarter of students at private HBCUs said they were unlikely to return this fall if courses were entirely online.
Reopening the nation's HBCUs wouldn't have been possible without widespread testing for the virus. And that couldn't have happened without millions of dollars in donations and in-kind support to the institutions.
Thermo Fisher Scientific announced in August that it would provide $15 million in diagnostic instruments, test kits and supplies to HBCUs — a figure the Gates Foundation matched in October. The initiative, dubbed "The Just Project," has at least seven HBCUs acting as testing hubs, collecting and analyzing specimens from their institutions and 39 of their peers. Schools do not pay anything to participate.
The White House has shipped a few hundred thousand tests to HBCUs since September.
Testing for America, a nonprofit founded by academics, engineers and entrepreneurs, is working with 16 HBCUs to establish safe opening and operating plans, identify test vendors and seek philanthropic support, according to spokesperson Karen Testa. Delaware State University, where the program was piloted, has conducted more than 26,000 tests as of late October, at no cost to the institution, President Tony Allen said. The public university has contributed "sweat equity," with coaches, athletes and health majors helping to conduct the tests, he said.
Delaware State was recently awarded $1.15 million by the National Institutes of Health to research social and behavioral factors related to COVID-19 infection in minority communities. Meharry also received NIH funding for its clinical trials.
Some HBCUs have also offered testing to the surrounding community, including Alabama State University, which partnered with state and local officials to provide free coronavirus testing for some residents of public housing in its hometown of Montgomery. The university did not pay for testing.
"Because these schools are located in the community they serve, there is a level of trust there," Williams said.
A legacy of medical mistreatment
Still, convincing Black Americans to participate in testing, contact tracing and vaccine trials can be challenging, even for institutions with legacies of trust in Black communities. In a poll of about 1,000 adults conducted in the spring, Black respondents were more likely than White and Hispanic participants to say they did not plan to get the vaccine if it became available.
When Walter Kimbrough and Reynold Verret, the presidents of Dillard and Xavier, sent their message this September urging their communities to consider enrolling in a coronavirus vaccine trial, they thought they were leading by example.
"We're not going to know if a vaccine works if we don't have a representative sample of the population," said Kimbrough, Dillard's president. "I thought we'd raise awareness and move on."
Instead, the pair was accused of pressuring students to enroll, of profiting off the trials, and of forgetting the lessons of the Tuskegee experiment, in which Black men with Syphilis were misled about their disease and denied treatment for it. The study ended only in 1972.
The presidents' letter acknowledged the study's painful history, noting that "today, there are many regulations in place to assure the ethical execution of medical studies, including oversight by Human Subjects Committees with diverse membership and participation of clinicians of color." Its message was consistent with previous communications from the Congressional Black Caucus Foundation and Black medical schools.
"People only focused on students — 'Why are you forcing the students?'" Kimbrough said. "It wasn't targeted to students."
Kimbrough said he found the "hysteria" the message produced a bit ridiculous, but is glad it started a conversation around diversity in clinical trials.
"There is an inherent trust that has been engendered by those institutions over a long period of time. There is also a cultural sensitivity."
President, Meharry Medical College
In an effort to overcome their communities' skepticism surrounding vaccines, Hildreth and the leaders of other HBCU medical schools conducting clinical trials are enlisting trusted messengers, including faith leaders and Black doctors, to get the word out about the trials.
Hildreth, meanwhile, is asking Congress to provide $5 billion over five years to finance a consortium of Black medical schools that would work to "ameliorate the disproportionate impact of COVID-19 on communities of color," he told the U.S. House of Representatives' Ways and Means Committee in the spring.
"Meharry and the other HBCU medical schools are uniquely qualified to address this pandemic for this population in a way that no others are," he said during the testimony.
While the schools haven't received the money yet, Hildreth is hopeful Congress will provide it in a future relief bill.
"We have champions who understand our importance in this fight," he said.