HD Insights™

H D I N S I G H T S Meet the Company VITAL SIGNS NAME: Teva Pharmaceutical Industries, Ltd. HEADQUARTERS: Petah Tikva, Israel STOCK PRICE AS OF 3/5/13: $37.25 52 WEEK RANGE: $36.63 - $46.38 MARKET CAPITALIZATION: $31.92B EMPLOYEES: ~46,000 HD INSIGHTS: How did you first become interested in Huntington disease (HD)? MICHAEL HAYDEN: My interest in HD goes back to my life as a medical student in the middle of the 1970s, when I first saw patients in South Africa who had HD. At the time, HD was not diagnosed because it was thought not to occur in Africa. I realized that not only did HD in fact occur in Africa, but in people of Caucasian or mixed-race background it occurred at a similar rate to that seen in Europe. By contrast, HD was rare in the black populations of Southern Africa. I was drawn to HD. I traveled to every one of the 16 psychiatric and neurological hospitals in South Africa. I examined every single patient with chorea, and from this I compiled a list of 400 to 500 patients with a family history of HD. People in South Africa with HD were discriminated against. Many were of mixed race. Our cardinal observations were that there was a high frequency of juvenile HD in South Africa, and the incidence of HD in people of Caucasian and mixed-race background was similar to the incidence of HD in Europe. We traced the introduction of the HD gene mutation back to Dutch settlers who came to South Africa in the mid 1600s. We started documenting the difficult social and psychological impact of HD on the family. In 1978 we started the first HD clinic in Africa, and we provided an integrated model of HD – comprehensive neurology, psychiatry, social work and physiotherapy. The clinic was integrated in every way; not only by virtue of the specialties to treat HD patients, but also racially. This was the first multiracial clinic at the Groote Schuur Hospital in Cape Town, where ten years previously the first human heart transplant had been done. We wanted to provide support for all families with HD irrespective of their race and irrespective of their past. In the late 1970s we also formed the first lay HD organization in Africa. Just as we established a multiracial clinic for HD, I wanted to integrate the experience of medical students of different racial backgrounds in hospital wards in Cape Town. Generally, white medical students did not see black patients and black medical students were barred from seeing white patients. Inevitably at that time, this put me into conflict with the authorities. I met Marjorie Guthrie in San Diego in 1977 at the Second International Congress on HD. Marjorie and I became close buddies. I told her that I was very worried about my future. I had to choose which struggle I was going to dedicate my life to – was it the struggle to change South Africa, or was it the struggle to have an impact on families with HD and do something for them? Marjorie persuaded me to come to the United States, and helped organize my move. The late Senator Ted Kennedy wrote a letter to the Immigration Department to support my application for immigration on a Green Card. I thought that after I left South Africa I could never go back, and needed to find a home. Senator Kennedy recommended that I go to Boston, so I interviewed at the Children's Hospital and was accepted into the genetics program. I arrived in Boston in June 1980 as a post-doc. At that time there were no reference books on HD. There had not been a single monograph on HD. I took my thesis of 1979 which formed the basis of the first single-author monograph on HD. This was published while I was in Boston in 1981. I dedicated the monograph to my research assistant at the time, who later became my wife, and Marjorie. Those were the two people who really had played a key role in me being able to complete that work. INSIGHTS: What was the next step for you? (continued on Page 3...) 2 Copyright © Huntington Study Group 2013. All rights reserved. HD Insights, Vol. 4

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