A Man Who Believed We Could Defeat AIDS

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Researcher Joep Lange was on his way to an HIV/AIDS conference in Melbourne before the chaos in Eastern Ukraine cut his life short. Laurie Garrett remembers him:

Like so many of the great AIDS scientists that toiled through the years of extreme loss and urgency before there was effective treatment, Joep Lange absorbed the political dimensions of the pandemic, and gained the skills necessary to translate lab and clinical findings into high-level battles inside the United Nations and across the global stage. He became a leader, in the fullest sense of that word. Like Jonathan Mann, Joep blended science, medicine, and an activist spirit to help bring the life-sparing medicines to people in all of the world – not just rich countries.

The last time Joep and I spent time together we argued, I’m sorry to say. And I may have been completely wrong, he completely right.

The saga we argued about hasn’t played out yet. Joep believed without hesitation that effective treatment, “is like a vaccine,” as he put it. The global epidemic could be stopped, he said, simply by getting every HIV+ person on the planet put on an effective regimen of treatment. Once on medicines, he insisted, the load of viruses in their blood, vaginal fluids, and semen would drop so low that they would not be contagious. And that, he said with a grin, will be the end of AIDS. I was skeptical – there were too many cases of drug resistance, non-adherence to treatment, supply chain failures to deliver vital drugs to remote or impoverished areas. I resented use of the word “vaccine” to describe universal treatment – we still desperately need an actual HIV vaccine, I insisted.

I want Joep’s optimism about eliminating AIDS through treatment to win out. I want to be wrong.

I think Joep was right – and profoundly prescient. Charles Kenny reviews Lange’s work:

Lange’s research demonstrated the importance of simple drug regimens: if people only have to take a few pills with smaller side effects, they are far more likely to take them and stay healthy. He also founded a research collaboration based in Thailand that carried out studies on sexually transmitted disease—including an ongoing study of using HIV treatment as a tool to prevent the spread of the virus.

Harold Pollack considers the legacy Lange has left:

[Friday’s] New York Times includes an old quote from Lange, in which he said: “If we can get a cold can of Coke to any part of Africa, we can certainly deliver AIDS treatment.” In the year 2000, Lange founded the PharmAccess Foundation to improve drug access in sub-Saharan Africa.

This vision caught the imagination of President George W. Bush, among others. At that time, many people believed that the obstacles to providing high-quality care in low-resource environments would prove too severe. I was one of those skeptics. Fortunately, people like Bush and Lange proved the skeptics wrong. The efforts of Lange and others contributed to dramatic improvement in HIV prevention, treatment, and care around the world. These efforts made possible the one genuinely shining accomplishment of George W. Bush’s presidency: the Presidents Emergency Plan for AIDS Relief (PEPFAR), which has saved millions of lives.

For the record, I was wrong too. I was far too gloomy about the potential for the new meds in Africa and the developing world. But what greater legacy can a man leave than the lives now being lived because of his passion?

(Photo: A woman signs the condolence book for Dutch Aids expert Joep Lange and his assistant Jacqueline van Tongeren, on July 19, 2014 in the Academic Medical Centre (AMC) in Amsterdam. Lange and Van Tongeren, were on their way to the International Aids Conference in Melbourne when their plane from Malaysia Airlines crashed in Ukraine, last Thursday. By Evert Elzinga/AFP/Getty Images)