Two months before veteran AIDS researcher Joep Lange perished in the Malaysia Airlines jetliner shot down over Ukraine, he was in Moscow, pressing for Russia to start programs to prevent HIV spread among drug users.
Lange was "advocating harm reduction," said Michel Kazatchkine, a close friend of Lange and the United Nations envoy on HIV/AIDS in Eastern Europe and Central Asia. "We talked about this. We felt that in times of crisis, you need to remain engaged." The 59-year-old Dutch doctor, one of 298 victims on flight MH17, was on his way to the International AIDS Conference in Melbourne, where colleagues and friends expected to see again the passionate brand of advocacy he was known for. Lange reached every corner of the world through his work: pursuing trials that led to new HIV drugs, campaigning for treatment access in poor nations and mentoring the next generation of public health researchers.
"When I think of Joep, I think of the fact that he was a friend and a terrific guy," said National Institute of Allergy and Infectious Diseases Director Anthony Fauci, an immunologist who has headed NIAID in Bethesda, Maryland, for 30 years. "It was his charismatic, activist personality, to push and do the right thing that, I think, he will be remembered much more for than for any particular experiment."
Kazatchkine, friends and colleagues gathered at the AIDS conference describe an intellectual and humanitarian who was as caring of those closest to him as of those as far away as Thailand and Nigeria. And, as Fauci described, he was as comfortable showing him how to eat herring Dutch-style as he was corralling world leaders.
Lange, the head of global health at the Academic Medical Center of the University of Amsterdam, and his partner, Jacqueline van Tongeren, were among six delegates on board flight MH17 whose deaths have cast a shadow over the Melbourne meeting.
Lange, a former International AIDS Society president, graduated from University of Amsterdam with a medical degree in 1981. He had been a fixture at almost every major meeting on HIV for decades.
"I expect him to walk in any time," said David Cooper, director of Australia's National Centre in HIV Epidemiology and Clinical Research, opening his tablet computer to show a photograph of himself and Lange taken with their daughters in Bangkok about a decade ago.
Cooper recalled gravitating toward the then 33-year-old infectious diseases physician at a reception in Paris in 1987. Doctors from across the developed world, including HIV discoverer Francoise Barre-Sinoussi, were gathered in the French capital to hear the results of one of the earliest human trials using azidothymidine, or AZT, in AIDS patients.
"There were 20 deaths in the placebo group versus one death in the AZT group," Cooper said.
Lange and Cooper, a clinical immunologist at St. Vincent's Hospital in Sydney at the time, were excited by the results. Over drinks on the Left Bank, the two men plotted how they could test AZT on HIV patients with less advanced disease in trials that eventually proved the drug could stave off deadly manifestations of AIDS.
In the early 1990s, Lange became convinced that three antiretroviral medications needed to be used in combination because single-tablet treatments were stoking drug resistance.
He was instrumental in persuading pharmaceutical companies, initially reluctant to testing combination HIV therapies, to pursue the trials, said Cooper. Working in the Netherlands, he joined forces with Cooper in Sydney, Julio Montaner in Vancouver and Stefano Vella in Rome to investigate the combination of drugs nevirapine, didanosine and zidovudine. The researchers called their international collaboration the INCAS group. Montaner presented their findings at the 11th International AIDS Society-USA Conference in July 1996.
The results were stunning. The viral loads of half of the participants fell to undetectable levels after a year of treatment. The research marked a turning point in the battle against AIDS. There was now a way to suppress HIV such that it would be rendered a chronic infection, not certain death.
"If it wasn't for Joep, that study wouldn't have been done," Cooper said. "It wasn't that he was the only voice, but he was the most persuasive, and that persuasion probably saved millions of lives."