'Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centres of energy and daring, those ripples build a current which can sweep down the mightiest walls of oppression and resistance.' - Robert F Kennedy, Cape Town 1966.
Joep Lange (1954 - 2014)
Robert Kennedy's words - which always held a resonance with me - took on new meaning at the memorial of Joep Lange and Jacqueline van Tongeren, in Amsterdam, last month. Joep's life epitomised Kennedy's words. He stood up for HIV and AIDS sufferers, at a time when no one else would. He worked tirelessly to achieve universal healthcare, and struck out against the injustice of limited access to anti-retroviral treatment in developing countries.
Trained as a doctor, Joep's pioneering research on HIV set the course for how we treat the virus today. He was the first to recommend triple-combination drug therapy, which is now an integral factor in health programmes to treat AIDS, and his pivotal 2003 study found that giving medication to babies prevented infants from catching HIV from their mother's breast milk. This radical recommendation reduced the rate of infection from breastfeeding from 15% to only 1%.
Joep was more than an innovative scientist. In the words of Kees Storm, Joep was a "driving force in leading all of us on the road towards an AIDS-free generation and affordable access to quality care, especially in Africa and Asia." At the PharmAccess Foundation, he distributed drugs in African countries by partnering with private sector companies, before going on to support the development of medical-insurance schemes and public heath schemes across the African continent.
Public-private partnerships have long been considered the future of international development, but PharmAccess' success in this arena has proven how important these really are. Indeed, The Wellbeing Foundation Africa and I first came into contact with Joep and PharmAccess through their work in my home state of Kwara, Nigeria. Partnering with the Kwara State government, the Dutch government, as well as local health insurance organisations, PharmAccess introduced a Community Health Insurance Scheme in 2007. The unique programme provides subsidised health insurance and healthcare to Kwara residents, some of whom earn less than $1.50 a day. The programme has gone from strength to strength, and earlier this year, the Kwara State government pledged to scale up the initiative, and expand affordable quality healthcare to at least 60% of Kwara's population by 2018. This demonstrates the power of innovative financing and partnerships in achieving the goal of universal healthcare.
A large part of this success is due to Joep's efforts to bring together partners from different areas to achieve his vision of universal healthcare and inclusive access to health insurance. PharmAccess united diverse partners, ranging from international figures like Queen Máxima of the Netherlands and Desmond Tutu, to notable academics, to insurance companies, to achieve these goals. It is through the continued commitment of PharmAccess and of Joep's research institute AIGHD to these partnerships and goals that Joep's vision lives on.
Often, the challenges facing the global health community can seem insurmountable. When you look at the sheer numbers facing organisations working to improve access to healthcare in developing countries, it can be daunting. 5700 people contract HIV each day, and of the 35 million people who are now living with HIV, only 12.9 million sufferers have access to antiretroviral therapy. 800 women die every day from preventable causes related to pregnancy and childbirth. Nearly 17 000 children under the age of five died every day in the year 2013, and 45% of these deaths occurred within the first 28 days of a child's life. These numbers are important. These numbers are how we understand the challenges ahead and measure the impact of our work.
Although these numbers can be overwhelming, it is important to remember that the most powerful number can also be one. One person with the courage to stand up for patients, who acts to improve the health of others, and strikes out against the injustice of unequal access to healthcare, can set forth a tiny ripple of hope that eventually turns into a current that transforms global health. Joep did more than send a ripple of hope forth in global healthcare. He was a tidal wave that will be sorely missed.
We must honour his vision for universal healthcare and inclusive access to innovative financing for health by developing further partnerships that can enact real change. Every one of us within the global health community can set forth a ripple of hope through our actions, but together, we can become the current that Joep was, and change the very nature of global health.
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