Remembrance October 14, 2014

Symposium and international remembrance in honor of Joep Lange and Jacqueline van Tongeren

 

On Tuesday 14 October, 850 family members, friends, colleagues, prominent scientists and dignitaries from all over the world gathered in Amsterdam to pay tribute to the lives and legacies of Joep Lange and Jacqueline van Tongeren.

The remembrance was held at the Amsterdam Medical Centre (AMC), where Joep and Jacqueline met and worked together for many years, and was organized by the AMC, the Amsterdam Institute for Global Health and Development (AIGHD) and PharmAccess, which were both founded by Joep. A morning symposium titled Research in Action: From AIDS to Global Health to Impact highlighted the scientific legacy. During the remembrance in the afternoon, a range of speakers shared memories of Joep and Jacqueline. As was the case during their lives, the personal and the professional were closely intertwined throughout the day. As Prof. Peter Piot said, Joep and Jacqueline shared a common perspective on life: “La folie suprême est de voir la vie comme elle est et non comme elle devrait être.” If there was one thing that defined them both, it was indeed that they saw life –and lived it– not as it was, but as it should be.

Scientific legacy

‘Joep has a place in history as the visionary architect of combination therapy,’ Prof. Piot stated, adding that ‘it cannot be stressed enough that he was ahead of his time, a true innovator.’ Joep’s contribution didn’t stop at science. Dr. Khama Rogo of the World Bank explained that ‘it’s not enough to be a doctor or a researcher if you’re not also an activist.’ Joep fully understood the importance of translating research into action and generating impact for people. Prof. Marcel Levi, chairman of the AMC, summarized the enormity of the impact Joep had on the world with the words ‘It’s rare to know someone who has saved millions of lives.’

The scientific symposium traced Joep’s career, starting in the early eighties with the treatment of the first AIDS patients and the design of ARV therapy, moving towards the emerging field of global health and ending with his most recent focus: using knowledge derived from scientific research to improve access to quality healthcare in real-world settings. From Prof. Françoise Barré-Sinoussi, who won the Nobel Prize for the discovery of HIV, to Prof. Michael Merson, who founded Duke University’s Global Health Institute, the list of presenters reads like a who’s who of people involved at key moments in the history of HIV and global health. ‘And Joep,’ as Barré-Sinoussi said, ‘contributed to all eras of HIV.’

Joep’s first visit to Africa in 1992 was a life-changing event for him. Dr. Elly Katabira of Kampala’s Makerere University, who later became a great friend of Joep and Jacqueline’s, showed him what the HIV epidemic looked like in Uganda. The suffering and despair he encountered there formed a new source of determination. ‘Joep and Jacqueline were the personification of the fight against HIV/AIDS,’ said Dutch Minister for Foreign Trade and Development Cooperation Lilianne Ploumen, going on to describe how Joep tread new ground and achieved a much broader change in mentality in the development world. ‘With his pioneering approach to HIV/AIDS, Joep showed once and for all that broad-based partnerships were indeed possible. And that such alliances between the public sector, private sector and civil society could help those less fortunate.’

Local last mile

In addition to the scientific significance of Joep’s career, speakers shared memories of a compassionate doctor with a heartfelt commitment to individual patients, and of an activist with a mission to change dysfunctional healthcare systems. Khama Rogo referred to Joep as ‘a health revolutionary, the Che Guevara of global health.’ Both Jacqueline and Joep were rational but passionate people who were not afraid to take action and effect change. ‘Inaction kills,’ was the new greeting that Khama Rogo and Joep had recently developed. He and Joep were born in the same year, but on different continents. Joep’s life expectancy at birth was twice Khama’s. ‘In that sense, our early experiences couldn’t have been more different. Today, life expectancy in Kenya continues to rise because Joep made it possible for people to access healthcare. Inaction kills. Good action saves lives. So let us act.’

Joep had no qualms about asking uncomfortable questions. He focused on how to get things done. PharmAccess managing director Onno Schellekens affirmed that Joep based his actions on facts, whether they were politically convenient or not. ‘Ultimately,’ Schellekens said, ‘Joep was determined to change policies at government level, but also to deliver care all the way to the local last mile.’

US Ambassador John Simon lauded Joep’s visionary and holistic approach to addressing gaps in the developing world. ‘With PharmAccess and the Health Insurance Fund, Joep improved healthcare quality and created health insurance schemes that ensured that people are no longer a disease or a mosquito bite away from complete destitution.’

Training a next generation of researchers was another issue close to Joep’s heart. He not only acted as promoter for over 50 PhD students, but also trained doctors and nurses all over Africa. Dr. Debrework Zewdie of the World Bank: ‘I remain in awe of Joep and Jacqueline’s work in building African scientists, especially by how they shepherded the INTEREST workshop (International Workshop on HIV Treatment, Pathogenesis and Prevention Research in Resource-Poor Settings). Now, it is up to us to step in and make sure to continue what they started.’

Sublime art of life

Joep and Jacqueline had a profound effect on everyone they met, in their professional as well as in their personal relationships. They were erudite and sharp intellectuals, and their sincere interest in others led to many friendships all over the world. As Peter Piot put it, ‘they both had mastered the sublime art of life.’

While the morning symposium was scientific in nature, focusing on Joep’s academic career, the presenters also shared personal memories. Prof. David Cooper started by saying this was one of the hardest talks he had ever given, Prof. Menno de Jong spoke of how Joep taught him to ‘be creative and think big to tackle the real problems,’ and Prof. Eric Goosby said that Joep’s authentic way of living continues to reverberate with him. Prof. Michel Kazatchkine reflected on how this would be the first time he would be travelling back to Geneva without a W.F. Hermans book that Joep insisted he read.

One of the things that Joep and Jacqueline shared was a love of the arts. From the opening notes played by the Nederlandse Reisopera to the moving performance by the Nederlands Dans Theater and the contributions of bandoneonist Carel Kraayenhof, the Consensus Vocalis choir and Dutch author Adriaan van Dis, the program featured several cultural intermezzos from artists Joep and Jacqueline admired.

Many speakers looked back on their long-time friendship with Jacqueline, highlighting her beauty, elegance, charm, kindness and great sense of humor, but also her power. Peter Piot described her as a force of nature, someone who made things happen. As such, she and Joep were the perfect team. Jan Willem Sieburgh, who was friends with Jacqueline for over 50 years, traced her career, which spanned from pastry maker, realtor and art dealer to head nurse and finally to director of communications at AIGHD. ‘She was dedicated, curious, methodical and very professional, bringing something unique to every role.’ Jacqueline was modest and low-profile, but deeply involved. ‘A woman with a deep inner refinement,’ as Han Nefkens said. ‘We would talk for hours, and even then conclude that there was so much left to say. I still feel that way.’

In her closing speech, Princess Mabel of Oranje-Nassau described how important Joep and Jacqueline had been to her. They had taught her, like so many others, about the scientific side of HIV/AIDS, helped guide her through the maze of politics and players in the AIDS community, and Joep had been her mentor in finding her own way to make a contribution to his vision of a healthier world for all. Over the years, they had become close friends. She shared excerpts from a letter Jacqueline sent her during some of the darkest days of her life, offering words of comfort but also emphasizing the importance of dealing with loss in a positive manner. Frequent celebration of the unique lives of those we have lost and that we had the fortune of having them among us. In Jacqueline’s words, ‘The tangible is gone. A new life starts, a life with the memories.’

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