Lancet Medical Journal Tribute

Andrew Corbett-Nolan

Obituary

Steve Andrews Leading South African HIV/AIDS physician and activist. He was born on June 9, 1970, in KwaZulu-Natal, South Africa, and died unexpectedly of a heart attack on June 27, 2009, in Cape Town, South Africa, aged 39 years. Steve Andrews will be remembered first and foremost as a “caring human being”, an unsung hero who instilled in his patients the belief that they could lead full lives despite living with HIV. “Unnoticed, Steve helped us develop a new paradigm: the philosophy of positive living at a personal level while engaging in bigger battles out there. With his support and the support of each other, we began to celebrate life with HIV as one part of who we are”, said Derrick Fine, a trustee of The Openly Positive Trust, a non-profit organisation that supports people living with HIV/AIDS in South Africa. Andrews ran a part-time practice in Brooklyn, near Cape Town, that focused on the management of patients with HIV/AIDS and he was well known in HIV/AIDS activist circles. Perhaps his most famous patient was Treatment Action Campaign (TAC) founder Zackie Achmat, who described Andrews’ death as “tragic and untimely”. Andrews supported Achmat in his refusal to initiate combination therapy while the treatment was not accessible to fellow South Africans in the public sector. Passionate about medicine from an early age, Andrews qualified as a physician from the University of Cape Town (UCT) in 1993 and did postgraduate training in immunology at Groote Schuur Hospital. He went on to become a member of South Africa’s College of Family Practitioners 780

and in 2004 obtained a master’s degree in bioethics from UCT. Alongside his work as a physician, Andrews helped to design and implement large HIV programmes in South Africa’s public and private sectors. He was a medical adviser to various public and private HIV programmes, including the Aid for AIDS managed care programme, Médecins Sans Frontières’s (MSF) Khayelitsha Antiretroviral Programme, and the Council for Health Service Accreditation of Southern Africa, which formulated management standards for HIV in district and provincial hospitals. MSF’s Medical Co-ordinator in South Africa and Lesotho, Eric Goemare, said Andrews was “a rare mixture of someone with extreme HIV competence, who pushed politically for access to ARVs and was contagiously enthusiastic at the same time”. As an executive member of the Southern African HIV Clinicians Society, Andrews sat on antiretroviral guidelines committees. Society President Francois Venter said South Africa had lost a “passionate humanitarian”. Andrews was part of a small, committed group that oversaw the Society’s growth into an influential organisation. In 2001, Andrews defied the Pfizer patent and dispensed the life-saving drug Diflucan to his patients, which the TAC had illegally imported from Thailand. His friend Lance Carr recalls when South African Airways (SAA) lost Andrews’ luggage: “Such was the intensity of the man, that he managed to get the CEO of SAA on the line, requiring him to get involved in the lost luggage incident, particularly in view of the ‘life saving drugs’ he was carrying.” Andrews supported the TAC in various defiance campaigns. In 2002, he was a medical complainant in the action taken with the South African Competition Commission against GlaxoSmithKline over its excessive pricing of antiretroviral drugs. His deposition stated that it was “morally debilitating” for clinicians to be “restrained by the political and financial impediments imposed by the rich on the poor”. Andrews was principal investigator in 25 HIV clinical trials and was recognised by his peers as a major academic force. Professor Gary Maartens, head of UCT’s Clinical Pharmacology Division, wrote in the Southern African Journal of HIV Medicine that Andrews was an “outstanding” postgraduate teacher. He held sessions for primary care doctors in southern Africa and ran a website offering HIV training. “His seminars on ethical aspects of HIV were particularly memorable—he would get the most jaded doctors up on their feet, arguing passionately”, said Maartens. “Steve was an ardent crusader for justice; and this was not only applicable to his professional life but his private life as well. He genuinely cared for people, particularly those that others rejected. He was a passionate man who lived life to the full in the service of others,” said Carr. Andrews is survived by his wife, Lyndall, and young daughter, Sarah.

Adele Baleta [email protected]

www.thelancet.com Vol 374 September 5, 2009