Obituary
and in 2004 obtained a master’s degree in bioethics from
Andrew Corbett-Nolan
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 immuno-
logy at Groote Schuur Hospital. He went on to become a
member of South Africa’s College of Family Practitioners
780
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 Pharmaco-
logy 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
a.baleta@mweb.co.za
www.thelancet.com Vol 374 September 5, 2009