With the passing of Scientia Professor David Cooper on March 18, the HIV world lost a unique contributor to global health. A precocious talent, entering medical school at the University of Sydney as a 15 year old, David was always destined to leave a professional legacy.
It was during his academic fellowship at the Dana-Faber Cancer Institute in Boston from 1981 that the first AIDS cases were described among gay men in the United States. By his return to Australia in 1983 to take up a position as Clinical Immunologist at St Vincent's Hospital, Sydney, HIV had been discovered and transmission routes characterised. Over the next 35 years he would bring his intellect, clinical acumen, and considerable collaborative capacities to the task of improving the lives of people living with HIV.
These efforts were initially local, at St Vincent's Hospital in inner-city Sydney, where many of Australia's first diagnoses of AIDS emerged among gay and bisexual men. From the beginning, his clinical and research initiatives were interlinked as was evidenced through the first description by David and colleagues of the symptoms and signs of acute HIV infection.
David's contributions soon expanded to the national level, taking on the role of inaugural Director, National Centre in HIV Epidemiology and Clinical Research in 1986. The Centre had been established through Australian Government funding, following bipartisan political support for a concerted response to HIV/AIDS. Under David's leadership the Centre monitored the HIV/AIDS epidemics in Australia and established clinical research networks to evaluate therapies as they emerged. David initiated vital national collaborations and working groups that brought together hospital specialists, primary care physicians and affected community members across Australia. The promotion of involvement of people living with HIV/AIDS in the development and conduct of clinical research was a particular feature of David's leadership.
David always maintained an active role in clinical care. He was Head of the St Vincent's Hospital HIV services for more than two decades. The empathy and care he showed for patients who were highly stigmatized provided comfort for numerous people affected by the epidemic. This level of attention was associated with outstanding clinical insight, an example of which was his observation and then first description of the antiretroviral therapy-related lipodystrophy syndrome-a diagnosis that was initially controversial.
David was at the forefront of antiretroviral therapy implementation through his leadership with numerous national and international protocols, and key public and industry sector advisory positions. David believed that Australia had an important role to play in responding to the HIV epidemic in the Asian region. Together with Professors Joep Lange and Praphan Phanuphak in 1996, he created HIV-NAT (Netherlands Australia Thailand) a clinical research centre in Bangkok to which he was passionately committed and took immense pride in its growing accomplishments. Further contributions in Asia included his participation and leadership in the American Foundation for AIDS Research (AmFAR) TREAT Asia initiative.
David played a pivotal role in the development of international clinical research collaborations for strategic HIV trials, including being a key leader in the NIH-funded INSIGHT network. He was also a strong advocate for the role of fundamental science in addressing clinical problems not solved by antiretroviral therapy alone, including poor immune recovery, immune activation, and associated serious non-AIDS conditions.
Perhaps David's greatest contribution was his leadership with other key figures in promoting the concept that life-saving HIV therapies should be available to all people living with HIV globally, and subsequently his demonstration that these therapies should be utilised for all stages of HIV infection.
Prevention was also core to David's interests and he was a firm believer that an end to HIV would be impossible without a vaccine. He strongly supported the development of other biomedical preventions and co-led the EPIC study in New South Wales, one of the largest demonstration projects of pre-exposure prophylaxis (PREP). Only weeks before his death, the exciting findings of a decline in new HIV infections in New South Wales were presented at CROI in Boston and the day following his funeral, the Australian government announced a fully funded reimbursement program for PREP for all at risk Australians.
David was committed to HIV and human rights, and supported expanded research in infectious diseases particularly viral hepatitis and sexual transmissible infections. These and his other initiatives led to the National Centre being renamed the Kirby Institute in 2011, after his great friend and human rights advocate, the Honourable Michael Kirby.
For us, and numerous others, David was an inspiring scientific colleague, teacher, mentor and friend, providing insightful guidance and support. He engendered dedication and a shared vision for improving the lives of people, particularly those from vulnerable populations. His sudden loss is felt deeply by his wife Dorrie, daughters Becky and Ilana, his extended family and many friends, colleagues and the broader community.
Gregory Dore, Jennifer Hoy, Praphan Phanuphak, Jay Levy and Sharon R. Lewin