In a time when everything of real significance is overwhelmed by babble about the president's sexual deceits, let me tell you about someone who actually mattered. Dr. Jonathan Mann was killed in the crash of Swissair Flight 111 off Nova Scotia last week, along with his wife, Dr. Mary Lou Clements-Mann. Both were 51 years old. At the time of their deaths they were on their way to Geneva to promote the worldwide effort against AIDS, the cause to which they had devoted so much of their careers -- indeed, the cause that was forced onto the world agenda by Jonathan Mann long before celebrities started wearing red ribbons.
As a longtime colleague told the New York Times, recalling Dr. Mann's role as the first director of the World Health Organization program to stop the epidemic, "Jonathan was the architect of the global mobilization against AIDS." Helping to save millions of people, as he certainly did, might have been achievement enough for anyone. Yet while the AIDS epidemic was his central professional concern and passionate commitment during the last 15 years, Mann's project transcended any single issue or disease. His titles included a doctorate in public health, but he was in fact a philosopher of public health who discovered and then revealed the inextricable links between human rights and human health. He was a college professor and dean, but he was more importantly a true teacher, meaning someone who could permanently improve the perception and the consciousness of anyone who would listen to him for an hour or two. When I had the privilege of hearing him give a talk last year, he explained brilliantly how it is the deprivation of dignity, for individuals and whole populations, that leads inexorably to ill health for them and for society. He was an intellectual who dared to ask the world's most mundane and profound questions: Who lives? Who dies? Who prospers? Who suffers? Why? And when we find the answers, what should we do?
He asked those questions about AIDS from the very beginning, and thus helped to shape the world's response. He knew that a medical solution to the epidemic would be a long time coming, and that in the interim many would die. Until the advent of a cure or a vaccine, he argued, the world needed to pursue preventive strategies to stop the spreading infection. And only by breaking down the social barriers to AIDS prevention could those millions be saved. This meant, in his words, a strategy that "excludes classic practices such as isolation and quarantine ... and explicitly calls for supporting and preventing discrimination against HIV-infected people." Starting with his own small project in Zaire in 1984, Mann's energy and intellect inspired health professionals in well over 100 countries to believe that they could prevail against a seemingly uncontrollable virus.
After several years of service at the World Health Organization, he resigned in 1990, having grown impatient with the bureaucratic and political problems inherent in the organizational affiliate of the United Nations. By then an AIDS program was well-established at W.H.O., so he could move on to create new institutions that could act upon his insights about public health and human rights. At Harvard, where he became a professor in the School of Public Health, he opened the Francois-Xavier Bagnoud Center for Health and Human Rights, which served as his base for several years.
Even in academia he continued to be oriented toward action. He always seemed to work as if there might not be enough time to do all that needed to be done. Within a year of leaving W.H.O., he helped found Doctors of the World, USA, the humanitarian and medical relief group that now has the largest corps of volunteer medical professionals in the country. Doctors of the World's dual mission -- providing health care to marginalized people at home and abroad, and exposing human rights violations against those it serves -- is the embodiment of Mann's ideas. Volunteer doctors inspired by his vision, rather than by HMO incentives, may be found in places as diverse as orphanages in St. Petersburg, peasant clinics in Chiapas, hospitals in Kosovo and the Immigration and Naturalization Service detention center in York, Pa.
It is a radical vision, to be sure. Victoria Sharp, who directs the AIDS Center at St. Luke's Roosevelt Hospital Center in New York and chairs Doctors of the World, considered Mann a mentor. Mourning him, she said: "Health care as a right, not a privilege, was his anthem -- whether that be for HIV-infected peoples of Africa, malnourished refugees in Bosnia or homeless substance abusers in the South Bronx."
We see and hear much, in these pages and elsewhere, about the shortcomings of the baby-boom generation, especially the fading of humane ideals into acquisitiveness, cynicism and self-absorption. That generalization, of course, tends to serve the interest of those who prefer the world as it is.
Jonathan Mann was born in 1947, one year before the signing of the Universal Declaration on Human Rights, that great document whose promise of decency to all inhabitants of this planet he spent a lifetime trying to fulfill. He was not discouraged by failure, nor did he let frustration serve as an excuse for apathy. If anything, his dedication grew stronger as he entered middle age. To me he seemed far wiser than his age would have suggested. In his passing, the world has lost not only a committed healer but a modern sage.
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