Obituary: Jonathan Mann and Mary Lou Clements-Mann

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AS THEY had done so many times before, Jonathan Mann and Mary Lou Clements-Mann were on their way to Geneva, to pursue work that had taken them all over the world. But this trip was more than just another trip to a meeting. For both of them, married in December 1996, it was the start of a voyage into a new phase of their lives, to which they were both looking forward with optimism and hope.

They were bringing to Geneva their unique personal and professional partnership to support the global response to the AIDS pandemic. Mary Lou was bringing her scientific expertise, and Jonathan his vision of a world where HIV/AIDS would be recognised and responded to through a combined, largely expanded health, social and economic development strategy. The new strategy would encompass a broad variety of interventions, from the development of HIV vaccines relevant to developing country needs - and not only to rich countries - to the social and economic changes needed to reduce the vulnerability of individuals and communities to HIV/AIDS.

Mary Lou Clements-Mann was a professor at the Johns Hopkins University School of Public Health. She was also founder and first director of the Center for Immunisation Research at Johns Hopkins University, Baltimore, and a Principal Investigator in the National Institute of Health AIDS Vaccine Evaluation Unit network. Her involvement with World Health Organisation datedback to 1975 when she served as consultant to their Smallpox Eradication Program in India, following her post-graduate diploma in Tropical Medicine and Public Health from the London School of Tropical Diseases.

Her extensive experience in the clinical research and development of vaccines for humans had led to her world-wide recognition as a vaccine expert. She was a member of the US Centers for Disease Control Advisory Committee on the Children's Vaccine Initiative. Her HIV/AIDS- related work had earned her a membership to the World Health Organisation's steering committee for HIV vaccine development. She contributed to keeping HIV vaccines for the developing world firmly anchored in the agenda of global scientific research.

On 3 September, Clements-Mann was on her way to the WHO headquarters to attend a technical consultation where she was to share her experience with other experts on lessons learned from non-HIV vaccines for AIDS vaccines. With her death, the world is losing much of its collective memory and experience in this field.

Jonathan Mann gained his medical qualification from Washington University, St Louis, having already graduated from Harvard in History, and began to build his public health career in 1975 as an Epidemic Intelligence Service Officer with the US Centers for Disease Control. He then worked as a state epidemiologist and assistant director of the health department in New Mexico. Born and brought up in Boston, Mann always retained his roots both in conservative, often cold New England and in the arid and vast wilderness of New Mexico.

From 1984 to 1986, he founded and directed the Project SIDA, a collaborative AIDS research project based in Kinshasa, Zaire and played a key role in documenting the rapid spread of HIV in sub-Saharan Africa, at a time when the epidemic was still considered by many as the exclusive attribute of rich countries.

From 1986 to 1990, he was the founding Director of the World Health Organisation's Global Programme on AIDS, based in Geneva. He made a vast contribution to mobilising the world against HIV/AIDS, becoming a public figure, advocating global responses to the pandemic that were sound, effective and, most importantly, respectful of human rights.

In disagreement with the then Director General of the WHO, on what ought to be done to enhance the global strategy on AIDS, Mann resigned from the WHO in 1990, to become Professor of Epidemiology and International Health at the Harvard School of Public Health. Subsequently, in 1993, he was appointed the first professor of Health and Human Rights and founding director of the Francois-Xavier Bagnoud Center on Health and Human Rights.

His international experience with AIDS policies had brought the link between human rights and health to his attention. He was particularly interested in the effect of health policies on human rights, the health impact of human rights violations, and the inextricable connection between promoting and protecting health and rights. In January 1998, he left Harvard to become the Dean of the Allegheny School of Health Sciences in Philadelphia. His specific interest in this new position was to apply the public health he had taught in an academic setting to training public health practitioners who could undertake the practical application of this thinking in a context of social justice.

Hours after the confirmation of their tragic deaths, the staff of the World Health Organisation and of the United Nations programme on AIDS and other friends met in the WHO Executive Board Room - the largest auditorium of the WHO headquarters in Geneva. For Mann, this room had been the theatre of a wide variety of events in his career. At times, it was a welcome gathering place, both for him and his colleagues. But, at other times, it was a battlefield. Here, the battles were often about pushing the boundaries of public health beyond traditional thinking.

They were also about giving the global AIDS epidemic a new perspective, new dimensions and most importantly, generating new hope for what he called a global mobilisation. And these battles were also about putting human rights on the agenda of public health. The struggle was also about building a new World Health Organisation. Today, the renaissance of WHO is well underway.

The last time I saw Mann in that room was 16 March 1990. On that day he announced to WHO and the world that he was resigning his post as the first Director of the Global Programme on AIDS. When he walked through those doors at the back of this room, the entire staff of GPA was there, applauding and making a corridor for him to walk through, leading him away from this organisation, which he cherished, and into a new life and new challenges at the Harvard School of Public Health.

The intensity of Jonathan Mann and Mary Lou Clements-Mann's lives and their work, the profound impact they had on friends, co-workers, and people round them - particularly those in greatest need - will continue to inspire.

Jonathan Max Mann, epidemiologist: born Boston 30 July 1947; director, Project SIDA, Kinshasa, Zaire 1984-86; Director of Global Programme on AIDS, World Health Organisation 1986-90; Professor of Epidemiology and International Health, Harvard School of Public Health, 1990-93; Director, Francois-Xavier Bagnoud Center for Health and Human Rights, Harvard 1993- 98; Dean, Allegheny School of Health Sciences, Philadelphia 1998; married 1970 Marie-Paule Bondat (one son, two daughter; marriage dissolved), 1996 Mary Lou Clements; died off the coast of Nova Scotia, Canada 2 September 1998.

Mary Lou Clements, epidemiologist: born Longview, Texas 17 September 1946; Assistant Professor, University of Maryland School of Medicine 1979- 85; Associate Professor, Department of International Health, Johns Hopkins University 1985-90, Professor 1990-98; Director, Johns Hopkins Center for Immunisation Research 1986-96; married 1996 Jonathan Mann; died off the coast of Nova Scotia, Canada 2 September 1998.