Lives of the fellows

David Albert Cooper

b.19 April 1949 d.18 March 2018
AC(2018) AO(2003) BSc Sydney(1969) MB BS(1972) FRCPA(1978) FRCP(1998) FRACP(1979) MD New South Wales(1983) FAFPHM(1990) FACVen(1991) DSc(1993) FAA(2007) FAHMS(2015)

David A Cooper was an Australian clinician and researcher who played a leading role in the global fight against the human immunodeficiency virus, HIV. He was born in Sydney to Jewish immigrant parents. His father, Max Cooper, a manufacturer, had migrated to Sydney from Poland, arriving before the outbreak of the Second World War. His mother, Anita (‘Annie’) Lazarus, had migrated to Australia with her family from Lithuania, via England. David and his sister, Bettina, were raised in Dover Heights in the eastern suburbs of Sydney.

David raced through high school at Sydney’s Cranbrook School and commenced medical studies at the University of Sydney aged just 15. During his undergraduate studies, he had his first scientific publications, and in 1972 he graduated with first class honours, aged 23. With this foundation, David embarked on a career in clinical immunology, completing his fellowship qualifications as both a physician and a pathologist and his doctorate in B cell immunology at St Vincent’s Hospital in Sydney through the University of New South Wales.

In 1981, he and his young family moved to Boston, where he worked at the Dana-Farber Cancer Institute for two years. It was here that blood samples from very ill gay men revealed the tell-tale signs of the devastation that HIV, the then yet to be described virus, caused to the body’s immune defences. Observing the key risk groups in the USA, David rightly hypothesised that the illness would make its way to Australia, and that St Vincent’s Hospital, located at the hub of Sydney’s gay suburbs, would be at the epicentre.

Upon his return to St Vincent’s towards the end of 1983, he was confronted with an escalating number of patients presenting with the devastating illness and immersed himself in efforts to care for people with this new and frightening condition. He and colleagues set up one of Australia’s first clinical HIV research studies; a prospective cohort study enrolling young men who were patients of the hospital and of local general practices. One of the results, published in The Lancet, was the first description of the seroconversion illness; the initial stage of HIV infection (‘Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion.’ Lancet. 1985 Mar 9;1[8428]:537-40). This insightful linking of acute clinical observations to laboratory results was a notable demonstration of David’s clinical acumen and ability to make connections that others could not, a talent he demonstrated multiple times during his career, providing one piece of irrefutable evidence of his ability as an exemplar clinician. The other evidence comes from the testimonials of his patients and colleagues.

In 1986, he was approached by the Commonwealth Government of Australia to lead the National Health and Medical Research Council of Australia’s Special Unit in AIDS Epidemiology and Clinical Research, which later became the National Centre in HIV Epidemiology and Clinical Research and then the Kirby Institute, established as part of the early response to the epidemic. At the same time, he was director of St Vincent’s AIDS unit. He spoke often about the effects of ignorance and stigma on his patients, with some staff refusing to take food trays into their rooms. His approach, which was concordant with the mission of the Sisters of Charity, the religious order which ran St Vincent’s, was that every patient deserved dignity, care and compassion, and that none would be turned away.

From the earliest days, David understood that rigorous research would be required to discover the treatments needed to stop HIV infection, and that, along with clinicians and scientists, those affected should be involved in decisions about how trials should be designed and run. He was an international leader in clinical trials of new drugs that emerged in the 1990s which, when used in combination, proved in 1996 to be the breakthrough that showed sustained viral suppression prevented progression of the disease. Combination antiretroviral treatment also allowed robust immune reconstitution, leading to a reduction in the numbers of people dying from AIDS.

David served as president of the International AIDS Society from 1994 to 1998, and during his tenure significantly influenced the Society’s strong, inclusive and effective position on treatment access. This was during a time when the benefits of these new medications were realised almost exclusively by wealthy countries. His advocacy for equality of treatment access led, in large part, to the International AIDS Society’s decision to host its annual conference in the year 2000 in Durban, South Africa, placing a spotlight on the heart of the global epidemic for the first time.

He continued to work, designing strategically important trials and setting up collaborative networks of clinicians to conduct these trials, in order to accelerate research and to make sure patients, no matter where they were, could access the best available evidence-based treatments. Along the way he identified, encouraged, mentored and supported young clinician researchers and scientists across a range of relevant disciplines, many of whom are now authorities in their own right.

He was deeply involved in research and capacity building activities in Australia’s immediate region, the Asia Pacific. In 1996, along with two other visionary leaders in HIV research, Joep Lange and Praphan Phanuphak, he founded HIV-NAT (the HIV Netherlands Australia Thailand Research Collaboration) in Bangkok. HIV-NAT is now the acknowledged leader in Southeast Asia in HIV treatment research.

As director, he facilitated and supported the Kirby Institute’s work with Aboriginal and Torres Strait Islander populations in Australia, and in vulnerable populations throughout Australia and the region, in Papua New Guinea, Indonesia, the Pacific Islands, and Cambodia. Most recently, in 2017, he established the Myanmar-Australia Research Collaboration for Health (MARCH) with the University of Medicine Two in Yangon to address the challenge of communicable diseases in that resource-poor setting.

David continued this ambitious work, whilst maintaining his clinical practice, right up until his illness and death. The intent of the research was always to ensure the best evidence-based treatment regimens were available in vulnerable, underserviced populations, and this work now continues through the Kirby Institute.

David was a leader in global research, an extraordinary clinician, a cherished colleague and friend, and a devoted family man. He was survived by his wife, Dorrie (née Stark), daughters Becky and Ilana, and two grandchildren.

Anthony Kelleher

[The Kirby Institute Kirby Institute Director Professor David Cooper, AO, passes away 19 March 2018 https://kirby.unsw.edu.au/news/kirby-institute-director-professor-david-cooper-ao-passes-away – accessed 27 April 2019; UNSW Sydney Newsroom Vale David Cooper: Australia’s pioneer in HIV research 20 March 2018 https://newsroom.unsw.edu.au/news/health/vale-david-cooper-australias-pioneer-hiv-research – accessed 27 April 2019; UNAIDS Update UNAIDS saddened by the death of pioneering HIV researcher David Cooper 21 March 2018 www.unaids.org/en/resources/presscentre/featurestories/2018/march/20180321_david-cooper – accessed 27 April 2019; News.com.au The man who diagnosed Australia’s first HIV case dies 27 March 2018 www.news.com.au/technology/science/human-body/the-man-who-diagnosed-australias-first-hiv-case-dies/news-story/cea425e66bbdf3a78fa383d814a0bbfd – accessed 27 April 2019; The Sydney Morning Herald 28 March 2018 www.smh.com.au/national/david-cooper-leader-in-the-global-fight-against-hiv-20180327-h0y0r7.html – accessed 27 April 2019; Retrovirology 2018 15:40 https://retrovirology.biomedcentral.com/articles/10.1186/s12977-018-0418-1 – accessed 27 April 2019; BMJ 2018 361 1567 www.bmj.com/content/361/bmj.k1567 – accessed 27 April 2019; AIDS June 1 2018 Vol.32 Issue 9 1205-6 https://journals.lww.com/aidsonline/Citation/2018/06010/Professor_David_Cooper.17.aspx – accessed 27 April 2019]

(Volume XII, page web)

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