Alan Berkman

Gunshot wound

A witness claimed that Berkman had treated one of the gang members for a gunshot wound, but the doctor refused to cooperate with authorities in the investigation. He was charged as an accessory after the fact to the crime, becoming, according to his lawyers, the only US physician so indicted since 1865 when Samuel Mudd treated the broken leg of John Wilkes Booth, the fugitive assassin of President Abraham Lincoln.

Berkman was released on bail pending his trial and simply disappeared. He later surfaced as part of an armed robbery of a supermarket in Connecticut. When authorities caught up with him and a companion in Pennsylvania in May 1985, they seized a pistol, shotgun, and 100 pounds of dynamite. He was tried, found guilty, and served eight years in a federal penitentiary.

His experience in prison changed his tactics but not his commitment to social justice. He told the New York Times in a 1994 interview, “Power is corrupting. And the use of violence is a form of power. People motivated to stop the suffering of others have to be careful not to be caught up in the same dynamics” (www.nytimes.com, 10 Jan 1994, “Healing on parole; doctor and ex-prisoner, he treats others on probation”).

Berkman subsequently worked at a drug addiction clinic in the poverty stricken South Bronx part of New York city and as medical director of a skilled nursing facility for people with AIDS and mental health comorbidities. He returned to Columbia University for postgraduate work, eventually joining the faculty as vice chair of the department of epidemiology at the Mailman School of Public Health.

His work with HIV took him to Africa and the Caribbean, where the epidemic was raging, and access to treatment was something that only an elite few within those societies could even dream about.

He was frustrated by the 1998 International AIDS Conference in Barcelona, where there was no thought of bringing to Africa the then relatively new and expensive HIV drugs that had revolutionised treatment in the US and Europe. A visit to the preserved Nazi concentration camp at Dachau a few days after the conference would crystallise his commitment that something must be done.

Asia Russell was a community organiser and AIDS activist with ACT UP (AIDS Coalition to Unleash Power) Philadelphia when she first met Berkman a few months later at the initial planning meeting of what was to become Health GAP (Global Access Project). She later went to work for the organisation, where she serves as director of international policy.

You felt immediately that you were in the presence of someone who was both a visionary and also very grounded in practicality, she said of that first encounter. “He was not afraid to call this crisis what it was—medical apartheid, racism, a crime against humanity. He was never afraid to speak out, even when it made powerful people uncomfortable.”

Cost was the major impediment to bringing antiretroviral drugs to developing nations. Health GAP sought to break the pharmaceutical business model of pricing and patents that made treatment prohibitively expensive. It challenged wealthy nations to provide the money that would make affordable HIV drugs available to all who need them.

Staggering audaciousness

The audaciousness was staggering; the fact that it came to be is without precedent. The price of a first line HIV treatment plummeted from $12 000 to less than $100 a year in developing countries. In nations where people taking antiretroviral once could literally be counted on fingers, the number receiving treatment now approaches four million. Although many individuals and organisations worked to achieve this goal, Berkman’s role was crucial.

“Alan Berkman was a deeply committed humanitarian who put the needs of world’s disenfranchised above his own,” said Salim S Abdool Karim, director of the Centre for the AIDS Programme of Research in South Africa. “He leaves an indelible imprint on the global effort to make AIDS treatment accessible to all by his passionate advocacy, his selfless caring, and his deep compassion for the poor who were struggling to get AIDS treatment.”

Berkman leaves his wife, Barbara Zeller, and two daughters.