Hoosen Coovadia, 83, Medical Force in South Africa’s H.I.V. Fight, Dies

Hoosen Coovadia, a pediatrician who used science to fight for racial justice in apartheid South Africa and later transformed the approach to H.I.V. treatment for pregnant women in Africa and beyond, died on Oct. 4 at his home in Durban. He was 83.

His daughter, Anuschka Coovadia, a physician in South Africa, confirmed the death, saying he had been in poor health for two years and was further debilitated by a case of Covid-19 several months ago that kept him in intensive care for weeks.

Dr. Jerry Coovadia, as he was familiarly known, was a leader in the struggle against white rule in South Africa and campaigned for decades for the political transition that brought the African National Congress to power in 1994.

But when, four years later, President Thabo Mbeki began to deny that the human immunodeficiency virus caused AIDS, and asserted that new treatments for H.I.V. were poisons he would not permit to be given to South Africans, Dr. Coovadia became one of the government’s fiercest critics.

“Never was a doctor so vilified as Jerry Coovadia in the A.N.C. for his implacable and quietly militant stand against Thabo Mbeki,” said Zackie Achmat, the founder of the Treatment Action Campaign, a movement of people living with H.I.V. that also battled Mr. Mbeki, who was unseated in a party putsch in 2008.

Dr. Coovadia and the activists he supported eventually won that fight, and he helped make South Africa a global leader in H.I.V. care and research. He also mended some relationships with the government, although he remained a vocal critic of inequity in the post-apartheid years.

In a statement after Dr. Coovadia’s death, President Cyril Ramaphosa of South Africa said, “Our nation’s loss will be felt globally, but we can take pride at and comfort from the emergence of a giant of science and an icon of compassion and resilience from our country.”

Hoosen Mahomed Coovadia was born on Aug. 2, 1940, in Durban. His parents, Mohamed Coovadia and Khateja Moosa, came from prosperous merchant families in Durban’s Indian community, though his father, a compulsive gambler, lost most of his wealth while Dr. Coovadia was still young.

He was admitted to the University of Natal medical college, set up by the apartheid government for Black and so-called colored students like Dr. Coovadia, but after a short time he concluded that the education it offered was inferior. He applied to study in Cape Town, but the government denied him the permit to travel that he required as a nonwhite student.

Instead, he traveled to India and enrolled at Grant Medical College in Bombay (now Mumbai). There he was exposed to anticolonial ideas and met other South African students, with whom he organized a political association. Prominent leaders of the anti-apartheid movement visiting India would address them.

Dr. Coovadia, with a medical degree from Grant, returned to South Africa in 1966. Three years later, he married Zubeida Hamed, who had also graduated from Grant and was finishing her training in dermatology. Dr. Hamed shared her new husband’s growing interest in activism, and their home, in Durban, became a mecca for political meetings. Dr. Coovadia went to work as a pediatrician at King Edward VIII Hospital in Durban, an institution that could treat only nonwhite South Africans under apartheid, and later joined the department of pediatrics at the University of Natal Medical School (now part of the University of KwaZulu-Natal). He came under suspicion by the regime for conducting research on topics such as racial disparities in infant mortality in South Africa. He also joined the Natal Indian Congress, an anti-apartheid organization, and soon became a leader of it.

In 1975, Dr. Coovadia earned a master’s degree in immunology from the University of Birmingham in Britain. Returning to South Africa, he found opposition to apartheid there swelling into open revolt. He helped found the United Democratic Front, a coalition of more than 400 trade unions, religious organizations and other civic groups opposed to white rule. In 1989, the police raided and ransacked his home in search of papers related to secret talks between the regime and the A.N.C.

A month later, South African secret police planted a bomb in front of Dr. Coovadia’s home. His son, Imraan, a novelist and professor of creative writing at the University of Cape Town, said his father had become such a prominent critic of apartheid abroad, speaking at scientific meetings, that the regime had decided to eliminate him. The bomb destroyed the second floor of the house, but the family survived.

“It took weeks to get the walls rebuilt,” his daughter, Anuschka, said, “and during that time, my father’s medical students came on a schedule, protecting the house with broom poles and sticks, sitting out all night. There was so much love from his community of students.”

In addition to his son and daughter, he is survived by his wife and five grandchildren.

Dr. Coovadia wrote a textbook on child health now in its seventh edition, mentored dozens of students and researchers, many of whom became health ministers and key figures in global health, and conducted pioneering work on measles and pediatric kidney disorders. He advised successive South African governments from various positions, including a seat on the powerful National Planning Commission; led international research projects; published widely in scientific journals; and received awards, including the Star of South Africa, the country’s highest honor, presented by President Nelson Mandela.

But it was his work on H.I.V. that had perhaps the greatest impact on global policy, and which drew him into an unexpectedly vicious political battle.

In the late 1980s, he started to see babies with H.I.V. arriving at the hospital, prompting him to begin researching ways to stop the transmission of the virus from mothers to their children. “He considered it another form of oppression for these women, who were Black, who were poor, who were often rural — and on top of all of that, had H.I.V.,” said Salim Abdool Karim, a leading authority on H.I.V. globally and a former student of Dr. Coovadia’s.

By the 1990s, the World Health Organization was recommending that women with H.I.V. feed their children with baby formula rather than breast milk, which could transmit the virus. But Dr. Coovadia suspected — and then proved in a series of studies — that the risk was minimal in exclusively breastfed infants, and that the health benefits for infants whose mothers did not have access to clean water with which to mix formula far outweighed the risk from H.I.V.

Dr. Coovadia battled the W.H.O. and succeeded in having the policy reversed. He also helped demonstrate that giving antiretroviral drugs to pregnant women could prevent them from transmitting the virus to babies at birth.

South Africa had the world’s largest number of people living with the virus by the late 1990s, but when President Mbeki, to whom Dr. Coovadia had earlier been close, created a commission to govern the AIDS response, he stacked it with rogue researchers and self-proclaimed experts known as “AIDS denialists.” Manto Tshabalala-Msimang, a health minister appointed by Mr. Mbeki, told people living with H.I.V. that they could stave off AIDS by eating garlic and beets. Dr. Coovadia was incensed.

In 2000, as he prepared to become a co-chair of a major global AIDS conference in Durban, the A.N.C. government put immense pressure on him to present the denialist view.

“He was such a courageous and principled person: He would not give in,” said Dr. Peter Piot, who was then the head of the United Nations AIDS agency and who joined Dr. Coovadia in “turbulent” meetings with government officials ahead of the event.

President Mbeki, as head of state, opened the conference and, to the horror of much of the audience, reiterated his denialist view. The government then demanded that Dr. Coovadia allow Dr. Tshabalala-Msimang to close the event.

Dr. Coovadia’s daughter recalled that 10 “thuggish” men came to the family’s hotel room the night before the conference ended and ordered him to a meeting with the minister. “When he came back, he was utterly shaken,” she said. “He didn’t sleep that night.”

Knowing it might mean both the end of his professional life and ostracism from the party for which he had fought for decades, Dr. Coovadia nevertheless refused the minister the platform. Instead, the keynote speaker at the final session was Mr. Mandela, who had stepped down as president a few years earlier. He exhorted the world to bring AIDS treatment to his country and the rest of Africa.

After Mr. Mbeki left office, Dr. Coovida helped South Africa roll out what became the world’s largest H.I.V.- treatment programs.