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Professor Wallace Fox

Peter Davies
Tuesday 23 November 2010 01:00 GMT
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Wallace Fox was leader of the Medical Research Council (MRC) programme that provided effective treatment for tuberculosis, even in the poorest developing countries

Born in Bristol on 7 November 1920, he contracted tuberculosis shortly after qualifying as a doctor in 1941. In the era preceding drug therapy, he received the standard treatment of bed rest and fresh air for the next two years in hospital, in his home city of Bristol. This experience was to inspire a career dedicated to finding a cure for tuberculosis (TB) on the world stage.

Fox joined the MRC Tuberculosis Research Unit in London under Professor Philip d'Arcy Hart in 1952 just as the first effective new antibacterial drugs such as streptomycin were being introduced. However bacterial resistance to streptomycin was seen in the first clinical trial in TB patients. Fox's first clinical trials in the UK demonstrated that this resistance could be prevented by using a combination of streptomycin, p-Aminosalicylic Acid (PAS) and isoniazid; a finding which led to the standard three drug regimen that was used throughout Western Europe for the next 15 years.

While this was a major breakthrough for the developed world, Fox recognised that the high cost of PAS made it unavailable in many poorer countries. Collaborating with physicians in East Africa to find a much cheaper alternative, they found that Thiacetazone could replace it. The finding led to affordable regimens that were rapidly introduced in Africa and elsewhere.

In 1956, Fox was seconded bythe MRC to the World Health Organisation to set up a research unit for TB drug trials. He selected Madras, where he lived and worked for five years on a series of ground-breakingstudies which revolutionised the treatment of TB in the developed and developing world.

He met his wife, Gaye Akker, a few weeks before he was due to move to India, marrying her six weeks later in the Cochin synagogue. In Madras and for the rest of his career, Fox worked closely with Dennis (Denny) Mitchison, a clinical microbiologist, who had also worked on the early trials and was subsequently the Director of the MRC Unit for Laboratory Studies of Tuberculosis and with Ian Sutherland, Director of the MRC Statistical Services and Research Unit, who provided statistical expertise.

Fox's landmark trial demonstrated that using the standard combination of three drugs, treatment at home was just as effective as in sanatoria and also that the treatment at home did not expose the families to added risks of infection. This trial was responsible for closing TB beds in hospitals and sanatoria throughout the world, with huge savings of lives and money.

He is survived by his wife, Gaye and three sons.

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