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Renowned Madras experiment

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Wallace Fox
Wallace Fox

It was the other day that someone casually mentioned in passing the Madras Tuberculosis Experiment and wondered whether I knew anything about the trials that had become internationally known. I’m afraid I didn’t, but naturally turned to Dr. A. Raman in New South Wales who is my source for matters concerning Madras medical history and he came up with the name of Wallace Fox. The trials Fox conducted in Madras, I discovered, were path-breaking in tuberculosis history, yet when he died in 2010 there was no obituary of him in any Indian paper that I came across at the time.

Fox, who had while he was young been ‘rested’ in a hospital for two years to help him recover from tuberculosis, was in the first decade after World War II, into research in Britain into a disease then dreaded world-wide. In India, at the time, there were far too many affected by the disease and too few sanatoria. The sanatoria themselves were proving too costly for Government or too expensive for patients if they were privately run. It was during international discussions on this common problem in all developing countries, that the World Health Organisation agreed to study it. With the Indian Council for Medical Research (ICMR) offering to host the study and the British Medical Research Council willing to send out a team of specialists, WHO launched the project. The Madras Government, which had a long history of anti-tuberculosis work, agreed to have the study conducted in the State. And in 1956 it welcomed the team led by Wallace Fox.

Over the next five years, supervising strictly controlled trials and carefully monitoring statistics, Fox and his team came up with an answer that changed the way tuberculosis was to be treated worldwide, but particularly in the developing countries. Fox found the tuberculosis patients treated with a strictly supervised medication regime (which included a cocktail of drugs), even in the overcrowded homes of the poor where diets were not nutritious, did as well as patients in well-run sanatoria that provided good food and comfortable facilities for rest. The research team also found that in the case of home treatment, the disease was not communicated to any one in the house.

The report of Fox’s team was not only to make world headlines — which again I don’t remember — but it also saw the number of sanatoria decreasing and the cost to Government and patients coming down. Interacting with Fox during the five-year trials in Madras were many well-known Madras medical names, like P.V. Benjamin, described as ‘The Father of the Anti-Tuberculosis Movement’ and who was the ICMR’s advisor with the project, K.S. Sanjivi, K.V. Thiruvengadam and P.R. J. Gangadharam, a medical microbiologist whose Ph.D. was on the use of chemotherapy in the treatment of tuberculosis.

The success of the project reflected something rare in India, teamwork. A writer commenting on the project some years later stated that the teaming of WHO, BMRC, ICMR and the State Government authorities was something remarkable and worthy of a management case study. Out of this teamwork there was born an Indian institution whose work is recognised worldwide, the Tuberculosis Research Centre on Spur Tank Road in Chetput, now known as the National Institute for Research in Tuberculosis. Its neighbour is the State’s Tuberculosis Research Centre.

Both are memorials to Dr. Wallace Fox, who, after he left Madras, contributed much more to ways and means of tackling tuberculosis. While in Madras, he married Gaye Akker, an artist. He himself had a wide world of interests beyond medicine: art, music, history, geology etc. But though he might have relaxed with them, at work he expected his team to be as driven as he was, as well as being perfectionists.

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