Pioneering nephrologist who contributed to early advances in haemodialysis. Born in London, UK, on Nov 8, 1931, he died on Dec 20, 2013, in Monaco, aged 82 years. Brilliant, principled, and always willing to speak his mind, Stanley Shaldon was a pioneer of nephrology who once said his aim had been to make “dialysis the insulin of the chronic nephritic”. Yet by his own account, Shaldon wasn't initially interested in nephrology until he was forced into the field by leading hepatologist Sheila Sherlock. While Shaldon was her registrar, she sent him to the first International Congress of Nephrology to deliver a paper, and on his return told him he was to become nephrologist. “I think if I had been left alone I would have…ended my days doing experimental medicine on humans”, he said in a 2010 interview. It wasn't to be. Shaldon had studied medicine at the University of Cambridge and the Middlesex Hospital, London. After 2 years of military service in Nigeria he became Sherlock's registrar at the Royal Postgraduate Medical School, Hammersmith Hospital. Moving with Sherlock to the Royal Free Hospital in 1960, he began a lifetime's work developing haemodialysis. “In those pioneering days chronic haemodialysis treatments were limited by vascular access problems. Stanley Shaldon devised and produced a series of vascular access catheters leading to the first use of the Seldinger technique for repetitive percutaneous access for haemodialysis, including percutaneous catheters allowing temporary clamping, still referred to as the ‘Shaldon catheter’, so establishing the pattern of thrice weekly dialysis treatments that continues today”, says Andrew Davenport, consultant nephrologist and honorary senior lecturer at the University College London Centre for Nephrology, Royal Free Hospital. Andrzej Wiecek, Chief of the Department of Nephrology, Endocrinology, and Metabolic Diseases at the Medical University of Silesia, Poland, remembers using Shaldon catheters for dialysis of patients with acute renal failure in the 1980s. “I remember how many lives we were able to save because of this simple but very efficient method.” In 1964, Shaldon became the first nephrologist in the UK to introduce home dialysis, aiming to free patients from the need to attend hospital, and the Royal Free Hospital unit became one of the first to train and use nurse technicians to oversee dialysis. 2 years later, in 1966, he left the Royal Free to set up the National Kidney Centre in London. The aim of the centre was to show that dialysis could be done outside the hospital and that home training would be facilitated in a domestic setting. The centre treated some 30 home dialysis patients between 1966 and 1968. “What struck me as being very interesting was the concept of self-treatment”, Shaldon said. “That you could inspire in somebody who had a potentially fatal disease…a sense of independence, not dependence.” Writing in 1994, his colleague Karl Koch noted that “his subsequent enormous success proved that he was correct”. Although the idea of home dialysis later fell out of favour, it has recently experienced a resurgence, says Raymond Vanholder, President of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). “He was 50 years ahead of his time when he initiated home dialysis, nocturnal dialysis, and extended long dialysis: all options that only started thriving during the last decade.” Shaldon was also one of the first nephrologists to reuse dialysers and, more importantly, drew attention to the importance of pure dialysis water. “That was a really neglected thing that he really modified together with Karl Koch and Charles Dinarello”, says Vanholder. In the course of his career, Shaldon published more than 350 peer-reviewed publications on topics that included the role of chemokines in uraemia and the toxicity of dietary salt, which became something of a personal crusade. Shaldon was a founding father of the ERA-EDTA, a society that now boasts more than 6600 members, and which awarded him the ERA-EDTA Award in 2011. As a prominent figure in the international nephrology community, Shaldon was willing to speak up against what he saw as dishonesty and superficiality. “He expressed great integrity, dedication, friendship, and understanding on the one hand, and sometimes controversy and intolerance on the other”, says Jacques Bernheim, a past president of the ERA-EDTA. “He was a sensitive man and an independent and honest scientist.” Shaldon is survived by his wife, Penelope, and two children.

Pioneer of veterinary public health. Born on April 3, 1913, in Chicago, IL, USA, he died aged 100 years on Nov 10, 2013, in Houston, TX, USA. When James Steele was a veterinary student at Michigan State University in 1939, there was a laboratory accident in the bacteriology building where he had a part-time job. The bacterium Brucella melitensis had somehow become aerosolised in the basement of the building, leading to the death of at least one student. Steele later learned that the US Army were considering use of this bacterium as a bio-warfare agent. He was a sensitive young man and this early exposure to the threat animal infections could pose to human health was a turning point, says his biographer Craig Carter, Professor in the Department of Veterinary Science at the University of Kentucky. “It was an event that fuelled his passion to learn everything he could about the zoonotic class of diseases.” Today, some 70% of emerging diseases in human beings are classified as zoonoses, says Carter. “Jim Steele was the first to recognise this, and spent his career helping the world to deal with this growing list of more than 200 diseases shared by animals and man.” Steele earned a Doctor of Veterinary Medicine degree from Michigan State College in 1941. He was encouraged by the Dean of the State Veterinary College, Ward Giltner, to integrate veterinary medicine and public health, and by Henrik Stafseth, his Professor of Microbiology, to do a Master of Public Health at Harvard. It was at Harvard that he received some important advice from Cecil Drinker, the Dean of the School of Public Health. Drinker urged him to use his doctor of veterinary medicine qualifications to improve the field of public health. That was what he did, starting the veterinary public health programme at the United States Public Health Service in Washington in 1945, and 2 years later moving to Atlanta, setting up the veterinary division of what is now the Centers for Disease Control and Prevention (CDC). At a time when stray dogs and cats made rabies a major problem in the USA, Steele oversaw the development of the first effective vaccine and control programmes, which were successfully used during an outbreak in Memphis in 1950 and in other major cities around the USA. He went on to encourage the establishment of veterinary public health programmes in health departments in every US state. In 1950, he also founded the American Board of Veterinary Public Health, which later became the American College of Veterinary Preventive Medicine. He became the country's first Assistant Surgeon General for Veterinary Affairs, in 1968, and Deputy Assistant Secretary for Health and Human Services in 1970. Steele travelled to more than 60 countries, speaking and consulting with scientists and governments to build veterinary public health units to combat zoonotic diseases. His wide knowledge of these diseases was matched by keen insights into the impacts they might have, says Michael Cates, a former student of Steele's who is now Professor of Veterinary Medicine and Director of the Master of Public Health Program at Kansas State University. “He shared this knowledge in many forms—multiple papers, conferences, and one-on-one and small group interactions. He mentored many of us.” Indeed, many leading veterinarians have since followed Steele into the profession of veterinary public health. “He was incredibly inspiring, clearly evidenced by the thousands of students and scientists he touched around the world who have become force multipliers in his global public army that continues to battle for better public health for all of mankind”, says Carter. Jay Glasser, past president of the American Public Health Association, says Steele was always willing to listen to opposing views, and equally willing to venture his own opinion. His “enthusiasm, encyclopaedic knowledge, uncanny skills in networking, and his command of the science and literature as well as the history of a topic” made him a compelling leader, Glasser says. At 6 foot 7, “he was a big man with a personality to match”. After retiring from the CDC in 1971, Steele was appointed Professor of Environmental Health at the University of Texas School of Public Health, and became Editor-in-Chief of the world's first comprehensive series of medical texts on zoonotic diseases, the CRC Handbook Series in Zoonoses. He stayed active in the field he helped establish until his death. He is survived by his wife, Brigitte Maria Steele, three sons, and four grandchildren. “Jim Steele's legacy is found in what he did for his global family for 100 years”, says Carter. “As he would always say at the end of a discourse, ‘Carry On!’”

Haematologist and pioneer in the treatment of chronic myeloid leukaemia. Born in London, UK, on Nov 30, 1938, he died from cancer of the bile duct on Dec 24, 2013, aged 75 years. In the early 1970s, when John Goldman began to study and treat chronic myeloid leukaemia (CML) at the Hammersmith Hospital in London, the disease was incurable. Today, the situation is remarkably different and the treatments available to patients are in part thanks to the work of Goldman, a man who towered over the global haematology community for more than a generation. Goldman began his academic career reading classics and switched to psychology and physiology at Magdalen College, Oxford. He completed his medical studies at St Bartholomew's Hospital, London, before training in haematology and oncology in the USA at the University of Miami and Massachusetts General Hospital. In 1971, he joined the Department of Haematology at Hammersmith Hospital, London, where his major focus was CML, and which was where he spent the next four decades as a member of the Medical Research Council Leukaemia Unit, Chair of the Department of Haematology (1994–2004), and as Emeritus Professor of Leukaemia Biology. Goldman pioneered the treatment of CML using autologous and allogeneic bone-marrow transplantation, and undertook some of the first transplants in Europe using cells donated by related donors. Although these procedures were largely successful, most patients lacked a suitable donor, explains Robert Peter Gale, a Visiting Professor of Haematology at Imperial College London. “To overcome this limitation, John and his colleagues developed ways to use other relatives and, eventually, unrelated volunteers as donors.” To help find those donors, Goldman also became involved in the Anthony Nolan Bone Marrow Register (now Anthony Nolan), the first stem cell register in the world, and helped to establish the World Marrow Donor Association. In the 1990s, Goldman began championing research into the new drug imatinib, which had been developed by scientists at the Ciba-Geigy pharmaceutical company and was among the first targeted cancer therapies. “There were a lot of obstacles placed in the way of this work, because a lot of senior people and the funding agencies did not feel it could possibly yield anything important”, Goldman once told a reporter. He flew to Basel to help persuade the Swiss pharmaceutical firm (which had become part of Novartis) to manufacture imatinib. He succeeded, and did many of the early clinical trials with the drug. Imatinib and its successors are now given to thousands of patients worldwide. Goldman also developed sensitive molecular techniques that allowed clinicians to detect remaining leukaemia cells in patients, which helped improve the effectiveness of imatinib therapy and allows some patients to discontinue imatinib altogether. Goldman's research output was prolific, but his influence extended far beyond the laboratory. A prominent figure in the haematology world, he served at various times as President of the International Society for Experimental Haematology and the European Group for Blood and Marrow Transplantation, as a founding member of the European Haematology Association, and as a member of the Executive Committee and the International Scientific Committee of the European School of Hematology. “John was a central figure in all aspects of CML research and therapy. No one was more essential to bringing the community together to work towards the common goal of saving lives”, says George Daley, Director of the Stem Cell Transplantation Program at Boston Children's Hospital. “He had a special ability to make everyone feel like an essential and treasured friend and colleague.” Goldman, who helped to develop the International CML Foundation and was Editor of the journal Bone Marrow Transplantation, is survived by his daughter, Lucy, from his marriage to Jeannine Fuller, which ended in divorce, and by his daughter, Cassie, and son, Jasper, with his former partner, Constance Byam Shaw. Colleagues remember Goldman's combination of cleverness, diplomacy, and good humour. “He was a gentleman and a scholar”, says Gale. “John also tried to solve the problem of the Elgin Marbles by suggesting a duplicate set be made and that each side alternately choose the piece they wanted until two full sets were assembled. No one has come up with a better solution but the quandary remains. Apparently a trickier problem than curing CML.”

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Leading researcher in early child development. Born in Philadelphia, PA, USA, on Dec 1, 1944, she died of cancer in New York, USA, on Sept 22, 2012, aged 67 years.From hands-on field work to scholarly analyses and advocacy with national policy makers, Patrice Engle did whatever it took to help children in developing countries receive the health care, nutrition, and opportunities they needed to be successful. A pioneer in the field of global early childhood development, she persistently built bridges—between academic disciplines and across countries—in the belief that all children deserve early childhood experiences that will enable them to fulfil their potential.Born and raised in Philadelphia, USA, Engle studied psychology at Wellesley College and completed a PhD in child development and psychology at Stanford University. After 2 years at the University of Illinois in Chicago, she travelled to Guatemala where she worked for 4 years at the Institute of Nutrition of Central America and Panama. “She went off to Guatemala, where she really got to start thinking about the interaction between children's early nutrition and experiences that contribute to their development”, says her friend and colleague Maureen Black, Professor of Pediatrics at the University of Maryland School of Medicine.Returning to the USA in 1980, Engle joined the faculty at California Polytechnic State University, in San Luis Obispo. Cal Poly would be Engle's academic home for the rest of her career, aside from the time she spent as Chief of Early Child Development for UNICEF between 1999 and 2006 with postings in New Delhi and New York. Engle was Chair of the Department of Psychology and Child Development at Cal Poly from 1992 to 1995. “Over the course of her career, Pat enriched the research in child development by stimulating an interest in early child development scholarship in a range of disciplines from around the world”, said Black. “Above all, Pat was a relentless proponent of early child development. She befriended many folks and was respectful of them and that served as an entree to their listening to what she had to say. She was very outreaching and welcoming, but very dogged and focused on nutrition and child development.”By gathering evidence that successful human capital begins with strong early child development, Engle was a primary force in ensuring that indicators related to family life and early child development were included in UNICEF's Multicountry Indicator Cluster Surveys. Her goals were to ensure that child development programmes were based on scientific evidence, were evaluated rigorously, and were a central component of efforts to ensure the health, development, and wellbeing of children. “Pat was an advocate-researcher who not only knew how to generate and recognise high-quality evidence but also masterfully knew how to apply it to create change”, said Pia Britto, an Assistant Professor in the Child Study Center at Yale University who worked with Engle from 2002. “She took her role of mentorship very seriously and gave generously of her time, expertise, and guidance”, Britto said.In 2007 and 2011, Engle helped to spearhead two Lancet Series of on early child development. “Those two series really represent the integration of academics, people who work for UNICEF and WHO, and some direct service people who work for foundations, and Pat was a driving force in both of those series,” Black said. Susan Walker, Professor of Nutrition and Director of the Tropical Medicine Research Institute at the University of the West Indies, Jamaica, also worked with Engle on those series. “Pat was one of the most positive persons I've ever known”, she said. “She was indefatigable. When others were saying something could not be achieved, she would never be dissuaded and would find a way.” After the first Lancet series, Engle was one of the founding members of the Global Child Development Group. “We very much wanted the structure of that group to be outside the US, so it was headquartered at the University of the West Indies in Jamaica. It was an illustration that the work should be integrated across people from different disciplines but also should be very much in partnership with people from low and middle income countries”, notes Black.Engle was the recipient of the 2011 Distinguished International Contributions To Child Development Award from the Society for Research in Child Development, and was also an honorary professor at the University of Hong Kong. She is survived by her son, Sawyer Fuller, her husband, Henry Hammer, her twin sister, Sally Engle Merry, and her brother, Robert Fry Engle III.As a legacy to Pat Engle, the Bernard van Leer Foundation, along with her friends and colleagues, have established the Patrice L Engle Dissertation Award For Global Early Child Development to provide opportunities for junior scholars from or working in developing countries to conduct dissertation research in global early child development. The award includes US$5000 to support dissertation research and a 2-year student membership to the Society for Research in Child Development. For more information about the award see http://www.srcd.org or request information from [email protected]For 2007 and 2011 Lancet Series on child development in developing countries see http://www.thelancet.com/series/child-development-in-developing-countries and http://www.thelancet.com/series/child-development-in-developing-countries-2 Leading researcher in early child development. Born in Philadelphia, PA, USA, on Dec 1, 1944, she died of cancer in New York, USA, on Sept 22, 2012, aged 67 years. From hands-on field work to scholarly analyses and advocacy with national policy makers, Patrice Engle did whatever it took to help children in developing countries receive the health care, nutrition, and opportunities they needed to be successful. A pioneer in the field of global early childhood development, she persistently built bridges—between academic disciplines and across countries—in the belief that all children deserve early childhood experiences that will enable them to fulfil their potential. Born and raised in Philadelphia, USA, Engle studied psychology at Wellesley College and completed a PhD in child development and psychology at Stanford University. After 2 years at the University of Illinois in Chicago, she travelled to Guatemala where she worked for 4 years at the Institute of Nutrition of Central America and Panama. “She went off to Guatemala, where she really got to start thinking about the interaction between children's early nutrition and experiences that contribute to their development”, says her friend and colleague Maureen Black, Professor of Pediatrics at the University of Maryland School of Medicine. Returning to the USA in 1980, Engle joined the faculty at California Polytechnic State University, in San Luis Obispo. Cal Poly would be Engle's academic home for the rest of her career, aside from the time she spent as Chief of Early Child Development for UNICEF between 1999 and 2006 with postings in New Delhi and New York. Engle was Chair of the Department of Psychology and Child Development at Cal Poly from 1992 to 1995. “Over the course of her career, Pat enriched the research in child development by stimulating an interest in early child development scholarship in a range of disciplines from around the world”, said Black. “Above all, Pat was a relentless proponent of early child development. She befriended many folks and was respectful of them and that served as an entree to their listening to what she had to say. She was very outreaching and welcoming, but very dogged and focused on nutrition and child development.” By gathering evidence that successful human capital begins with strong early child development, Engle was a primary force in ensuring that indicators related to family life and early child development were included in UNICEF's Multicountry Indicator Cluster Surveys. Her goals were to ensure that child development programmes were based on scientific evidence, were evaluated rigorously, and were a central component of efforts to ensure the health, development, and wellbeing of children. “Pat was an advocate-researcher who not only knew how to generate and recognise high-quality evidence but also masterfully knew how to apply it to create change”, said Pia Britto, an Assistant Professor in the Child Study Center at Yale University who worked with Engle from 2002. “She took her role of mentorship very seriously and gave generously of her time, expertise, and guidance”, Britto said. In 2007 and 2011, Engle helped to spearhead two Lancet Series of on early child development. “Those two series really represent the integration of academics, people who work for UNICEF and WHO, and some direct service people who work for foundations, and Pat was a driving force in both of those series,” Black said. Susan Walker, Professor of Nutrition and Director of the Tropical Medicine Research Institute at the University of the West Indies, Jamaica, also worked with Engle on those series. “Pat was one of the most positive persons I've ever known”, she said. “She was indefatigable. When others were saying something could not be achieved, she would never be dissuaded and would find a way.” After the first Lancet series, Engle was one of the founding members of the Global Child Development Group. “We very much wanted the structure of that group to be outside the US, so it was headquartered at the University of the West Indies in Jamaica. It was an illustration that the work should be integrated across people from different disciplines but also should be very much in partnership with people from low and middle income countries”, notes Black. Engle was the recipient of the 2011 Distinguished International Contributions To Child Development Award from the Society for Research in Child Development, and was also an honorary professor at the University of Hong Kong. She is survived by her son, Sawyer Fuller, her husband, Henry Hammer, her twin sister, Sally Engle Merry, and her brother, Robert Fry Engle III. As a legacy to Pat Engle, the Bernard van Leer Foundation, along with her friends and colleagues, have established the Patrice L Engle Dissertation Award For Global Early Child Development to provide opportunities for junior scholars from or working in developing countries to conduct dissertation research in global early child development. The award includes US$5000 to support dissertation research and a 2-year student membership to the Society for Research in Child Development. For more information about the award see http://www.srcd.org or request information from [email protected]For 2007 and 2011 Lancet Series on child development in developing countries see http://www.thelancet.com/series/child-development-in-developing-countries and http://www.thelancet.com/series/child-development-in-developing-countries-2 As a legacy to Pat Engle, the Bernard van Leer Foundation, along with her friends and colleagues, have established the Patrice L Engle Dissertation Award For Global Early Child Development to provide opportunities for junior scholars from or working in developing countries to conduct dissertation research in global early child development. The award includes US$5000 to support dissertation research and a 2-year student membership to the Society for Research in Child Development. For more information about the award see http://www.srcd.org or request information from [email protected]For 2007 and 2011 Lancet Series on child development in developing countries see http://www.thelancet.com/series/child-development-in-developing-countries and http://www.thelancet.com/series/child-development-in-developing-countries-2 As a legacy to Pat Engle, the Bernard van Leer Foundation, along with her friends and colleagues, have established the Patrice L Engle Dissertation Award For Global Early Child Development to provide opportunities for junior scholars from or working in developing countries to conduct dissertation research in global early child development. The award includes US$5000 to support dissertation research and a 2-year student membership to the Society for Research in Child Development. For more information about the award see http://www.srcd.org or request information from [email protected] For 2007 and 2011 Lancet Series on child development in developing countries see http://www.thelancet.com/series/child-development-in-developing-countries and http://www.thelancet.com/series/child-development-in-developing-countries-2

Public health worker who improved access to reproductive health and family planning in Africa and Asia. Born in Newton, KS, USA, on June 5, 1951, he died in a cycling accident in Dar es Salaam, Tanzania, on May 1, 2013, aged 61 years. Tim Manchester was the kind of man who made things happen. From Tanzania to China, and in many countries in between, he used straight-talking charm and passion to drive improvements in family planning and reproductive health in a career that spanned 30 years. “No-one could move and shake it like Tim”, remembers Alisa Cameron, Health Office Director at USAID Tanzania, where he had worked since 2009. “He would literally roll up his sleeves and say let's do this, let's make it happen. Tim's legacy is the impact he had on people.” Born in the USA, Manchester was raised by his missionary parents in Belgium, New York, Connecticut, and Zaire, now the Democratic Republic of the Congo. After earning an undergraduate arts degree at Goddard College, Vermont, he returned to Zaire as a Peace Corps volunteer before joining the Peace Corps staff. Those years marked the beginning of a life-long passion for improving health care, and of an equally committed partnership with his wife Jill. By the early 1980s, they had returned briefly to the USA, where Manchester took an MSc in epidemiology at Tulane University, acquiring skills that were soon called into use when he returned to Africa as part of Tulane's rural health improvement project in Niger. Later he took a post with Save the Children in Cameroon, and it was there he was introduced to the global health organisation Population Services International (PSI). PSI was looking for someone to help expand a social marketing programme for condoms and develop a programme to promote oral contraceptives and oral rehydration salts. “I needed someone who was entrepreneurial and had a lot of energy and Tim was right in front of me”, recalls Duncan Earle, now Director of the Malaria Control and Evaluation Partnership in Africa programme at PATH. Manchester made his name in setting up PSI's operations in Tanzania in 1993. “His jovial, easy-going and unselfish personality made working with him truly enjoyable. A result-driven professional, Tim was an inspiration to many and he believed in people's abilities and creative ideas”, wrote Halima Shariff, Director of Advance Family Planning Tanzania recently. Among the projects Manchester initiated were a groundbreaking social marketing programme for insecticide-treated bednets and the development of a new brand of condoms. “The work he did for PSI in the 1990s, and continued to support in his new role at USAID up until the day he died, helped prevent over 375 000 unwanted pregnancies in Tanzania in 2012. The kind of long-term impact Tim was truly proud of”, says Daniel Crapper, the current Country Director for PSI in Tanzania. He adds that Manchester “was one of the few among us to have the empathy to make true connection with people from all walks of life”. In 2001, Manchester and his family moved to China at a time when the country had just begun grappling with its HIV/AIDS epidemic. His work for Futures Group Europe with the China–UK HIV/AIDS Prevention and Care Project included developing a new condom brand, establishing a workplace social marketing project, and providing technical support to local partners. These projects were pioneering endeavours in China, says Feng Cheng, who was national manager for the project. “He was the first person to introduce the concept of condom social marketing into China”, says Feng. “He was always positive and inspired others to achieve more.” 5 years later, Africa called again and the Manchesters returned to Tanzania, at first with Futures Group, and then with USAID, where he was a senior reproductive family planning and health adviser. Manchester provided support to agencies implementing activities, and liaised with government and donors to improve the availability of contraceptives. “We needed someone who could be a lightning rod”, says Cameron. “He was a unifier. He was really able to bring people together to discuss and take it further.” A keen hiker and mountain-climber, Manchester reached the summit of Mount Kilimanjaro five times, among other peaks in Africa. A passionate sailor, he was vice-commodore of Dar es Salaam Yacht Club, where a memorial service was held and 650 friends and colleagues came to pay their respects. At the memorial, one speaker spoke of Manchester's impact with a message from Mitchell Warren, a PSI colleague: “Paul Farmer is quoted as saying ‘all of your most important achievements on this planet will come from working with others’. Tim has certainly proven this to be true.” He is survived by his wife Jill and their daughters Katherine and Chloe. Timothy Manchester's family are raising funds in his memory to support Comprehensive Community Based Rehabilitation in Tanzania; for more information see http://www.crowdrise.com/TimManchesterCCBRT/fundraiser/ChloeManchester Timothy Manchester's family are raising funds in his memory to support Comprehensive Community Based Rehabilitation in Tanzania; for more information see http://www.crowdrise.com/TimManchesterCCBRT/fundraiser/ChloeManchester

Physician and Editor of The Lancet from 1965 to 1976. Born in Harrogate, UK, on May 12, 1912, he died of heart failure in London, UK, on Oct 15, 2013, aged 101 years.During World War 2, Ian Douglas-Wilson served as a neurologist in Britain's Royal Army Medical Corps. He was one of the first physicians to enter the Bergen-Belsen concentration camp in Germany when it was liberated in April, 1945, where he and fellow soldiers found tens of thousands of ill and starving prisoners, and many more unburied bodies. Douglas-Wilson recorded the horrors he saw there in photographs—corpses lying on top of each other in mass graves, barrows full of bodies with limbs trailing on the ground—and carried the experience with him through his life.During his military service, Douglas-Wilson also treated servicemen, some of whom suffered from what would nowadays be known as post-traumatic stress disorder. In 1943, he wrote up his thoughts about the condition for publication in the Journal of the Royal Army Medical Corps and a year later his paper on the “somatic manifestations of psychoneurosis” was published in the British Medical Journal. When the war ended, the journal's Editor, Hugh Clegg, offered Douglas-Wilson a job, but after the two men met Clegg changed his mind, according to Douglas-Wilson's son David Wilson. “He told him he was too radical for an establishment journal and advised him to apply for a job with The Lancet.”It was clearly good advice. The Lancet had already had its share of reforming editors, starting with Thomas Wakley, who founded the journal in 1823 to lay bare corruption and nepotism in the medical profession. When Douglas-Wilson joined, the man in charge was Theodore (Robbie) Fox, who during the 1940s, against opposition from the British Medical Association, had helped persuade the medical profession of the need for a national health service.Douglas-Wilson started at The Lancet's Adam Street office as an Assistant Editor and stayed for 30 years, “working and dozing”—to use his own words—at an office whose entrance smelt of wine from the adjoining cellars of Sichel Ltd. Shortly before retiring, Fox (by then Sir Theodore) offered his thoughts on the future of medical journals. He distinguished two types—the recorders, which serve to provide “best opinion” in neutral tones, and the newspapers, whose role is to reveal and criticise, stimulate and shock. On appointment as Editor Douglas-Wilson emphatically chose the latter path. “If an editor does not please himself”, he used to remark, “he will please no-one”; and this was the policy he applied not only to editorial commentary but also to an ever-growing flood of submitted papers.Robin Fox, Lancet Editor from 1990 to 1995, worked alongside Douglas-Wilson and remembers his decisive approach when evaluating papers. “After a paper had been passed round the office for the reactions of colleagues, Ian made a summary decision on its quality and interest to a general readership. He seldom resorted to external review, and in a matter of days a paper would be either rejected politely or with the typesetters—often hugely abbreviated. He maintained that any defects in published papers could be aired in the correspondence columns, a retrospective form of peer review.”Fox also recalls Douglas-Wilson's progressive outlook. “When I joined the staff in 1968, revolution was in the air, with mass movements to end the Vietnam War, for civil rights, for nuclear disarmament, and against the abuse of authority in universities. The University of Essex, where Ian's son was then a student, was particularly noted for protest; and in May of that year a communist student activist, suspended for violence at a demonstration, had set out his philosophy in The Lancet. Ian's dislike of authority and elites, a feature of his whole time in office, was most clearly expressed after retirement in an essay for The New England Journal of Medicine. A polemic against peer review (‘The experts’ pronouncements tend toward cautious conservatism; they are not invariably beyond misplacing the big with the bogus; and they are apt to be swayed by the current vogue in their discipline'), this left former colleagues aghast because it was taken to represent The Lancet's editorial policy at the very time his successors were embarking on a change—to routine peer review. In the USA, where the journal was trying to recruit subscribers and contributors, The Lancet's image had become painfully close that of a British sports car—stylish and fast, but unreliable. This was not what US readers wanted: more quality control needed. Nevertheless, my personal memories of Ian are fond. Spiky and diffident, he was a superb teacher of his craft and I envied the moral certainties that guided his actions. Life at The Lancet was never more fun than under his editorship, and a family visit to his home in Kent revealed that his prowess with editorial pencil was matched by that with electric carving knife—rapid excision of large chunks. The obvious personal contradictions—the socialist who lunched at the Athenaeum—were cheerfully accepted by colleagues as part of a kindly and complex personality.”Ian Douglas Wilson and his wife Betty in Venice, ItalyView Large Image Figure ViewerDownload Hi-res image Download (PPT)David Sharp, a former Deputy Editor of The Lancet, remembers Douglas-Wilson's many achievements at The Lancet. “In life he was such a modest man, far easier to respect than to get to know well, but I owe him a lot. His editorial campaigns tended to be short and sharp, whether the targets were Lord Moran, the General Medical Council, or general practitioners who threatened to withdraw their services. He greatly expanded The Lancet's geographical profile, and in 1973 marked its 150th anniversary with an international review, published jointly with the Nuffield Provincial Hospitals Trust, entitled Health Service Prospects. Regarding the essay in The New England Journal of Medicine, I am inclined to think he saw it as an opportunity to defend his personal record—but the label ‘not a peer reviewed journal’ took us many years to shake off.”After growing up in Harrogate, Yorkshire, the son of a spa doctor, Douglas-Wilson attended Marlborough College, in Wiltshire, and graduated from Edinburgh University in 1936 and proceeded to his MD in 1938; he was slightly older than some of his fellow graduates because he had worked for the Player cigarette company before studying medicine. Douglas-Wilson spent time in Dublin delivering babies to women living in deep poverty, before working as a general practitioner in Presteigne, in central Wales, and West Hampstead in London. A man of principle and modesty, when interviewed on the radio he always insisted on being introduced as the “Editor of The Lancet” rather than by name.After the Soviet Union crushed the 1956 revolution in Hungary, Douglas-Wilson found homes for two refugees—one in his own home, and the other in the home of a friend. In 1972, his wife suffered a cerebral haemorrhage and he retired 4 years later, aged 64 years, to look after her. Douglas-Wilson is survived by his son, David, his two daughters, Elizabeth and Joanna, seven grandchildren, and seven great-grandchildren. His son David told The Lancet “My father was like a divining rod with water, unable not to react to the bogus and the dishonest, whenever they came in range. This made him a great editor and, more importantly to my sisters and I, a great father. He's still there in my mind, and hopefully in my actions.”Douglas-Wilson remains an influence on the current Lancet Editor, Richard Horton, who describes him as “one of the great Editors of The Lancet. He believed in the power of science to change not only lives, but also whole societies. He saw medicine as a political endeavour, as well as a scientific challenge. He used The Lancet as a means to hold governments accountable for their actions. He fearlessly championed the interests of the citizen over the state. How we need the likes of Ian Douglas-Wilson today.” Physician and Editor of The Lancet from 1965 to 1976. Born in Harrogate, UK, on May 12, 1912, he died of heart failure in London, UK, on Oct 15, 2013, aged 101 years. During World War 2, Ian Douglas-Wilson served as a neurologist in Britain's Royal Army Medical Corps. He was one of the first physicians to enter the Bergen-Belsen concentration camp in Germany when it was liberated in April, 1945, where he and fellow soldiers found tens of thousands of ill and starving prisoners, and many more unburied bodies. Douglas-Wilson recorded the horrors he saw there in photographs—corpses lying on top of each other in mass graves, barrows full of bodies with limbs trailing on the ground—and carried the experience with him through his life. During his military service, Douglas-Wilson also treated servicemen, some of whom suffered from what would nowadays be known as post-traumatic stress disorder. In 1943, he wrote up his thoughts about the condition for publication in the Journal of the Royal Army Medical Corps and a year later his paper on the “somatic manifestations of psychoneurosis” was published in the British Medical Journal. When the war ended, the journal's Editor, Hugh Clegg, offered Douglas-Wilson a job, but after the two men met Clegg changed his mind, according to Douglas-Wilson's son David Wilson. “He told him he was too radical for an establishment journal and advised him to apply for a job with The Lancet.” It was clearly good advice. The Lancet had already had its share of reforming editors, starting with Thomas Wakley, who founded the journal in 1823 to lay bare corruption and nepotism in the medical profession. When Douglas-Wilson joined, the man in charge was Theodore (Robbie) Fox, who during the 1940s, against opposition from the British Medical Association, had helped persuade the medical profession of the need for a national health service. Douglas-Wilson started at The Lancet's Adam Street office as an Assistant Editor and stayed for 30 years, “working and dozing”—to use his own words—at an office whose entrance smelt of wine from the adjoining cellars of Sichel Ltd. Shortly before retiring, Fox (by then Sir Theodore) offered his thoughts on the future of medical journals. He distinguished two types—the recorders, which serve to provide “best opinion” in neutral tones, and the newspapers, whose role is to reveal and criticise, stimulate and shock. On appointment as Editor Douglas-Wilson emphatically chose the latter path. “If an editor does not please himself”, he used to remark, “he will please no-one”; and this was the policy he applied not only to editorial commentary but also to an ever-growing flood of submitted papers. Robin Fox, Lancet Editor from 1990 to 1995, worked alongside Douglas-Wilson and remembers his decisive approach when evaluating papers. “After a paper had been passed round the office for the reactions of colleagues, Ian made a summary decision on its quality and interest to a general readership. He seldom resorted to external review, and in a matter of days a paper would be either rejected politely or with the typesetters—often hugely abbreviated. He maintained that any defects in published papers could be aired in the correspondence columns, a retrospective form of peer review.” Fox also recalls Douglas-Wilson's progressive outlook. “When I joined the staff in 1968, revolution was in the air, with mass movements to end the Vietnam War, for civil rights, for nuclear disarmament, and against the abuse of authority in universities. The University of Essex, where Ian's son was then a student, was particularly noted for protest; and in May of that year a communist student activist, suspended for violence at a demonstration, had set out his philosophy in The Lancet. Ian's dislike of authority and elites, a feature of his whole time in office, was most clearly expressed after retirement in an essay for The New England Journal of Medicine. A polemic against peer review (‘The experts’ pronouncements tend toward cautious conservatism; they are not invariably beyond misplacing the big with the bogus; and they are apt to be swayed by the current vogue in their discipline'), this left former colleagues aghast because it was taken to represent The Lancet's editorial policy at the very time his successors were embarking on a change—to routine peer review. In the USA, where the journal was trying to recruit subscribers and contributors, The Lancet's image had become painfully close that of a British sports car—stylish and fast, but unreliable. This was not what US readers wanted: more quality control needed. Nevertheless, my personal memories of Ian are fond. Spiky and diffident, he was a superb teacher of his craft and I envied the moral certainties that guided his actions. Life at The Lancet was never more fun than under his editorship, and a family visit to his home in Kent revealed that his prowess with editorial pencil was matched by that with electric carving knife—rapid excision of large chunks. The obvious personal contradictions—the socialist who lunched at the Athenaeum—were cheerfully accepted by colleagues as part of a kindly and complex personality.” David Sharp, a former Deputy Editor of The Lancet, remembers Douglas-Wilson's many achievements at The Lancet. “In life he was such a modest man, far easier to respect than to get to know well, but I owe him a lot. His editorial campaigns tended to be short and sharp, whether the targets were Lord Moran, the General Medical Council, or general practitioners who threatened to withdraw their services. He greatly expanded The Lancet's geographical profile, and in 1973 marked its 150th anniversary with an international review, published jointly with the Nuffield Provincial Hospitals Trust, entitled Health Service Prospects. Regarding the essay in The New England Journal of Medicine, I am inclined to think he saw it as an opportunity to defend his personal record—but the label ‘not a peer reviewed journal’ took us many years to shake off.” After growing up in Harrogate, Yorkshire, the son of a spa doctor, Douglas-Wilson attended Marlborough College, in Wiltshire, and graduated from Edinburgh University in 1936 and proceeded to his MD in 1938; he was slightly older than some of his fellow graduates because he had worked for the Player cigarette company before studying medicine. Douglas-Wilson spent time in Dublin delivering babies to women living in deep poverty, before working as a general practitioner in Presteigne, in central Wales, and West Hampstead in London. A man of principle and modesty, when interviewed on the radio he always insisted on being introduced as the “Editor of The Lancet” rather than by name. After the Soviet Union crushed the 1956 revolution in Hungary, Douglas-Wilson found homes for two refugees—one in his own home, and the other in the home of a friend. In 1972, his wife suffered a cerebral haemorrhage and he retired 4 years later, aged 64 years, to look after her. Douglas-Wilson is survived by his son, David, his two daughters, Elizabeth and Joanna, seven grandchildren, and seven great-grandchildren. His son David told The Lancet “My father was like a divining rod with water, unable not to react to the bogus and the dishonest, whenever they came in range. This made him a great editor and, more importantly to my sisters and I, a great father. He's still there in my mind, and hopefully in my actions.” Douglas-Wilson remains an influence on the current Lancet Editor, Richard Horton, who describes him as “one of the great Editors of The Lancet. He believed in the power of science to change not only lives, but also whole societies. He saw medicine as a political endeavour, as well as a scientific challenge. He used The Lancet as a means to hold governments accountable for their actions. He fearlessly championed the interests of the citizen over the state. How we need the likes of Ian Douglas-Wilson today.”

Pioneer of growth hormone research and leading clinical endocrinologist. Born in Chicago, IL, USA, on Feb 12, 1918, he died in Milwaukee, WI, USA, on May 3, 2013, aged 95 years. William Daughaday could trace his interest in endocrinology back to high school, when a friend's father was Paul Starr, the head of endocrinology at Northwestern University Medical School. During the Great Depression, Starr was forced to support himself through private practice but he maintained a laboratory that his son's young friend visited and worked in after his first year of medical school. “Working in that research lab that summer really turned him on”, says Clay Semenkovich, a former student of Daughaday's who is Chief of the Division of Endocrinology, Metabolism and Lipid Research at Washington University in St Louis. “Something clicked. He thought it was the most wonderful thing to study basic processes that could be translated to people.” From that summer, it seems, Daughaday's course was set. Entering Harvard in 1936 he gravitated towards the biology department, which was headed by an endocrinologist, and spent two summers at the Jackson Laboratory in Bar Harbour, Maine, where he studied the effect of castration on the development of adrenal adenomas in mice. By the time he had graduated from Harvard Medical School, his interest in endocrinology was established. In 1947, he was recruited to the School of Medicine at Washington University in St Louis where he worked as an assistant resident in medicine. Soon after, he began a research fellowship in the laboratory of Nobel Laureates Gerty and Carl Cori. By 1951, he had become the first director of the metabolism division, now the Division of Endocrinology, Metabolism and Lipid Research. He would work at the university for the next 47 years, where he was the founding director of Washington University's Diabetes and Endocrinology Research Center, in 1975, and its successor, the Diabetes Research and Training Center. In 1957, Daughaday and a colleague published a landmark paper in the field of growth hormone research. “They were trying to figure out a way to measure the biological activity of growth hormone…and made this seminal discovery that growth hormone didn't exert its growth-promoting effects directly, but indirectly through this group of substances called somatomedins or insulin-like growth factors”, explains Steven Chernausek, the Edith Kinney Gaylord Endowed Chair in Pediatric Diabetes/Endocrinology at Oklahoma University. Although scientists had understood for some time that the hormone was a growth-promoting substance, until that point “no one had a clue as to how it did what it did”, he says. Daughaday and his colleague showed that although purified growth hormone had no growth-promoting effects itself in vitro, the serum of mice that had been injected with growth hormone did have in-vitro biological effects. “He pretty much nailed it in this one paper that there was some substance that growth hormone produced incredibly rapidly in vivo that seemed to have growth-promoting properties that wasn't the growth hormone itself”, says Peter Rotwein, Professor and Chair of Biochemistry and Molecular Biology at Oregon Health and Science University. It took some years for the wider scientific establishment to catch on, but by the 1980s Daughaday's hypothesis had been fleshed out and broadly confirmed. “It really changed the way people thought about the control of growth”, says Rotwein. “That idea caused a lot of intellectual ferment and continues to be a touchstone that people use. It still stands up.” Daughaday's other contributions included discovering corticosteroid binding globulin, and uncovering the mechanism by which large tumours cause low blood sugar concentrations. “The phenomenon of tumour hypoglycaemia turned out also to be caused by insulin-like growth factor-2 and he published a number of important papers on that later on in his career”, says Rotwein. “He also worked on human growth disorders and growth hormone insensitivity.” Daughaday always maintained a focus on translating basic observations to the care of patients. “He was a breed that we need but is vanishing quickly—a world class scientist who was connected to people and diseases. At a time when people were under such pressure to do other things, Bill Daughaday insisted on actually seeing the patients”, says Semenkovich. Highly regarded as a teacher and mentor, he trained many endocrinologists. Among his many honours was the Fred Conrad Koch Award of the Endocrine Society. He is survived by his two children, grandchildren, and great grandchildren.

General practitioner who provided health care to marginalised people in Sydney's Kings Cross district and educated other clinicians about addiction medicine. Born in Sydney, Australia, on March 6, 1952, he died there on July 25, 2013, aged 61 years. Ray Seidler was fresh from his internship when he started practising in Sydney's Kings Cross district, known as the city's red-light area. It was the late 1970s, and Seidler was a young general practitioner (GP) who had already earned a reputation among his peers for thinking outside the box. Arriving at a practice where his patients ranged from lawyers and movie stars to drug users and sex workers must have been an eye-opener. Yet Seidler quickly found his feet, as his friend and fellow GP Michael Berger recalls. “He went in boots and all in the deep end and I think he really found his niche. His personality was warm and engaging, but he wouldn't take crap from anyone. I think a lot of people he interacted with probably needed that.” Seidler would remain committed to the neighbourhood for the next 35 years, weaving himself deeply into the area's cosmopolitan life. Eventually he was hardly able to walk down the street without being stopped by patients, some of whom became his friends. Ad hoc consultations as he walked from his car in the morning became a matter of course. As the years went by, he also learned the hard way many practical techniques for dealing with challenging patients. “I think of Ray every time I take an agitated patient out of the consulting room onto the street to have a consultation on the walk”, one mental health clinician told the magazine Australian Doctor. Out of his experiences of struggling to help many patients who used heroin or other substances, Seidler developed a passionate interest in addiction medicine. A firm believer in the need to take a harm minimisation approach to substance misuse, he worked at two private pharmacotherapy clinics in inner Sydney and served as Chair of the Pharmacotherapy Credentialing Subcommittee of NSW Health. He was also a strong supporter of the Sydney Medically Supervised Injecting Centre, which was established in the heart of Kings Cross in 2001. “Losing Ray Seidler will be keenly felt by many in Kings Cross”, says Marianne Jauncey, Medical Director of the centre. “He really did see the person and not just the drug user.” Seidler also worked to increase the integration of hospital and medical care for patients with significant drug and alcohol problems. In recognition of his work in this area, the nearby St Vincent's Hospital is naming a clinic after Seidler that will address the wider health of people with addiction problems. As time went on, Seidler took his advocacy for better addiction treatment to a wider audience, travelling nationally and internationally to share his knowledge and good sense of humour with clinicians at conferences and other educational events. “He combined his interest in addiction medicine with an interest in public speaking to become a proselytiser”, says his friend and fellow GP Ian Arthur. “He did a huge amount of travelling and talking. He took the stigma out of looking after patients with addiction problems—helping GPs to better manage an area that most of us are not particularly good at.” Seidler also took to the pages of newspapers and GP magazines, writing with humanity about the challenges of treating patients with addiction and a host of other issues. Seidler's work on addiction led to an interest in helping impaired doctors. He became a first-call panellist for a doctors' health advisory line run by the Australian Medical Association, a member of the Professional Standards Committee of the New South Wales Medical Council and supervised impaired practitioners in his practice. Liz Marles, a fellow Sydney GP and President of the Royal Australian College of General Practitioners, said Seidler's death was a great loss for his colleagues, as well as his patients. “It takes a special person to connect and work with the Kings Cross community over such a long period. It's a great tribute to him that he did that and was willing to share his experiences and expertise for our benefit”, she said. Seidler is survived by his wife Debbie and their four children.

The story of Basil Hetzel's fight against iodine deficiency begins in 1964, in the highland villages of Papua New Guinea. A medical scientist with an interest in thyroid disorders, Hetzel had been invited by the country's Public Health Department to investigate the goitre and cretinism that was prevalent in the mountain communities. Witnessing the situation first-hand, Hetzel remembers, was unsettling: “I was astounded to see the severity of the problem.” Cretinism had been described in Europe from the Middle Ages but it had declined in the 19th century. Now it was being reported not only in Papua New Guinea but in mountainous regions in other countries, including India and China, and doubt remained as to whether it was related to iodine deficiency. It had recently been shown in Papua New Guinea that an injection of iodised oil could prevent goitre, but it was not clear if iodine deficiency was actually present, Hetzel recalls. Laboratory studies by his group working with the Papua New Guinea Public Health Department confirmed that there was indeed substantial iodine deficiency and that it could be treated for up to 5 years by one dose of iodised oil. “We were able to demonstrate very severe iodine deficiency under the conditions in the mountains in New Guinea, where high rainfall leached the soil of iodine”, he says. In 1966, an intervention trial was undertaken in which families were alternately given injections of iodised oil or saline, and then followed up for the next 3 years. “This critical [follow-up] phase was undertaken double-blind with great skill and dedication by Peter Pharoah, an experienced Papua New Guinea medical officer who was seconded to this work by the Public Health Department at my request”, Hetzel wrote. After the trial was complete, there was no doubt that giving iodised oil before pregnancy prevented mental disability. Soon after, an iodised oil injection campaign that covered about 120 000 people was undertaken for the people in the mountains of Papua New Guinea. For Hetzel, addressing iodine deficiency became a passion. He led efforts to establish animal models of the condition, and helped reconceptualise the effect of iodine deficiency from goitre to brain damage, as part of a group of disorders that could be prevented by tackling iodine deficiency. On the world stage, Hetzel became a key figure in setting up the International Council for the Control of Iodine Deficiency Disorders, which has worked with WHO and UNICEF to help to develop national control programmes. Hetzel's dedication to establishing these programmes and his groundbreaking research on iodine deficiency has led to many awards, including the Pollin Prize in Pediatric Research, the Prince Mahidol Prize, and the Companion of the Order of Australia. On awarding him the Pollin Prize, the then President of New York-Presbyterian Hospital Herbert Pardes described how “Dr Hetzel has helped protect an estimated 80 million newborns from needless brain damage—a major public health triumph comparable to the campaigns to eliminate smallpox and polio.” “There is no doubt that he is an extraordinary person and one of the great figures in Australian medicine in the 20th century”, agrees Professor Creswell Eastman, Vice Chairman of the International Council for the Control of Iodine Deficiency Disorders and Principal of the Sydney Thyroid Clinic at Westmead Private Hospital and Consultant Emeritus to Westmead Public Hospital. “His indefatigable dedication to elimination of iodine deficiency disorders has characterised his professional life. I suspect he will continue with this dedication up until his last breath.” In Eastman's eyes, one of Hetzel's great attributes is his ability to influence those in power. “This is what sets him apart from many of his senior colleagues who have performed great work but were unable to translate that into worthwhile outcomes.” The son of Kenneth Hetzel, himself a prominent clinician and researcher, Hetzel grew up in the city of Adelaide, South Australia, graduating in medicine in 1944. Although he enlisted in the Royal Australian Air Force, a bout of pulmonary tuberculosis in 1945 meant he could not undertake military service. “Of course, many of my school contemporaries did not return [from war service] and I determined that I would do what I could to make the world a better place”, he recalls. After postgraduate education and research in Adelaide, a Fulbright Scholarship took him to New York for 3 stimulating years studying the effects of stress on the endocrine system, followed by time in London training in endocrinology at St Thomas's Hospital. In 1956, Hetzel returned to the University of Adelaide where he became Michell Professor of Medicine. From 1968 to 1975 he was Foundation Professor of Social and Preventive Medicine at Monash University in Melbourne, and went on to spend 10 years with the Commonwealth Scientific and Industrial Research Organisation (CSIRO) as the first Chief of the Division of Human Nutrition. Tony McMichael, who did a PhD in Hetzel's department at Monash, describes him as a “progressive and a risk-taker in his medical and public health career”. Hetzel and McMichael, who is now Professor of Population Health at the Australian National University, later worked together on diet, nutrition, and disease at CSIRO, and co-authored a book The LS Factor: Lifestyle and Health. For his part, Hetzel puts much of his success down to chance. “I've been very fortunate to have congenial opportunities at the right time”, he says. “I've been very, very fortunate. You've got to be lucky.”

Director-General of WHO from 1988 to 1998. Born in Chiba, Japan, on May 16, 1928, he died in Poitiers, France, on Jan 26, 2013, aged 84 years.Some 15 years ago, Sir George Alleyne was asked for his opinion of Hiroshi Nakajima's time as Director-General of WHO. It was 1998, the year Nakajima stepped down after 10 years of leadership that had been plagued by political tension and accusations of poor management. “I said then that history would treat him kindly”, says Alleyne, a former Director of the Pan American Health Organization, “and I think that sober reflection will reveal a lot that was good about his regime”.Nakajima was elected Director-General of WHO in 1988, replacing the charismatic Danish physician Halfdan Mahler. Even at that early stage, signs of political trouble were apparent. “Anybody following Halfden Mahler would have had a challenge because of the incredibly powerful person Mahler was”, says Michael Merson, Director of the Duke Global Health Institute in Durham, NC, USA, who worked at WHO from 1978 to 1995. Derek Yach, a former executive director at WHO, concurs with this view and says Nakajima's “sharply different approach to Mahler meant that he was never able to achieve the type of passion needed to be shown by the head of WHO. In small meetings, people were impressed by his depth of knowledge about major health issues but this rarely showed in public sessions.”In 1990, clashes between Nakajima and Jonathan Mann, the head of WHO's Global Programme on AIDS, resulted in Mann's resignation. “A more collaborative and engaging style might have yielded a different result for AIDS governance and management”, says Yach. “His inability to rise to the epidemic fast and effectively led to UNAIDS, the Global Fund, and PEPFAR…initiatives created to tackle what a more effective Director-General could have led from WHO.” Merson, who replaced Mann at WHO's Global Programme on AIDS, says “John had evolved into a very, very human rights approach to AIDS and Nakajima wanted WHO's approach to be more scientific. He wasn't against human rights, I just think it was a difference of emphasis. He and John had different perspectives on how prevention and care for HIV should be directed. John's departure was most unfortunate.” Although the USA and other western countries opposed Nakajima's appointment for a second term in 1992, he defeated his deputy, Algeria's Mohammed Abdelmoumene, in the election. “There is no doubt that his last years saw many problems in WHO, due in large measure to a loss of confidence in his leadership, but we have to balance those against the several positives of his regime”, argues Alleyne. “It is sometimes forgotten that it was in his administration that, after the success of eradication in the Americas, the Global Polio Eradication Initiative was launched and today polio eradication is within reach.”In a statement, WHO said some successful programmes owe Nakajima a debt, including directly observed treatment for tuberculosis, the integrated management of childhood illness initiative, and the expansion of the global programme for childhood immunisation. “One of Dr Nakajima's greatest passions was to see polio defeated”, current WHO Director-General Margaret Chan said in a statement. “We are doing so now, for many good reasons. Let these efforts also be a tribute to his memory.” Yach notes that Nakajima kept the focus on essential drugs under tough pressure from pharmaceutical companies, led initiatives to revise WHO's Health For All policies, and built stronger links between health and development.Nakajima earned his medical degree from Tokyo Medical University in 1955 and later studied in France, where he undertook research from 1958 to 1967. Returning to Japan, he gained a PhD in medical sciences and took a post as research director for Nippon Roche. He joined WHO in 1974, helping develop the concept of essential medicines, and served as director of WHO's Western Pacific Regional Office from 1978 to 1988. During these years, he collaborated with the Nippon Foundation to combat leprosy. “It was not an easy task, but Dr Nakajima's leadership and persistence contributed to the dramatic reduction in the leprosy burden we have witnessed over the past three decades”, says Yohei Sasakawa, Chairman of the Nippon Foundation.“Nakajima was really a believer in WHO, and wanted WHO to maintain its leadership, to be technically the highest quality when it came to health”, says Merson, who adds that he could be thought of as “more of a scientist than a public health person”. In 1997, Nakajima announced he would not seek a third term at WHO and former Norwegian Prime Minister Gro Harlem Brundtland was elected as his successor. He is survived by his wife Martha Nakajima and two sons. Director-General of WHO from 1988 to 1998. Born in Chiba, Japan, on May 16, 1928, he died in Poitiers, France, on Jan 26, 2013, aged 84 years. Some 15 years ago, Sir George Alleyne was asked for his opinion of Hiroshi Nakajima's time as Director-General of WHO. It was 1998, the year Nakajima stepped down after 10 years of leadership that had been plagued by political tension and accusations of poor management. “I said then that history would treat him kindly”, says Alleyne, a former Director of the Pan American Health Organization, “and I think that sober reflection will reveal a lot that was good about his regime”. Nakajima was elected Director-General of WHO in 1988, replacing the charismatic Danish physician Halfdan Mahler. Even at that early stage, signs of political trouble were apparent. “Anybody following Halfden Mahler would have had a challenge because of the incredibly powerful person Mahler was”, says Michael Merson, Director of the Duke Global Health Institute in Durham, NC, USA, who worked at WHO from 1978 to 1995. Derek Yach, a former executive director at WHO, concurs with this view and says Nakajima's “sharply different approach to Mahler meant that he was never able to achieve the type of passion needed to be shown by the head of WHO. In small meetings, people were impressed by his depth of knowledge about major health issues but this rarely showed in public sessions.” In 1990, clashes between Nakajima and Jonathan Mann, the head of WHO's Global Programme on AIDS, resulted in Mann's resignation. “A more collaborative and engaging style might have yielded a different result for AIDS governance and management”, says Yach. “His inability to rise to the epidemic fast and effectively led to UNAIDS, the Global Fund, and PEPFAR…initiatives created to tackle what a more effective Director-General could have led from WHO.” Merson, who replaced Mann at WHO's Global Programme on AIDS, says “John had evolved into a very, very human rights approach to AIDS and Nakajima wanted WHO's approach to be more scientific. He wasn't against human rights, I just think it was a difference of emphasis. He and John had different perspectives on how prevention and care for HIV should be directed. John's departure was most unfortunate.” Although the USA and other western countries opposed Nakajima's appointment for a second term in 1992, he defeated his deputy, Algeria's Mohammed Abdelmoumene, in the election. “There is no doubt that his last years saw many problems in WHO, due in large measure to a loss of confidence in his leadership, but we have to balance those against the several positives of his regime”, argues Alleyne. “It is sometimes forgotten that it was in his administration that, after the success of eradication in the Americas, the Global Polio Eradication Initiative was launched and today polio eradication is within reach.” In a statement, WHO said some successful programmes owe Nakajima a debt, including directly observed treatment for tuberculosis, the integrated management of childhood illness initiative, and the expansion of the global programme for childhood immunisation. “One of Dr Nakajima's greatest passions was to see polio defeated”, current WHO Director-General Margaret Chan said in a statement. “We are doing so now, for many good reasons. Let these efforts also be a tribute to his memory.” Yach notes that Nakajima kept the focus on essential drugs under tough pressure from pharmaceutical companies, led initiatives to revise WHO's Health For All policies, and built stronger links between health and development. Nakajima earned his medical degree from Tokyo Medical University in 1955 and later studied in France, where he undertook research from 1958 to 1967. Returning to Japan, he gained a PhD in medical sciences and took a post as research director for Nippon Roche. He joined WHO in 1974, helping develop the concept of essential medicines, and served as director of WHO's Western Pacific Regional Office from 1978 to 1988. During these years, he collaborated with the Nippon Foundation to combat leprosy. “It was not an easy task, but Dr Nakajima's leadership and persistence contributed to the dramatic reduction in the leprosy burden we have witnessed over the past three decades”, says Yohei Sasakawa, Chairman of the Nippon Foundation. “Nakajima was really a believer in WHO, and wanted WHO to maintain its leadership, to be technically the highest quality when it came to health”, says Merson, who adds that he could be thought of as “more of a scientist than a public health person”. In 1997, Nakajima announced he would not seek a third term at WHO and former Norwegian Prime Minister Gro Harlem Brundtland was elected as his successor. He is survived by his wife Martha Nakajima and two sons.

Physician and epidemiologist who helped show that chronic diseases have origins in the womb. Born in London, UK, on June 29, 1938, he died of a cerebral haemorrhage in Winchester, UK, on Aug 27, 2013, aged 75 years. David Barker experienced the power of epidemiology first-hand in the late 1960s, when he was living in Uganda and studying the disfiguring mycobacterial infection known as Buruli ulcer disease. It was 7 years after he had qualified as a doctor, and a grant from the UK's Medical Research Council had taken him to Makerere University in Kampala to study the disease, which received wisdom said was mosquito-borne. Barker had his doubts about this hypothesis and carefully observed people who developed the infection. He came to the conclusion that mosquitoes weren't the culprits after all. Instead, it was injuries from the sharp reeds growing near the Nile that triggered Mycobacterium ulcerans infection. “He always talked about that time as giving him confidence in observing things and listening, and that by doing so you could get information that would have an important effect on a lot of people”, says Caroline Fall, Professor of International Paediatric Epidemiology at the University of Southampton, who was Barker's MD student and collaborator. Barker and his family fled Uganda during Idi Amin's time as President. Returning to the UK, he became a senior lecturer in clinical epidemiology at Southampton. His research over the next decade ranged from thyroid disorders and Paget's disease to gallstones and appendicitis. Time and again, says Fall, his work proposed links between the conditions of early life and later disease: “He was fascinated by the way that biology in certain periods of life can have big effects on disease.” In 1979, Barker became Professor of Clinical Epidemiology at Southampton's Medical Research Council Environmental Epidemiology Unit, now the MRC Lifecourse Epidemiology Unit. It was during these years that he noticed the striking resemblance between maps of cardiovascular disease in the 1970s and 1980s, and maps of infant mortality in the 1920s. “That was the serendipitous discovery. It was really as a consequence of looking at the geographic and temporal pattern of non-communicable disease that he stumbled on the notion that the geography of coronary artery disease…was actually very similar to the geography of neonatal and post-neonatal mortality some 70 years earlier”, says Professor Cyrus Cooper, Director of the MRC Lifecourse Epidemiology Unit and Barker's former DM student. Barker and his colleagues, including statistician Clive Osmond, published a study outlining the correlation in The Lancet in 1989, reporting that among 5654 men from Hertfordshire, UK, those with the lowest weights at birth and at age 1 year had the highest death rates from ischaemic heart disease. Barker, who published more than 500 research papers and ten books, wasn't the first researcher to note the link between early life conditions and later disease. But rather than moving on to other research subjects, he made it his life's mission to proselytise the importance of early life to later illness. “He saw how important it was, which other people hadn't. He picked it up and really ran with it”, says Fall. At first, he struggled to get a hearing. The prevailing view was that heart disease, diabetes, and other non-communicable diseases were the result of a person's genetic heritage plus their adult lifestyle. However, Barker stuck to his guns, gathering more data with collaborators in Finland, China, and India, and forming collaborations with developmental physiologists in Adelaide, Auckland, and Toronto. He organised meetings that brought together fetal physiologists and epidemiologists, which later evolved into the International Society for Developmental Origins of Health and Disease. “His science was important but the reason he has had so much impact is because of his missionary zeal. He really brought to the world's attention the role of early development and its relationship to longer term consequences”, says Professor Sir Peter Gluckman, one of Barker's collaborators, now Chief Science Advisor to the Prime Minister of New Zealand. The field Barker championed in the face of controversy has since blossomed and has had a major impact on health policy internationally. Barker had a quick wit and a huge repertoire of jokes that helped him create an academically fruitful environment. He is also remembered by colleagues as an empowering leader. “What he did was say ‘I trust you, go off and do it’. He gave you enormous confidence by giving you that free rein to go off and do things”, says Fall. A fellow of the Royal Society and the Academy of Medical Sciences, he was awarded a CBE in 2006. Barker's first wife, Angela, died in 1980. He is survived by his second wife, Jan, five children from his first marriage, three stepchildren from his second, and 13 grandchildren.

Pioneering geneticist who helped to describe the regulation of gene expression. Born on June 17, 1920, in Nancy, France, he died on April 19, 2013, in Paris, France, aged 92 years. Before World War 2 intervened, François Jacob had intended to become a surgeon. However, after fighting for 4 years alongside the Free French Forces in Africa and France, he was severely wounded in Normandy in the summer of 1944. Although he completed his medical studies after the war, injuries to his arm and leg would leave him unable to practise surgery. Turning his attention elsewhere, he heard about research being done by microbiologist André Lwoff at the Institut Pasteur in Paris. Jacob pestered Lwoff for about a year until he relented and invited Jacob to join his laboratory in 1950. It was an attic laboratory with Lwoff working at one end of a corridor and the biologist Jacques Monod working at the other. “I decided that I gave myself 5 years. Either I find something in 5 years or I do something else”, Jacob would later remember. Jacob began studying the genetics of bacteria and the viruses that prey on them, working closely with Elie Wollman. “We were able to analyse the whole genetic system…in detail. Once we had this system in hand we realised it was a fantastic system to analyse any function of the bacterial cell”, Jacob said. That work also provided insights into a problem Monod had been working on about how bacterial cells respond to their environment. In 1958, Jacob and Monod began studying the regulatory pathways that adjust gene expression, leading them to reveal new concepts such as messenger RNA, regulator genes, and “operons”, or groups of genes whose expression is coordinated by a regulator. They showed that proteins existed in the bacterium Escherichia coli that could regulate the expression of particular metabolic enzymes by binding directly to genes. “In his rather small third floor attic, François deployed extraordinary levels of activity”, remembers Jean-Pierre Changeux, a neuroscientist who began his PhD under Jacob and Monod in 1959 and is an emeritus professor at the Institut Pasteur. “Despite his physical sufferings, he was constantly rushing from his small desk where he took notes, to his piles of Petri dishes looking quickly at the red agar with multiple bacterial colonies”, says Changeux, who recalls how Jacob would “run down to Jacques Monod's office”. Jacob's “prodigious imaginative power and experimental efficiency” were, according to Changeux, “complementarity to Jacques Monod's scientific personality at the time the operon model was conceived”. “Jacob and Monod were, in my opinion, two of the greatest scientists this world has known”, says Mitchell Lewis, Professor of Biomedical Research and Education at the University of Pennsylvania's Perelman School of Medicine. Their recognition that a key component of the operon model was a repressor that can respond to a metabolite, and that these effectors could alter the conformation of a protein and regulate transcription, “were two of the most important discoveries in molecular biology”, Lewis says. In 1965, Jacob, Monod, and Lwoff were awarded the Nobel Prize in Physiology or Medicine “for their discoveries concerning genetic control of enzyme and virus synthesis”. At the Nobel ceremony, Swedish bacteriologist Sven Gard described how “The group of French workers has opened up a field of research which in the truest sense of the word can be described as molecular biology.” Jacob went on to assume leadership roles at the Institut Pasteur, as its President between 1982 and 1988 and as head of its cellular genetics unit from 1960 until his retirement in 1991. He was also professor of cellular genetics at the Collège de France from 1965 to 1992. Claudina Rodrigues-Pousada, who heads the Genomics and Stress Laboratory at the New University of Lisbon's Institute of Chemical and Biological Technology, remembers him as an excellent teacher. “He was gentle and very rigorous and demanding”, she said. In 1962, Jacob was awarded the Charles Léopold Mayer prize by the Académie des Sciences. During his career he became an honorary member of several scientific academies in Europe. Later in life he wrote inventively of the impact of the scientific developments he was part of and their historical context; his books included The Logic of Life: A History of Heredity, The Possible and the Actual, and The Statue Within. Jacob is survived by his second wife, Geneviève Barrier, and four children from his first marriage to the pianist Lysiane Bloch, who died in 1983.

Physiologist who pioneered the development of in-vitro fertilisation. He was born in Batley, UK, on Sept 27, 1925, and died in Cambridge, UK, on April 10, 2013, aged 87 years.One of the last times Robert Edwards spoke in public was to mark the UK's National Infertility Day in 2008. His health declining, Edwards spoke for almost an hour about the early days of in-vitro fertilisation (IVF). As he finished, the audience of patients and patient advocates rose to give him a standing ovation. “The applause went on and on and on. It was hugely moving”, remembers his colleague and former student Mike Macnamee, now chief executive of Bourn Hall fertility clinics. “Of all the times I saw him recognised in public, throughout the world, that really profoundly moved him, because it was from the people he was helping, the patients.”By pioneering the development of IVF, Edwards and his collaborator Patrick Steptoe have helped make possible the birth of millions of babies worldwide since 1978. Edwards' life and work are “beacons of inspiration and persistence for everybody working in the field”, says Macnamee. “There are five and a half million families now who owe their very existence to Bob, and that legacy is the one that's going to grow and multiply. I hope that each one of those families understands his contribution to their existence.”Edwards' work to overcome human infertility emerged from research into the genetics of egg maturation he had undertaken at the universities of Edinburgh and Cambridge. As an academic, he was an inspirational figure, recalls Martin Johnson, one of his first graduate students and now Emeritus Professor of Reproductive Science at the University of Cambridge. “He completely captured our imagination with his vision, his breadth of knowledge, and his stimulating and exciting way of presenting it all.”In February, 1968, a chance meeting at the Royal Society of Medicine in London resulted in Edwards collaborating with Steptoe, a gynaecologist whose pioneering work in laparoscopic surgery had generated hostility from the medical hierarchy. In December of that year, Edwards, Steptoe, and graduate student Barry Bavister submitted a paper to Nature that described IVF in human beings convincingly for the first time. It was the beginning of what would prove to be a fruitful, yet difficult, decade for the two men. They quickly succeeded in collecting eggs from women after hormonal stimulation, and having eggs fertilised and dividing in vitro, but the media and some colleagues remained hostile. Funding was difficult to come by, and their willingness to talk to journalists offended the sensibilities of some scientists. It was a combination of challenges that might have daunted less determined individuals. “This was a strong man, and his convictions were total”, says Alan Trounson, President of the California Institute for Regenerative Medicine, whose work in Melbourne, Australia, helped improve the success rate of IVF. “I think he was an extraordinary person from that point of view. He'd never waver, and would always argue that what he was doing was genuinely in the benefit of the community.”Finally, in 1978, the first IVF baby, Louise Joy Brown, was born at Oldham General Hospital. Louise's parents, Lesley and John Brown, had been trying to conceive for 9 years. Edwards and Steptoe published this groundbreaking work in a letter to The Lancet. In 1980, the two men raised private funds to found Bourn Hall Clinic, the world's first dedicated IVF unit. As IVF became a more routine procedure, Edwards continued to lead the field, helping found the European Society of Human Reproduction and Embryology, and acting as editor of Human Reproduction.Edwards served in the British military during World War 2. He studied biology at the University of Wales in Bangor and, in 1955, received a PhD in physiology from Edinburgh University. In 2010, he was awarded the Nobel Prize in Physiology or Medicine for his pioneering work in developing IVF. The next year he was knighted. The determination that characterised so much of Edwards' career was underpinned by his socialist views, and a sense of humour, says Johnson. Before it was fashionable, Edwards supported legal reform on abortion, women's rights, and gay rights. “He had a great desire to help humanity, and a feeling you had to prevent suffering. And even when things were going wrong, he could always laugh about it”, recalls Johnson. Edwards is survived by his wife and long-time scientific collaborator, Ruth Edwards, along with their five daughters and 12 grandchildren. Physiologist who pioneered the development of in-vitro fertilisation. He was born in Batley, UK, on Sept 27, 1925, and died in Cambridge, UK, on April 10, 2013, aged 87 years. One of the last times Robert Edwards spoke in public was to mark the UK's National Infertility Day in 2008. His health declining, Edwards spoke for almost an hour about the early days of in-vitro fertilisation (IVF). As he finished, the audience of patients and patient advocates rose to give him a standing ovation. “The applause went on and on and on. It was hugely moving”, remembers his colleague and former student Mike Macnamee, now chief executive of Bourn Hall fertility clinics. “Of all the times I saw him recognised in public, throughout the world, that really profoundly moved him, because it was from the people he was helping, the patients.” By pioneering the development of IVF, Edwards and his collaborator Patrick Steptoe have helped make possible the birth of millions of babies worldwide since 1978. Edwards' life and work are “beacons of inspiration and persistence for everybody working in the field”, says Macnamee. “There are five and a half million families now who owe their very existence to Bob, and that legacy is the one that's going to grow and multiply. I hope that each one of those families understands his contribution to their existence.” Edwards' work to overcome human infertility emerged from research into the genetics of egg maturation he had undertaken at the universities of Edinburgh and Cambridge. As an academic, he was an inspirational figure, recalls Martin Johnson, one of his first graduate students and now Emeritus Professor of Reproductive Science at the University of Cambridge. “He completely captured our imagination with his vision, his breadth of knowledge, and his stimulating and exciting way of presenting it all.” In February, 1968, a chance meeting at the Royal Society of Medicine in London resulted in Edwards collaborating with Steptoe, a gynaecologist whose pioneering work in laparoscopic surgery had generated hostility from the medical hierarchy. In December of that year, Edwards, Steptoe, and graduate student Barry Bavister submitted a paper to Nature that described IVF in human beings convincingly for the first time. It was the beginning of what would prove to be a fruitful, yet difficult, decade for the two men. They quickly succeeded in collecting eggs from women after hormonal stimulation, and having eggs fertilised and dividing in vitro, but the media and some colleagues remained hostile. Funding was difficult to come by, and their willingness to talk to journalists offended the sensibilities of some scientists. It was a combination of challenges that might have daunted less determined individuals. “This was a strong man, and his convictions were total”, says Alan Trounson, President of the California Institute for Regenerative Medicine, whose work in Melbourne, Australia, helped improve the success rate of IVF. “I think he was an extraordinary person from that point of view. He'd never waver, and would always argue that what he was doing was genuinely in the benefit of the community.” Finally, in 1978, the first IVF baby, Louise Joy Brown, was born at Oldham General Hospital. Louise's parents, Lesley and John Brown, had been trying to conceive for 9 years. Edwards and Steptoe published this groundbreaking work in a letter to The Lancet. In 1980, the two men raised private funds to found Bourn Hall Clinic, the world's first dedicated IVF unit. As IVF became a more routine procedure, Edwards continued to lead the field, helping found the European Society of Human Reproduction and Embryology, and acting as editor of Human Reproduction. Edwards served in the British military during World War 2. He studied biology at the University of Wales in Bangor and, in 1955, received a PhD in physiology from Edinburgh University. In 2010, he was awarded the Nobel Prize in Physiology or Medicine for his pioneering work in developing IVF. The next year he was knighted. The determination that characterised so much of Edwards' career was underpinned by his socialist views, and a sense of humour, says Johnson. Before it was fashionable, Edwards supported legal reform on abortion, women's rights, and gay rights. “He had a great desire to help humanity, and a feeling you had to prevent suffering. And even when things were going wrong, he could always laugh about it”, recalls Johnson. Edwards is survived by his wife and long-time scientific collaborator, Ruth Edwards, along with their five daughters and 12 grandchildren. MATURATION IN VITRO OF HUMAN OVARIAN OOCYTES Full-Text BIRTH AFTER THE REIMPLANTATION OF A HUMAN EMBRYO Full-Text Robert Edwards: Nobel Prize for father of in-vitro fertilisationFrom humble beginnings in Manchester, UK, 85-year-old Robert Edwards would scarcely have believed he would become the symbolic father to millions of children and an inspiration for generations of fertility researchers. More than 32 years after the birth of the first child through in-vitro fertilisation (IVF), Edwards' pioneering work has been rewarded with the 2010 Nobel Prize in Physiology or Medicine . In making the award, Christer Höög, Professor of Cell Biology at Karolinska Institute, Stockholm, and Member of the Nobel Assembly, said that Edwards' work “represents a monumental medical advance that can truly be said to confer the greatest benefit to mankind”. Full-Text PDF