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The man who took on TB
Nick Thorpe talks to Sir John Crofton, the medical pioneer whose ground–breaking discoveries have saved millions of lives across the globe. Portrait by Murdo Macleod
One evening not long ago, Sir John Crofton received an unexpected long–distance call at his Edinburgh home. It was from Tom Frieden, the high–profile Health Commissioner of New York City, phoning for advice on how to spend $200 million.
“Tom has an enormously supportive mayor, Michael Bloomberg, who wanted to use his own millions for the good of developing countries,” explains the mild–mannered 95–year–old, clearly unfazed by the request. “So I told him to fight smoking: focus on high–incidence countries, maybe fund a major effort in the media.”
You may never have heard of Sir John Crofton, but if you value your lungs you should toast him. It was Crofton, 50 years ago, who discovered the first 100% cure for the age–old scourge of tuberculosis; Crofton, too, who pioneered the global method now used to fight terrifying new drug–resistant strains on Europe’s doorstep. For 70 years he has worked with quiet determination, bending influential ears and writing the rules of engagement in the war on respiratory disease.
With his campaigning doctor wife, Eileen, he laid 30 years of groundwork for Britain’s first public smoking ban in Scotland. Not content with that, he has widened his sights to take in the country’s binge–drinkers.
“Technically I retired in 1977, but it’s a very exciting time just now,” smiles the Dublin–born pioneer today, pouring tea at his home on the outskirts of Scotland’s capital. “It puts off the Alzheimer’s, we hope.”
Knighted three decades ago in recognition of his contribution to world health, he criss–crosses the globe, advising experts less than half his age. His achievements, arguably as important as Alexander Fleming’s discovery of penicillin, won him the Union Medal in 2005, and the 2008 Edwin Chadwick Medal for outstanding contributions to public health. He marked his 95th birthday with a speech on TB at the European Parliament in Brussels.
“With TB there’s never much time to rest on one’s laurels,” says Crofton. Indeed, the current global epidemic has key factors in common with the one that confronted him when he was drafted into Edinburgh’s crowded hospital wards.
It was the Fifties, and the first new antibiotics were producing patchy results among more than 50,000 TB patients in a depressed, post–war Britain. While some recovered, others relapsed and died in the classic way – the chest pains, the coughing of blood, the body’s slow “consumption”. Until, that is, the doctor and his team came up with a simple but revolutionary idea.
“Failure was always due to patients developing resistance to a drug,” says Crofton, then the Professor of Respiratory Diseases and Tuberculosis at Edinburgh University. “So we decided to try three drugs at the same time to be on the safe side – and to our astonishment we found we were curing everybody.”
Sceptics ate their words as the disease disappeared completely in Edinburgh within six years, and by 1987, programmes of mass BCG vaccinations had helped bring Britain’s toll to just 5,500. The “Edinburgh Method” was adopted in 23 European countries and in America. Crofton co–authored Clinical Tuberculosis, a basic guide for non–specialist health workers, which is about to go into its third edition, in 20 languages. It is no exaggeration to say that his efforts have saved millions of lives across the globe.
Yet poverty remains a formidable enemy. Five decades later, a new and almost untreatable strain of TB is mounting an alarming offensive – the worst since the Second World War – on the former Soviet fringes of Europe and in pockets of Africa, where TB is now the number one cause of death among Aids patients.
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