In Memoriam: 2012
Born in Algiers on 27 March 1930 to Catholic parents, themselves born in Algeria, Pierre was educated entirely in Algiers. A militant against colonial injustice even as a student, Pierre became involved in 1954 in the struggle for Algerian independence. He was imprisoned then expelled from Algeria in 1957. In December 1957, he defended his doctoral thesis in medicine in Paris and went to Tunis, where he continued his life as a militant until the independence of Algeria in 1962. His Algerian nationality was officially recognised in July 1963. Pierre was first a full-time physician, then assistant and finally associate professor at Mustapha CHU teaching hospital in Algiers from 1962 to 1972, before assuming the duties of head of the Department of Phthisiopulmonology at the Béni Messous CHU teaching hospital from 1972 to 1994. From June 1992 to February 1994, he served as special advisor on health matters for the head of the government. He was elected a delegate to the Popular Communal Assembly of Algiers from 1967 to 1971, and Vice President of the National Observatory of Human Rights from 1992 to 1996. In February 1994, after receiving direct threats from Islamic terrorists, Pierre went into exile, first to Paris, where he was offered a contract by Dr Nils Billo, the new Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), then to Geneva, where he worked for four years as a physician for the World Health Organization (WHO) in the Global Tuberculosis Control Programme. He undertook numerous missions to Africa, the Middle East and Asia, where he provided support for planning national tuberculosis programmes and medical training. After returning to Algiers in 1999, he served on the National Committee of Tuberculosis and Respiratory Disease Experts for the Minister of Health, and became a consultant for public health strategies with the National Economic and Social Council, starting in 2006. During all these years, Pierre never ceased to work for public health and for the improvement of patient access to care. A pioneer in the campaign against tuberculosis in Algeria, Pierre was able to inspire his colleagues with the enthusiasm and determination needed to modernise the National Tuberculosis Programme, which soon became a model internationally. A brilliant instructor, he was among the prime movers in an innovative pedagogical reform of medical education, and trained generations of doctors, specialists and instructors.
Pierre led numerous research projects with his team, particularly on the conduct of controlled clinical trials, in collaboration with the British Medical Research Council team directed by Professor
Wallace Fox. This work resulted in the adoption at national level of a 6-month tuberculosis treatment regimen in 1980, and several hundred publications and reports. Pierre was also a visionary: from 1980 he began to organise standardised care in anti-tuberculosis dispensaries in Algiers for other prevalent respiratory diseases. This line of work was resumed when he joined the WHO, and facilitated the preparation of a new WHO initiative: the Practical Approach to Lung Health.
He also contributed to the writing of a variety of technical WHO documents: “Treatment of tuberculosis: guidelines for national programmes” (1997, 2004), “Guidelines for the management of drug resistant tuberculosis”, under the aegis of Professor John Crofton (1996), and “Tuberculosis
control in refugee situations: an inter-agency field manual,” published in 1997 by the WHO and the United Nations High Commission for Refugees (UNHCR). He contributed with other colleagues to the “Tuberculosis – a manual for medical students”, written by Nadia Aït-Khaled and Donald Enarson, and published in 2003 by the WHO and The Union.
Pierre became a member of the International Union against Tuberculosis in 1962. In 1965, he helped to create the Algerian Committee for Tuberculosis Control (Comité Algérien de lutte contre la tuberculose), a voluntary non-profit association dedicated to health education, which became a Constituent Member of The Union. In September 1963, when attending the 17th International Conference on Tuberculosis in Rome, he first met Wallace Fox, who was giving a lecture on his experiences in Madras, demonstrating the effectiveness of fully ambulatory treatment for tuberculosis. Pierre worked with The Union for many years, along with several other outstanding personalities, in particular Dr Annik Rouillon, then Executive Director of The Union, Dr Karel Styblo and Dr Kilpatrick. He was president of The Union’s Committee on Treatment,and co-directed the International Course on Tuberculosis Control in Paris and then in Algiers, under the aegis of The Union and the WHO, from 1985 to 1993. Pierre regularly participated in The Union’s Africa Region and World Conferences, and in 1999 he received the international Princess Chichibu Memorial TB Global Award, given by the Japanese Anti-Tuberculosis Association (JATA). In 2004 he organised the XVth Conference of The Union Africa Region in Algiers, with Prof Larbaoui and colleagues. With his lifelong commitment as a militant, with his former students Pierre relaunched the Algerian Committee for the Control of Tuberculosis and Respiratory Diseases (CALT MR - Comité Algérien de Lutte contre la Tuberculose et les Maladies respiratoires), which had ceased to operate during the “black decade”. The CALT MR, of which he was named Honorary President, saw the day once again on 24 March 2012, at Bejaia, Algeria.
Pierre and his wife Claudine published their memoirs in 2012, in a book entitled “Le choix de L’Algérie : deux voix, une mémoire” [The choice of Algeria: two voices, one memory]. Only two weeks before he died, Pierre was still working on another book of memoirs, which he did not have time to publish, which was to be called “Cinquante ans demédecine.”[Fifty years of medicine]. Pierre died on 5 October 2012 and was buried in the Christian cemetery of Algiers on 9 October 2012. Algeria has lost one of its finest sons, a just man among the just, a man of conviction and a monument to public health. He devoted his life to the service of Algeria, fought unceasingly for the freedom of its people and worked relentlessly for the improvement of public health, for access to care for all, and particularly for those most destitute. Kind, modest, generous and considerate, Pierre also had an acute, critical mind, sometimes expressed by a fairly caustic sense of humour. Pierre’s work was vast, and his death is an irreparable loss to his family, his friends and his numerous students and disciples in Algeria, in Africa and worldwide. The Union and all those who knew him and loved him extend their deepest condolences to his family and friends in their time of grief.
Dr Moti Lall,President of the Guyana Chest Society and former head of the Guyana
Tuberculosis Programme, passed away on 10 January 2012.
Born in the village of Buxton, East Coast Demerara, Dr Lall was encouraged by his teachers to
become a doctor and received a scholarship to study medicine in Cuba. In his fourth year he transferred to Rostock University in Germany, where he gained an in-depth knowledge of TB and
completed his medical training. He went on to do postgraduate work in Germany and Canada, becoming qualified as a pulmonologist.
He returned to Guyana in 1968 and became the Medical Superintendent of West Demerara Regional Hospital, a post he held until his retirement in 2001. He also served as
principal TB officer from 1982 to 1997 and served as a consultant to the Ministry of Health overseeing the TB programme until 1999. In addition to his active role in the Guyana Chest Society, a constituent member of The Union, Dr Lall opened a Chest Clinic in Georgetown.
In recognition of his resolute efforts to fight TB, he was awarded the Silver Medal by the
Ministry of Health in 1983. In 1998, he received the country’s third highest honour – Cacique Crown of Honour (CCH) – from the Government in recognition of his long and dedicated service in the field of medicine.
Active in politics, Dr Lall was also a former Member of Parliament for the Progressive People’s Party (PPP), chairman of the board of the Central Housing and Planning Authority, and a Central Committee Member of the party.
Knut Ovreberg (1928-2012)
Born in Norway in 1928, Knut Ovreberg graduated as MD from the University of Oslo in 1954. He served as a physician in the United Nations forces in Suez-Gaza in 1959-1960, in Katanga, Congo in 1962 and in Lebanon in 1979-1980. He specialised in chest medicine in 1968 and
developed a modern chest clinic in Harstad, just within the Artic Circle.
Under the Ministry of Health, Dr Ovreberg coordinated a successful national project to treat all chronic and drug-resistant tuberculosis (TB) patients in the country using the three newly developed drugs rifampicin, ethambutol and capreomycin. All converted, but mortality was high, emphasising that in future such cases should be prevented by ensuring centrally advised, correct treatment, still today a very relevant message not only in Norway but also worldwide. He continued to advise the national authorities on TB until he retired, by which time the incidence of drug-resistant TB in Norway had fallen markedly.
Dr Ovreberg was a leading figure in the International Union Against Tuberculosis and Lung Disease’s (The Union’s) development of the new global TB strategy from the 1980s onward. He was a key advisor to the Norwegian National Health Association in relation to the NO-TB-BALTIC project and to their TB programmes in Nicaragua and Malawi. He was also advisor to the Norwegian Heart and Lung Patient Organisation (LHL) in their work in Nepal, at first in LHL’s
co-operation with The Britain Nepal Medical Trust, of which for many years he was a Trustee, and later as LHL’s advisor to the National Tuberculosis Programme. From 1997, after his retirement,
Knut’s expertise was needed in Archangel, Northwest Russia, where the incidence of TB and multidrug-resistant TB had increased dramatically. Through LHL his advice was crucial to the local TB programmes in managing to control the epidemic with these centres becoming training sites and models for their neighbours. He also provided advice to NORAD and the World Health Organization.
In recognition of his contribution to lung medicine both nationally and globally, Dr Ovreberg was awarded the Norwegian King’s Medal of Merit in gold and The Union Medal in 1998.
We in The Union and the wider world of tuberculosis will miss Dr Ovreberg not only because of his vast knowledge and experience, but also for his personal qualities of friendliness, generosity, kindness and approachability, as well as for his great sense of humour.
Ovreberg K, Bjartveit K. A national
therapy project for drug- resistant pulmonary tuberculosis. Scand J Respir Dis
1974; 55: 218-228.
In Memoriam: 2011
The Union honours the passing of the following members who made significant contributions to tuberculosis and lung health:
Prof Djilali Larbaoui (Algeria)
It is with great sadness that The Union announces the passing of Prof Djilali Larbaoui, an Honorary Member recognised in 2001 for his long and influential contributions to the fight against tuberculosis and lung disease.
A former professor of pneumophtisiology at the Faculty of Medicine of Algiers, Prof Larbaoui was the first president of the Algerian Society of Pneumophtisiology after independence and former head of department at the University Hospital of Beni Messous. He was president of the Algerian Red Crescent in 1965 and Chairman of the National Medical Committee Against Tuberculosis and Lung Disease within the Ministry of Health, Population and Hospital Reform from 1999 to 2007.
In addition, he was the Secretary General of the Algerian Committee Against Tuberculosis and Lung Disease, a constituent member of The Union, since the committee was founded in 1965. From 1999 to 2006, he represented the Africa Region on The Union's Board of Directors.
During his long career, Prof Larbaoui helped train several generations of doctors and specialists, and he will be greatly missed.
Prof Larbaoui died in Paris on 6 November 2011.
Source: El Watan.com
Dr John Sbarbaro (United States of America)
Dr John Sbarbaro, a longtime Union member who pioneered the use of patient-centred directly observed therapy (DOT) in the United States, died on 30 August 2011. Born in Chicago, Dr Sbarbaro completed his medical training at Johns Hopkins School of Medicine, did an Internal Medicine residency at the University of Illinois and obtained an MPH from Harvard University.
In 1965, he joined the Centers for Disease Control and Prevention (CDC). He was assigned as TB Control Officer for Denver then promoted to Director of the Denver Disease Control Service and Medical Director of the Neighborhood Health Program. In that position, he and colleagues demonstrated that the use of DOT improved adherence to the long treatment required to cure tuberculosis.
Dr Sbarbaro became a forceful advocate of DOT as a ‘standard of care’ to ensure optimal outcomes for all persons with tuberculosis. At the height of the unprecedented resurgence of TB in the USA in 1985–1992, he coauthored an editorial ‘Directly observed treatment of tuberculosis: we can’t afford not to try it’, convincingly stating the case for individual, societal, and economic benefits of DOT.
Over his long career, Dr Sbarbaro also served as Director of Public Health and Preventive Medicine and Deputy Manager of Medical Affairs of Denver Health and Hospitals and held leadership positions at the University of Colorado, where he was Professor of Medicine and Preventive Medicine at the University of Colorado School of Medicine.
Dr Sbarbaro’s life-long interests focused both on creating highly functional clinical delivery systems and on research to improve the treatment of TB. He was the author of 18 book chapters and over 160 articles. He also served as a consultant to the World Health Organization and many other organisations and agencies.
Sources: IJTLD and Denver Post
Dr Kjell Bjartveit (Norway)
Dr Kjell Bjartveit, a lung disease expert who played key roles in advancing cardiovascular disease screening and tobacco control and former Union President, died in Oslo on 22 February 2011 at the age of 83.
Dr Bjartveit was a Senior Officer in the Norwegian Mass Radiography Service (later the National Health Screening Service) from 1959 to 1963 and held the position of Director there from 1963 until his retirement in 1997. He was a pioneer in cardiovascular epidemiology, trials and screening and instrumental in the Cardiovascular Disease Study in Norwegian Counties. This study applied the wartime mass screening techniques used for TB and chest diseases to identify people at risk for heart disease and provided preventive advice and follow-up.
Dr Bjartveit also served as Director of the Norwegian Health Association from 1997 to 2001, in which role he contributed to the understanding the pathogenesis and prevention of tuberculosis.
An ardent advocate of tobacco control, Dr Bjartveit served on the committee that worked towards passage of Norway’s Tobacco Act in 1973, and was an expert advisor to the World Health Organization from the 1970s. He was also President of the Governing Council of the International Non-Governmental Coalition Against Tobacco (INGCAT).
In 2005, Dr Bjartveit and his colleague Aage Tverdal published a study of the health risks of smoking 1 to 4 cigarettes a day that received widespread publicity. The study results showed that, in both sexes, smoking 1–4 cigarettes per day was associated with a significantly higher risk of dying from ischaemic heart disease and from all causes, and from lung cancer in women. It urged policy makers and health educators to emphasise more strongly that light smokers also endanger their health.
Another study by the two researchers, published in October 2010 in Tobacco Control, examined whether pipe smoking was any safer than cigarette smoking. Their results showed it was not.
Active in a variety of Union committees over many years, Dr Bjartveit served as President of The Union in 1999 and 2000, presiding over the World Conferences in Madrid and Florence. According to Dr Nils E Billo, Executive Director, he was also instrumental in obtaining support from the Norwegian government that provided funds for Union programmes in tuberculosis, tobacco control and lung health.
Prof Asma El Sony of Sudan, also a former Union president, said she “admired his love for sports and politics” as well as his important contributions to the fights against tobacco and tuberculosis.
Kjell Bjartveit was born in Norway on 14 August 1927. He graduated from the University of Oslo as an MD in 1951, then specialised in lung diseases, receiving a Diploma in Public Health from the University of Toronto in 1962 and a DMedSc degree at the University of Oslo in 1984. He was married to the Norwegian physician and politician Eleonore Bjartveit, who predeceased him.
Sources: Kalevi Pyörälä
K Bjartveit, A Tverdal. Health consequences of smoking 1-4 cigarettes per day. Tob Control 2005;14:315–320.
A Tverdal, K Bjartveit. Health consequences of pipe versus cigarette smoking. Tob Control doi:10.1136/tc.2010.036780
In Memoriam: 2010
Dr Masakazu Aoki (Japan)
Masakazu Aoki was a driving force within the Japan Anti-tuberculosis Association (JATA) as its President and at the Research Institute of Tuberculosis (RIT) as its Director and Director Emeritus. He became a specialist in TB after working with the poor in devastated areas of Tokyo after World War II. At that time, TB was the most common cause of death in Japan. He did his medical training at Tokyo University and completed a PhD, writing his dissertation on the influence of corticosteroids on TB. He joined RIT in 1954 as a pathologist and became Director in 1987. He was an expert in epidemiology and Japan's national programme underwent important changes towards modern TB control under his leadership. He was a member of the Tuberculosis Surveillance Research Unit and served on The Union Board of Directors from 1985 to 1991. Over 45 years he taught international TB courses to more than 1,000 participants from around the world and published more than 240 papers and 40 books.
Prof Wallace Fox, CMG (United Kingdom)
Wallace Fox changed the course of TB history in the 1950s when he led a clinical trial in India which demonstrated that treatment at home was as effective as treatment in a sanatorium. This signaled the end of the sanatorium era and changed the lives of millions of TB patients.
Fox began his career with the UK's Medical Research Council in 1952, just as the first effective anti-tuberculosis drugs were being introduced. He was involved in early clinical trials that showed resistance to streptomycin could be prevented by combining it with isoniazid or p-Aminosalicylic Acid (PAS). This became the standard regimen used throughout Western Europe for the next 15 years, however, Fox recognised that the high cost of PAS made it unavailable in many poorer countries; he found that Thiacetazone was able to replace it.
In 1956, Fox was seconded by the MRC to the World Health Organization to set up and run a research unit for TB drug trials. He selected Madras for the series of ground-breaking studies that revolutionised the treatment of TB. He was made a Companion of the Order of St Michael and St George (CMG) for his extraordinary non-military service in a foreign country. A long-time Union member, Wallace Fox served as chair of the Executive Committee and Council from 1975 to 1978. (UK Guardian)
Prof Jorge Alberto Pilheu (Argentina)
Prof Jorge Alberto Pilheu of Argentina was a specialist in pneumology and respiratory diseases. He played a critical role in both TB and tobacco control and prevention in Argentina. His constant preoccupation was to create awareness on these two issues and their impact on health and the environment. He was active in The Union for many years and In 1982, he served as Vice President of the XXV Union World Conference on Lung Health, which was held in Buenos Aires. On World TB Day 2009 (24 March 2009), he was awarded the Bronze Badge of the Ministry of Health of the Argentine Republic for "his extensive work and his background in the fight against tuberculosis".
Dr NC Sen Gupta (The Philippines)
Narayan Chandra Sen Gupta began work with what would become the Singapore Anti-Tuberculosis Association (SATA) in 1948 and was active in early efforts to control TB, including introducing mobile mass radiography in 1955. In 1958 he became Medical Director of SATA and its clinic and between 1950 and 1970, TB dropped from the number one cause of death to number five.
Dr Sen Gupta also served on Singapore's Tuberculosis Research Committee and was active in The Union. In 1982 he was elected President and served until 1986, when the Union World Conference on Lung Health was held in Singapore. He worked closely with Executive Director Annik Rouillon and Director of Scientific Activities Karel Styblo during this period, when the principles of the DOTS strategy were being tested, and the first guide for low-income countries on the management of TB – "The Orange Guide" – was published. Dr Sen Gupta was made an Honorary Member of The Union for his many outstanding contributions to TB control.
Dr MM Singh (India)
Dr MM Singh, whose career in TB and lung health spanned five decades, was a long-time member of The Union, the first president of the South-East Asia Region (SEAR) and represented SEAR on The Union Board of Directors. He served as Medical Superintendent and Senior Consultant for Chest Diseases at Rajan Babu TB Hospital, the largest hospital for treatment, training and research in TB and chest diseases in India. He was also a professor at Delhi University and attached to V.P. Chest Institute and the Maulana Azad Medical College. He also served as Director of the New Delhi TB Centre, Vice President of the Delhi TB Association and Vice Chairman of the TB Association of India. Dr Singh published many papers and received many awards. As editor of the Indian Journal of Tuberculosis, he made a lasting impact and was an important inspiration to his colleagues. (TB Association of India)
Dr Abolhassan Zia-Zarifi (Iran)
Abolhassan Zia-Zarifi was an Honorary Member of The Union, recognised for his outstanding contributions to TB control, and one of the most important Iranian scientists of the 20th century. In his work he served as a model for maintaining rigorous scientific principles despite difficult field conditions. He was also a politician who supported democracy and development, and who fought for the rights of the Iranian people, especially women, and for human rights in all corners of the world.
Zia-Zarifi was a WHO consultant in the Middle East, Asia and Africa and served as Director General of Iran's laboratories from 1975 to 1979. The crowning success of his career was the establishment of Iran's National Reference Laboratories as a centre for epidemiology and national standard setting. His publications ranged from the Bacteriology of TB (1973) and Biosafety Guidelines for Health Care Workers against Viral Hepatitis and AIDS (2001) to Unanswered Questions in Extraordinary Years (autobiography; editor, 1997) and The Story of Life (2006). (Asma El Sony)