Princeton Class of '55 tackles control of TB Led by Ralph Nader, grads brainstorm at Hopkins on stopping spread of disease

November 02, 1997|By Jonathan Bor | Jonathan Bor,SUN STAFF

When the graying and almost gaudily accomplished alumni of Princeton's Class of 1955 set out to find a project that would be their enduring legacy, they didn't think small.

They didn't purchase a piece of public art, start a scholarship fund or endow an academic chair -- although they had done much of that sort of thing over the years.

Instead, they took on a problem of slightly greater significance: the international control of tuberculosis, the disease that claims 3 million lives a year and remains the leading infectious killer of adults around the world.

At a gathering of Princeton University graduates yesterday at the Johns Hopkins School of Public Health, it wasn't hard to see why the class felt so emboldened. The leader of this effort was Ralph Nader, the man -- as one classmate put it -- who single-handedly brought General Motors Corp. to its knees with his critique of auto safety and, in so doing, gave rise to the consumer movement.

Eating pastry during a break yesterday in the group's first major brainstorming session, Nader explained why the nation's leading consumer advocate was taking time to worry about a problem that is most often left to public health professionals.

"It's a health and safety issue, one that is tremendously neglected," Nader said. "There is probably no greater gap between knowledge and application in the world today -- between knowledge to diminish a problem and efforts to apply the knowledge."

R. Gordon Douglas, an alumnus who became president of Merck & Co.'s vaccine division, said the Princeton alumni can make a difference through advocacy -- by lobbying organizations to spend time and resources.

Yesterday's meeting served as a crash course for the Princetonians, who invited public-health experts to explain what is known about TB control. About 60 alumni and guests attended.

After a resurgence in the 1980s and early 1990s, tuberculosis rates are declining in the United States. But the disease remains a terrible problem in the developing world, particularly in parts of Asia, Africa and South America.

The experts talked about proven weapons against TB -- screening programs to find out who is infected, preventive drugs for people who are infected but not yet ailing and aggressive antibiotic regimens for those who are sick.

Perhaps most important is "directly observed therapy," a technique that helped Baltimore make the transition from being among the nation's worst TB hot spots to a model for effective control. The program was instituted in 1978 and has brought about steady reductions in TB rates. It couldn't be more basic: Nurses deliver medicines to patients and then watch them swallow each and every one. In the end, the program helps prevent lapses in treatment that can cause the disease to rebound and become deadlier.

Dr. George Comstock, a Hopkins epidemiologist, told the group not to forget the simplest weapon: educating people to cover mouths when they cough. The well-placed hand is the best way to keep the disease from spreading -- a common courtesy that, he lamented, has gone out of fashion.

When Nader and his classmates first clinked glasses in the early 1950s, the national concerns were McCarthyism, the Korean War and the draft. But Nader said the class was not a particularly intellectual one. What he remembers most are "white buck shoes, tan pants, the clubs on Prospect Street and the gentleman's 'C.' "

But the class went on to greater things. Of the 804 who graduated, 70 went to medical school and an even larger number attended law school. The largest number went into business.

The TB project was born about a year ago. Nader hopes to expand the project's power and influence by recruiting alumni groups from other colleges. "It's a natural constituency," he said.

Pub Date: 11/02/97

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