Table Of Content

Am.J.Trop.Med.Hyg.,91(2),2014,pp.435–436 doi:10.4269/ajtmh.14-0316 Copyright©2014byTheAmericanSocietyofTropicalMedicineandHygiene Tribute Dr. Jacinto Convit (1913–2014) On May 12, 2014, Jacinto Convit, MD, died in Caracas, grated into national health programs of several other coun- Venezuelaattheageof100.Dr.Convitwasamajorfigurein triesinLatinAmerica. thehistoryofleprosyandparasitologyresearch.Althoughbest In 1960, the World Health Organization (WHO) commis- known for his fundamental and lasting contributions to the sioned Dr. Convit to implement a drug development and studyofMycobacteriumleprae,thecausativeagentofleprosy surveillance program for the treatment of several parasitic (Hansen’sdisease),hisimpactonresearchintomanyparasitic diseases,andtoleadtheCooperativeCenterforDrugEvalu- agentsandthefieldofimmunotherapywassignificant. ation in the Americas. Later in 1971, he was appointed by Dr. Convit’s professional career covered a period of over WHOastheDirectoroftheCooperativeCommitteeforthe 70years. Itbegan in 1938when hereceived his doctorate of Study and Histologic Classification of Leprosy, and in 1973 medicinedegreefromtheUniversidadCentraldeVenezuela was appointed Director of the Pan American Center for inCaracas.AtthattimehishomecountryofVenezuelawasa Research and Training in Leprosy and Tropical Diseases rural, poor, and disease-ridden country in which any person (WHO/PAHO).Inaddition,hewasalsoappointedasaMem- suspectedofsufferingfromHansen’sdiseasewasstigmatized beroftheWHOpanelofexpertswhohelpeddrafttheReport and condemned to isolation. The conditions under which oftheExpertCommitteein1962–1967and1972. these patients were confined at Leprosaria, together with Dr.Convitwasalsorenownedforpioneeringinthefieldof Convit’s extraordinary human sensitivity, played a key role immunotherapybydevelopinginthemid-seventiesasuccess- in his lifelong crusade against stigmatization of leprosy fulmodelofimmunotherapyforleprosycombiningpurifiedlep- patients. At age 23, in the era where no cure was available rosybacilliobtainedfromthenine-bandedarmadillo(Figure2) for this feared disease, Convit (Figure 1) decided to devote and the powerful cell-mediated immunity Bacillus Calmette- his life to developing a cure for these patients and decided Gue´rin(BCG)vaccineasanadjuvant.Suchamodelwasalso to move into one of the largest leprosaria of Venezuela, the appliedtothetreatmentofleishmaniasis,anapproachthathas Leprosy Clinic of “Cabo Blanco.” His first goal was to end helped thousands of patients have access to therapy during prejudiceandexclusioncondemningthisdisease,anobjective shortagesofantimonialsandwithafarlesscostandcompara- thatheachievedsoonaftertakingovertheNationalDirector- bleefficacy. ateofLeprocomiums,whenheconvincedthegovernmentto Jacinto Convit’s academic career was extraordinary. He freethepatientsfromisolation.Hisworkhelpedchangethe beganhisteachingcareerintheDepartmentofTropicalMed- leprosycontrolmeasuresinVenezuela,replacingcompulsory icine at the Universidad Central de Venezuela, and later isolationwithambulatorytreatment. joinedasafull-timeProfessorattheDepartmentofDerma- Duringthesetoughyears,Dr.Convitalsovolunteeredasa tologyofthissameUniversity.In1976hefoundedthefellow- physician in other leprosy clinics around the country and ship training program in Dermatopathology and in 2000 he devoted a great amount of time to study the diverse clinical foundedtheMasterscourseinEpidemiologyofEndemicDis- and epidemiological aspects of leprosy. He managed to eases. He also contributed to the creation of the National inspire and form a small team of medical students, pharma- InstituteofDermatology,andin1984foundedtheInstituteof cists,andnursesthatdevoteddayandnighttoseekingacure Biomedicine,astate-of-the-artresearchinstitutiondevotedto for patients (Figure 2). At first, the only resource available basicscienceinvestigationsandpublicmedicalserviceforder- was Chaulmoogra oil, a poorly effective option that had matologicalandothertropicaldiseases.Hepursuedadditional severe nauseating effects when taken orally and which was training in Dermatology, Epidemiology, and Biostatistics at verypainfulwhenadministeredintramuscularly oras subcu- Columbia, Case Western Reserve and Stanford University taneousinjections.ThisledConvitandhisteamracingtofind andwasavisitingProfessoratStanfordandtheUniversityof a suitable therapeutic option, a goal that would soon be Miami.Hepublishedmorethan300originalarticles. achievedafterprovingtheefficacyofsulfonesandseveralof Asaskillfulclinicianwithasuperbclinicalinsight,hecon- itsderivativesonleprosyintheearly1940s. tributedgreatlytothestudyandclassificationofaplethoraof One of Convit’s major achievements was the creation of dermatological illnesses. He was the first person to describe regional public health dermatology services (PHDSs) themalignantpoleofAmericancutaneousleishmaniasisnam- throughoutthecountry,whichallowedhimnotonlytoimple- ing it“anergic”or“diffuse cutaneousleishmaniasis” and also ment ambulatory treatment of leprosy patients, but also to was included among the authors who first described the rare provide health education and the control of contacts. These and peculiar pigmentary disorder “Erythema Dyschromicum regionalservicesprogressivelyexpandedtheirrangeofactiv- Perstans (ashy dermatosis).” However, his contribution to ities to include other endemic diseases such as leishmaniasis medicineandinfectiousdiseaseswasfarwiderthanhispartic- and onchocerciasis and were replicated as models and inte- ularinterestinleprosyandleishmaniasis.Hestudied,wrote, and lectured extensively on many endemic diseases such as systemic and subcutaneous mycoses, lymphatic filariasis, onchocercosis, and intestinal parasitosis. Even in his final years, Dr. Convit asked all of his collaborators and friends Address correspondence to Alberto E. Paniz Mondolfi, 55 Park Street, PS656, New Haven, CT 06511. E-mail: alberto.paniz- to carry one last and ambitious project, to extrapolate his [email protected] lifelong experience in microbial immunotherapy models to 435 436 PANIZMONDOLFIANDBLOOM SocietyforInvestigativeDermatology,andafoundingmember oftheInternationalSocietyforTropicalDermatology. Dr.Convit’sscientificlegacyincludesnotonlyhisoutstand- ing achievements in Tropical Medicine, chemotherapy, and immunotherapy of infectious diseases, but also his contribution to the careers of many others. He trained an important numberofdoctoralstudents,postdoctoralfellows,andunder- graduate researchers who are now spread at academic research institutions around the world. In addition, he also trainedgenerationsofpublichealthinspectorsandphysicians who now play an important role as health policy decision makers and spokespersons around the globe. His door was alwaysopen,anditwasnotasurprisetocomeintohishouse andseehimhavinglunchwithhispatients. One of Dr. Convit’s great influences was on a group of youngscientistswhowerekeentoapplytheirskillsinimmu- Figure1. Dr.JacintoConvitinhisLaboratoryattheInstituteof nology and epidemiology to an important problem of devel- Biomedicine in Caracas, Venezuela handling a nine-banded arma- opingcountries.Hereveledinlearningaboutthenewscience dillo,theanimalmodelusedtoobtainlargequantitiesoftheunculti- andgenerouslysharedhisvastclinicalknowledgewithevery- vable leprosy bacillus for vaccine development (Image: Jacinto one. This group became IMMLEP, the immunology of lep- ConvitFoundation). rosy group at WHO, which was so successful at exchanging ideas, data, and reagents that it inspired the creation by the cancer world. “There is a lot we have to learn about WHO,UnitedNationsDevelopmentProgram(UNDP),and immunity and cancer, and bugs may be holding a clue for the World Bank of the Special Program for Research and progressinthisfield,”heoncestatedinhisfinalyears. TraininginTropicalDiseases. Dr.Convit’sprominencewithinthefieldofTropicalMed- He had a great insight and understanding for people and icine was acknowledged by a series of highly prestigious treated everybody as equals, always with a mix of fondness awards,includingthePrinceofAsturiasPrizeinscienceand and great respect. For his patients, he had a special gift for technology, France’s Legion of Honor, The Medal “Health touchingtheirheartsaswellastheirskinandconveyinghow forAll”awardedbytheWorldHealthOrganization(WHO), muchhecaredabouteachofthem.Hewasahumanitarianin theAbrahamHorwitzPrizeforleadershipinInter-American everysenseoftheword. Health, the Armand Frappier Medal, and the Alfred Soper Training under Dr.Convit’smentorshipwas withnodoubt Award and “Hero of Health” medal awarded by the Pan notonlyaneducational,butaninspirationalandexcitingexpe- AmericanHealthOrganization.Hewasalsoincludedamong rienceforthoseofusfortunatetoworkwithhim.Hepracticed the 65 Caring Physicians of the World by the World Med- what he taught as he worked until his last day of life. His icalAssociation. researchandmentorshipactivitiesareonlyapartiallegacyof Overtheyears,heheldanumberofacademicpostsatdif- hisextraordinaryaccomplishments.Histruelegacyliesinthe ferentinstitutionsandchairedatnumerousinternationalmeet- role model he set as a husband, father, teacher, friend, and ings. He was elected president of the International Leprosy aboveallasaphysicianwhoseliferevolvedaroundthecareof Association, which he led for a decade (1968–1978); and was hispatients.Withhisquiet,modest,andperseverantcharacter, honorarymemberoftheAmericanSocietyofTropicalMedi- hewillneverbeforgotten.Weallfeelagreatsenseoflossnow cine and Hygiene, the Royal Society of Tropical Medicine that he is no longer with us. We have lost not only a great and Hygiene, the American Dermatological Association, the scientist,butamentorandverydearfriend. ALBERTOE.PANIZMONDOLFI DepartmentofLaboratoryMedicine YaleUniversitySchoolofMedicine NewHaven,Connecticut;and InstitutodeBiomedicina LaboratoriodeBioqu´ımica/Fundacio´n JacintoConvitCaracas,Venezuela BARRYR.BLOOM HarvardSchoolofPublicHealth DepartmentofImmunologyandInfectious DiseasesandtheDepartmentofGlobal HealthandPopulation Boston,Massachusetts This is an open-access article distributed under the terms of the CreativeCommons AttributionLicense,which permitsunrestricted Figure 2. Dr. Jacinto Convit and collaborators at the Leprosy use, distribution, and reproduction in any medium, provided the Clinicof“CaboBlanco”(Image:JacintoConvitFoundation). originalauthorandsourcearecredited.