HSPH Lecturer Wins Fries Prize

Senior Lecturer at the School of Public Health Richard A. Cash received the 2011 Fries Prize for Improving Health for his work in developing Oral Rehydration Therapy, a practical treatment for cholera and other diarrheal diseases.

The World Health Organization estimates that Oral Rehydration Therapy, which was co-developed by Cash in 1968, has saved the lives of at least 60 million children worldwide. Taken orally, the solution of salts and sugars helps to retain water in the body, a key determinant of survival in patients with cholera.

“In terms of number of lives saved, Richard Cash probably takes the record of anyone I know of at Harvard,” said Barry R. Bloom, a professor at the School of Public Health who nominated Cash for the award.

Cash first developed the treatment while working in Bangladesh, where cholera tends to spread rapidly due to a lack of clean water. Diarrhea induced by the disease, which causes severe dehydration, can kill children in as few as four hours, according to Bloom.

At the time, the only existing treatment was expensive intravenous therapy, which was administered exclusively at hospitals.

Working with a colleague, Cash formulated a simple and inexpensive mixture to treat dehydration. In the 1980s, Cash worked with the Bangladesh Rural Advancement Committee to instruct millions of families in preparing the solution from household ingredients.

The most basic version of the mixture can be made from a pinch of salt, a fistful of sugar, and a jug of boiled water.

Since then, relief organizations such as UNICEF have packaged the formula into packets, and currently distribute 800 million packets each year worldwide, according to Bloom.

“This is a general, inexpensive treatment for acute diarrhea that costs pennies,” Bloom said.

Cash said that he was eager to find other applications for the mixture after his initial discovery.

“Does it work for children as well as adults? Does it work for non-cholera as well as cholera?,” Cash said. “At each step, you’re thinking of how to push this further.”

Oral Rehydration Therapy is now used to treat a wide variety of diarrheal diseases. According to Bloom, it has also been used to keep AIDS patients alive in the U.S.

Before Cash’s discovery, the worldwide fatality rate for severe cholera was 30 percent, according to Bloom. Since then, that number has been reduced to less than 0.5 percent. “It really is an extremely important contribution in health,” Bloom said.

Cash received the $60,000 prize on Tuesday at the Centers for Disease Control and Prevention headquarters in Atlanta, Ga. He said he felt honored “to join such an august group.”

Cash currently conducts research and teaches classes and workshops at Harvard.

“He is an absolutely inspiring teacher, and the students adore him,” Bloom said.