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Richard Alan Cash (born June 9, 1941) is an American
global health Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problem ...
researcher, public health physician, and internist. He is a Senior Lecturer in International Health at the
Harvard T.H. Chan School of Public Health The Harvard T.H. Chan School of Public Health is the public health school of Harvard University, located in the Longwood Medical Area of Boston, Massachusetts. The school grew out of the Harvard-MIT School for Health Officers, the nation's first ...
in Boston. He is an alumnus of the
University of Wisconsin–Madison A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United Stat ...
(B.S., 1963).
New York University School of Medicine NYU Grossman School of Medicine is a medical school of New York University, a private research university in New York City. It was founded in 1841 and is one of two medical schools of the university, with the other being the Long Island School of ...
(M.D., 1966), and
Johns Hopkins School of Hygiene and Public Health The Johns Hopkins Bloomberg School of Public Health is the public health graduate school of Johns Hopkins University, a private research university in Baltimore, Maryland. As the second independent, degree-granting institution for research in epi ...
(MPH, 1973). Cash began his international career over 40 years ago when he was assigned by NIAID of the
NIH The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
to the Pakistan-SEATO Cholera Research Laboratory (CRL) in
Dhaka Dhaka ( or ; bn, ঢাকা, Ḍhākā, ), formerly known as Dacca, is the capital and largest city of Bangladesh, as well as the world's largest Bengali-speaking city. It is the eighth largest and sixth most densely populated city i ...
, East Pakistan (now th
ICDDR,B
in
Dhaka Dhaka ( or ; bn, ঢাকা, Ḍhākā, ), formerly known as Dacca, is the capital and largest city of Bangladesh, as well as the world's largest Bengali-speaking city. It is the eighth largest and sixth most densely populated city i ...
,
Bangladesh Bangladesh (}, ), officially the People's Republic of Bangladesh, is a country in South Asia. It is the eighth-most populous country in the world, with a population exceeding 165 million people in an area of . Bangladesh is among the mos ...
). While there, he and his colleagues developed and conducted the first clinical trials of
oral rehydration therapy Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydrat ...
(ORT) in adult and pediatric cholera patients and patients with other infectious causes of diarrhea. This technology matches the volume of fluid losses from dehydration patients with the volume they consume so that the fluid replacement packets greatly reduce or completely replace IV therapy (particularly where it is not feasible or unavailable), which was then the only current treatment for cholera. Discoveries in ORT have been estimated to have saved over 50 million lives worldwide.
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO) estimates are that at least 60 million children have been spared painful deaths because of ORT. They also conducted the first field trials of ORT, the first community-based trials of ORT, and the first use of amino acids (
glycine Glycine (symbol Gly or G; ) is an amino acid that has a single hydrogen atom as its side chain. It is the simplest stable amino acid ( carbamic acid is unstable), with the chemical formula NH2‐ CH2‐ COOH. Glycine is one of the proteinog ...
) as an additional substrate. In the late 1970s, Cash worked with BRAC (presently the world's largest NGO in terms of programs and personnel) on their OTEP
Oral Therapy Extension Programme)
which taught over 13 million mothers and caregivers how to prepare and use ORT in the home using the "pinch and scoop" method. It is estimated by WHO researchers that, each year, around 500 million packs of the oral rehydration solution are used in more than 60 developing countries, saving over 60 million lives around the world. For demonstrating how inexpensive and simple-to-use oral rehydration therapy (ORT) could treat cholera and other diarrheal diseases, then by promoting in the developing world customized applications of oral rehydration therapy (ORT) developed by Cash and David R. Nalin (at Merck in Vaccine Development from 1983 to 2002), Cash, David Nalin, and Dilip Mahalanabis became joint recipients of th
2006 Prince Mahidol Award
in public health for "exemplary contributions in the field of public health" and for their contributions "to the application of the oral rehydration solution in the treatment of severe diarrhea worldwide, including Thailand. On November 8, 2011, Cash was presented with the 2011 James F. and Sarah T. Fries Foundation Prize for Improving Health at the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
for his leadership in the development and dissemination of
Oral Rehydration Therapy Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydrat ...
as a practical treatment for cholera and other diarrheal diseases that has saved the lives of at least 60 million children worldwide.


Contributions to ethics

Cash has lectured internationally and authored or co-authored a number of published papers on research ethics and teaches a Harvard course and had long directed (until 2009) a summer intensive workshop on those issues. He won continued NIH funding for a series o
courses on research ethics in medical and health research done in resource-poor nations
that touch on over a dozen issues listed o
the public course's website
The use of case method teaching has been a critical element of all his courses. Many of the currently-used ethics case studies, the course outlines, many readings, and other course material
are available on that site
After the breakup of the
Soviet Union The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a List of former transcontinental countries#Since 1700, transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, ...
, Cash served (beginning in 2003) with the
Russian Academy of Sciences The Russian Academy of Sciences (RAS; russian: Росси́йская акаде́мия нау́к (РАН) ''Rossíyskaya akadémiya naúk'') consists of the national academy of Russia; a network of scientific research institutes from across ...
project on development of bioethics capacity in the
Commonwealth of Independent States The Commonwealth of Independent States (CIS) is a regional intergovernmental organization in Eurasia. It was formed following the dissolution of the Soviet Union in 1991. It covers an area of and has an estimated population of 239,796,010. ...
.


Contributions to public health

Cash explored contrasts within and between nations in health research ethics as a PI (Principal Investigator) of a training grant from the National Institutes of Health on "Ethical Issues in International Health Research" at HSPH. For eleven years, as Director of th
Program on Ethical Issues in International Health Research
and in line with his deep commitment to capacity building in growing nations, he has conducted training workshops based on this research in a
HSPH
and in 18 nations in South America, Africa, India, and the Middle East, covering issues of informed consent, confidentiality, conflict of interest, investigator responsibilities to study populations, research in resource poor environments, and the development of ethical review committees. He has also overseen the training of 20 Fellows from Asia, and he has conducted over 30 workshops on research ethics in 12 nations.


Current public appearances

Richard Cash is interviewed intermittently (often in remote meetings) to comment on the legacy of work he has done in the
Middle East The Middle East ( ar, الشرق الأوسط, ISO 233: ) is a geopolitical region commonly encompassing Arabia (including the Arabian Peninsula and Bahrain), Asia Minor (Asian part of Turkey except Hatay Province), East Thrace (Europ ...
,
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
, and
Himalayas The Himalayas, or Himalaya (; ; ), is a mountain range in Asia, separating the plains of the Indian subcontinent from the Tibetan Plateau. The range has some of the planet's highest peaks, including the very highest, Mount Everest. Over 10 ...
.


Accolades

* 1994 - Special Citation - 25th Anniversary of the development of Oral Rehydration Therapy (ORT) ICDDRB/Government of Bangladesh * 2006
2006 Prince Mahidol Award, received in January 2007 in Bangkok
* 2007 - Solomon A. Berson Medical Alumni Achievement Award, New York University School of Medicine * 2008 - Distinguished Alumni Award, New York University * 2011 - 2011 Fries Prize for Improving Health * 2018 - '50 Years of ORT: Cashing in on the Poor Man's Gatorade' - Symposium celebrating the development of ORT and the contributions of Richard Cash and David Nalin, November 19, 2018, sponsored by the Department of Global Health and Population, Harvard Global Health Institute, and
Harvard T.H. Chan School of Public Health The Harvard T.H. Chan School of Public Health is the public health school of Harvard University, located in the Longwood Medical Area of Boston, Massachusetts. The school grew out of the Harvard-MIT School for Health Officers, the nation's first ...
, Boston, MA.Dr. Marcia Castro's Twitter tweet about the '50 Years of Oral Rehydration Therapy' event. Accessed November 19. 2018
/ref>


Books and publications

Dr. Richard A. Cash has published over 120 peer-reviewed academic papers, spanning his work over 50 years. Some highlights include: * Oral maintenance therapy for cholera in adults. Nalin DR, Cash RA, Islam R, Molla M, Phillips RA. Lancet. 1968 Aug 17;2(7564):370-3. :This paper in
The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...
is the original report of Dr. Nalin and colleagues’ work with ORT. * Oral or nasogastric maintenance therapy in pediatric cholera patients. Nalin DR, Cash RA. J Pediatr. 1971 Feb;78(2):355-8. :This paper describes the use of ORT in pediatric patients. * Cash, R., Wikler, D., Saxena, A., Capron, A. <
Casebook on Ethical Issues in International Health Research
/u>, Geneva:
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
, 2009, 2010. :Translated into five other languages, includin
Arabic
Chinese

French
Russian
an
Spanish
; second edition forthcoming. (NLM classification: W 20.5).


External links


"Cholera: A Not-So-Simple Solution"

HSPH Faculty Profile

Ethical Issues in Global Health Research summer intensive course at HSPH

Link to ScienceHeroes.com

Link to Cash’s biography as recipient of the Prince Mahidol Award

Against the Odds – Making a difference in global health – A Simple Solution

Woodward, Billy. "David Nalin-Over 50 Million Lives Saved." Scientists Greater Than Einstein. Fresno: Quill Driver Books, 2009

Harvard Catalyst Profile page for Richard Alan Cash, MD

10 Questions with Richard Cash - interview with Harvard Chan School basic degree candidates

Harvard edX Profile page for Richard Alan Cash, MD


Further reading


Scientists Greater than Einstein: The Biggest Lifesavers of the Twentieth Century
(Hardcover) b

(Author, Fresno: Quill Driver Books, 2009

ttps://www.facebook.com/people/Karin-Kiewra/1416643992 Karin Kiewra ttp://www.HSPH.Harvard.edu Harvard Public Health Review 2007.


References

{{DEFAULTSORT:Cash, Richard A. American public health doctors American ethicists Johns Hopkins Bloomberg School of Public Health alumni New York University Grossman School of Medicine alumni University of Wisconsin–Madison alumni Physicians from Boston Educators from Cambridge, Massachusetts Physicians from Cambridge, Massachusetts People from Madison, Wisconsin Living people 1941 births Harvard T.H. Chan School of Public Health faculty Harvard Institute for International Development