Assumes New Role to Improve Maternal and Child Health in Developing Countries
Duane Alexander, M.D., Director of the NICHD, announced recently that he would soon leave the institute on October 1, 2009, to begin a new assignment within the NIH.
In his new position, Dr. Alexander will serve as a senior scientific advisor to the Director of the NIH’s Fogarty International Center, Roger Glass, M.D., on the NIH’s role in a White House initiative to reduce maternal and infant mortality and morbidity in the developing world.
“The opportunity to work at this level to translate research advances, many of them from NICHD and NIH, to people in challenging settings is too good to pass up,” Dr. Alexander stated.
Dr. Alexander joined the NICHD in 1968, upon completion of his internship and residency at the Department of Pediatrics at Johns Hopkins Hospital. He left briefly to complete a fellowship in pediatrics at the John F. Kennedy Institute for Habilitation of the Mentally and Physically Handicapped Child at Johns Hopkins. He returned to the NICHD in 1971 as an Assistant to the Scientific Director.
In that capacity, Dr. Alexander directed the NICHD National Amniocentesis Study. In 1974, the Study reported the results of 1,040 women who had undergone the procedure, concluding that it was both safe and accurate. Although amniocentesis for prenatal diagnosis had come into use by 1970, studies to test whether it posed any serious risks to the fetus had not been conducted.
At the September meeting of the NICHD’s advisory council, NIH Director Francis Collins, M.D., Ph.D., thanked Dr. Alexander for his role in a shepherding to completion a variety of important projects that improved the nation's health.
He noted that during Dr. Alexander’s tenure, NICHD scientists developed a vaccine for Haemophilus Influenzae Type b (Hib) . Hib meningitis was once the leading cause of acquired mental retardation in the United States. Among the 15–20,000 cases of Hib meningitis each year, 1 in 10 children died, 1 in 3 was left deaf, and 1 in 3 was left with mental retardation. Today, mental retardation from Hib has almost been eliminated from the developed world.
Dr. Collins also commended Dr. Alexander for going beyond the conventional wisdom of the time and fostering research of the practice of placing infants to sleep on their backs. For many years, placing infants to sleep on the back was thought to increase an infant’s risk of serious lung infection, brought on by inhaling vomit.
NICHD-sponsored research verified that placing infants to sleep on their backs not only reduces the risk of Sudden Infant Death Syndrome (SIDS), but does not carry with it any other risks to infant health. Based on this evidence, in 1994, Dr. Alexander formed a coalition of national organizations to join the NICHD to launch Back to Sleep, a national public awareness campaign. Since the campaign began, the overall rate of SIDS in the United States has declined by more than 50 percent.
Dr. Collins noted that research conducted under Dr. Alexander’s tenure also provided the first intervention shown to be both safe and effective in reducing the risk of preterm birth in women at high risk for preterm delivery. An NICHD network study showed that weekly doses of a synthetic progesterone reduced the risk for preterm birth by one third among women who had previously given birth prematurely 
. Subsequently, The American College of Obstetricians and Gynecologists recommended that all of their members prescribe progesterone to prevent preterm birth for women with a history of delivering prematurely.
It was also during Alexander’s tenure as NICHD Director that the rate of mother-to-child HIV transmission was reduced dramatically in the U.S., from 27 percent, to less than 2 percent. In collaboration with the National Institute of Allergy and Infectious Diseases, NICHD sponsored a number of studies of azidothymidine (AZT) and other antiretroviral drugs that led to the dramatic decline.
Dr. Collins thanked Dr. Alexander for his service to the NICHD and for taking the next step, of bringing his considerable expertise to the advancement of maternal and child health on a global scale.
Dr. Collins also announced to the NICHD Council that Susan Shurin, M.D., now Deputy Director of the National Heart, Lung, and Blood Institute, has agreed to serve as the NICHD Acting Director while a search for a new director is conducted. Dr. Shurin oversees the clinical research portfolio of the NHLBI. She has served as the chief of the Division of Hematology-Oncology at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, and was professor of pediatrics at Case Western Reserve University.
Originally Posted: September 23, 2009
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