H15 A treatment for leprosy developed on the edge of Europe: Vincent Barry (1908–1975)

Abstract

Abstract Leprosy is the prototype of a biblical disease. Without an effective cure, it was deemed a ‘curse’ for millennia. It is an infection caused by Mycobacterium leprae and Mycobacterium lepromatosis. With an affinity for peripheral skin (due to lower temperatures), a rash is a common presenting feature. A tropism to infiltrate neural tissue causes a reduction in sensation leading to repeated injury, infection and disfigurement. Affected individuals were often shunned from society and sent to leper colonies. Treatment for leprosy only became effective in the mid-20th century. Initial treatment for leprosy was with promin and dapsone. Clofazimine and rifampicin were later added in the 1960s–70s. Treatment for leprosy consists of a multidrug therapy regime of rifampicin, dapsone and clofazimine for 6–12 months. This was first recommended by the World Health Organization (WHO) in 1981 and remains the recommended treatment. Clofazimine was developed in a laboratory in Trinity College Dublin by Vincent Barry and his scientific team. Vincent Barry was born in Cork, Ireland, and later graduated in chemistry from University College Dublin. He became associate professor of chemistry in Galway where he lectured bilingually in Irish and English and co-authored the first Irish-language textbook for chemistry (Ceimic). Barry spent time working in and observing leper colonies in both Zimbabwe and India. In 1943, he was given a fellowship by the Medical Research Council of Ireland to carry out research on the chemotherapy of tuberculosis (TB). However, as TB became more curable, he focused his attention on leprosy. His team were given laboratory space in Trinity College Dublin, and in 1957, they developed compound B663, clofazimine. Intended as an anti-TB medication, clofazimine showed more effectiveness against leprosy. The product was launched in 1969 after several clinical trials in Nigeria. In 1974, they devoted the patents of the drug to India to allow it to be produced in a more cost-effective manner. The team was not interested in fame or fortune; their goal was simply to make the drug available in the developing world. They received the Boyle Award from the Royal Dublin Society in 1969, and the UNESCO Science prize in 1980 ‘for their work on the synthesis of an anti-leprosy agent, B-633’. The achievements of Mr Barry and his team, seldom discussed, have led to millions of lives being saved. Clofazimine is part of the WHO Model list of Essential Medicines.