Stop TB Partnership

Obituary - Professor Denny Mitchison

It is with great sadness that I report the death of Professor Denis Anthony Mitchison CMG with whom I had the privilege of working for several decades.

Denis Anthony Mitchison was born in Oxford on 6 September 1919 in a family of scientific and scholarly distinction: he was the son of the Labour politician Dick Mitchison and his wife, the writer Naomi (née Haldane). His uncle was the biologist J.B.S. Haldane and his grandfather the physiologist John Scott Haldane.

Educated at the Dragon School, Oxford and Abbotsholme School, he went on to Trinity College, Cambridge where he studied Natural Sciences, obtaining a 1st class degree and a senior scholarship. He then changed to Medicine, qualifying from University College in 1943.

Throughout his academic life, Professor Mitchison has played a major role in the treatment of tuberculosis (TB) starting with the first randomised clinical trial which compared streptomycin with bed rest alone for the treatment of tuberculosis (1946). His subsequent collaborative work then showed that domiciliary treatment of tuberculosis was as effective as treatment in hospital. This led to the ambulatory treatment of patients and closure of sanatoria, a great economic benefit to the health services. His most important contribution was, with other colleagues, of identifying combinations of different drugs which led to the reduction of treatment duration for tuberculosis from 18 months to 6 months. These short-course regimens are the basis of current standard therapy worldwide.

He continued his life-long interest in the treatment of TB with a pivotal role in the clinical trials organised by the Medical Research Council's Tuberculosis Research Unit. Following the identification of the decisive importance of drug-resistant tubercle bacilli in treatment, he was appointed in 1964 as Director of a new MRC Unit on Drug Resistance in Tuberculosis at the Royal Postgraduate Medical School. He then worked on developing effective treatment for tuberculosis at a cost sufficiently low to be affordable in developing countries. The framework of this work was a series of clinical trials in the UK and in larger numbers in East Africa, India, Hong Kong, Singapore and Czechoslovakia. He established specialist TB laboratories in Kenya, Uganda, Tanzania and Zambia and in Hong Kong.

After his retirement in 1985, he continued working first at the Royal Postgraduate Medical School, Hammersmith and then at St George's, University of London. With colleagues in South Africa, he developed the technique of measuring the early bactericidal activity of drugs, which is now standard practice as the initial step in the Phase II of clinical development of new drugs. At the time of definitive retirement in 1995, he was engaged in work that may eventually lead to treatment reduction to 4, or even, 3 months.

He authored more than 300 scientific papers and received many awards including the British Thoracic Society Medal, the Stop TB Partnership Kochon Prize and the Union Medal. In 1984 he was made a Companions of the Order of St Michael and St George.

The advances in the treatment of tuberculosis has been through a collaborative effort involving many scientists and collaborative work. Starting from the first trial on streptomycin, Professor Miichison’s contribution stands out in identifying, through laboratory experiments, the steps that have led to successful trials in humans leading to the establishment of ambulatory treatment and, eventually to a reduction in treatment duration from 18 months to 6 months.

Through his work in tuberculosis, Professor Mitchison’s main contribution has been on humanity at large. His work has saved more lives than any other person who is alive today. His ideas, drive and organisational abilities for 65 years, led the clinical trials which resulted in successful tuberculosis therapy. A conservative estimate would be that he has saved 300,000 lives per year, or more than 10 million lives over 65 years. Some might even say that he has made a major impact in the global effort to eradicate tuberculosis which has saved more than 100 million lives over 65 years

He died on 2nd July, 2018 aged 98 of a heart attack. He is survived by two children, four grandchildren and two great grandchildren.

He will be greatly missed not only by his family but also the academic world and those of us still struggling to eradicate a curable disease which still kills 5,000 people daily.

Amina Jindani, MD, FRCP.

Honorary Senior Lecturer

Institute for Infection & Immunity

Division of Clinical Sciences

St. George's, University of London