With the passing of James Gear, just nine months short of his ninetieth birthday, South Africa lost one of its greatest doctors and a pioneer in the prevention and control of infectious diseases.
James Henderson Sutherland Gear was born in Germiston and matriculated at St John’s College, Johannesburg. He graduated in medicine at the University of the Witwatersrand in 1929, having first received a BSc degree in 1926. From 1932 to 1935 he acquired the diploma in public health from Witwatersrand and the diploma in tropical medicine and hygiene and the diploma in bacteriology from the University of London. Between 1940 and 1945 he saw active service in the South African Medical Corps, eventually becoming the officer commanding the Medical Laboratory Service. During these war years he was responsible, among others, for the development of yellow fever and typhus vaccines which were used extensively in North Africa and the Russian front and undoubtedly saved many hundreds, if not thousands, of lives.
In the late 1940s Gear made three monumental discoveries, for only one of which was he really given the credit he so rightly deserved. While studying US servicemen receiving yellow fever vaccine he demonstrated the presence of an antigen in those individuals who developed jaundice, which was probably the Australia antigen discovered some two decades later. Also, in some remarkable studies many years ahead of his time, he demonstrated the pathological effects on the body of its own immune system - the so-called auto-allergic and hyper-reactive immune deficiency diseases which were to be rediscovered many years later as the auto-immune diseases. Both of these discoveries were presented at conferences whose proceedings received little publicity and Gear’s contributions were largely forgotten. However, in 1948, Gear achieved world renown as the discoverer of Coxsackie B virus as the aetiology of infantile myocarditis and later went on to become an international authority in the field of Coxsackie viruses. It was, however, in connection with studies of a related virus that the name of Gear received its greatest international recognition, namely poliomyelitis. Towards the end of the 1940s Gear campaigned for the establishment of a research institute to develop a poliomyelitis vaccine and in 1953 the laboratories were opened with himself as the first director. He worked closely with Jonas Salk and Albert Sabin. On 19th September 1955 thousands of children in South Africa were immunized with inactivated polio vaccine, a mere three months after the announcement of the discovery of the vaccine by Salk in the USA, making South Africa one of the first countries in the world to plan and institute routine polio immunization. In 1960 South Africa pioneered the use of oral polio vaccine for nationwide routine immunization.
Gear made many other contributions, especially in the field of the enteroviruses, viral haemorrhagic fevers and the arboviruses. In addition to virology, he was an international giant in the world of tropical medicine. His vast contributions included seminal studies and discoveries in bilharzia, malaria, trypanosomiasis, onyalai, relapsing fever, rickettsial and chlamydial diseases, sporotrichosis and other fungal infections, and many others. His over 200 publications represent a vast storehouse of medical discovery and knowledge which has contributed immensely to the control of communicable diseases. His expertise was acknowledged by the World Health Organization where he served on four expert committees (on viral diseases, polio, yellow fever and biological standardization) as well as four study groups (on rickettsial diseases, immunology, trachoma and bilharzia).
He received some of the most prestigious international honours in tropical medicine, including the Chalmers and later the Manson medals of the Royal Society of Tropical Medicine and Hygiene, and the Bruce memorial medal of the American College of Physicians. He served as visiting professor of tropical health at the Harvard School of Public Health and visiting professor of tropical medicine at the University of Maryland and was one of some 200 foreign associates of the National Academy of Sciences of the USA. In South Africa he received numerous honours, including honorary MD degrees from the Universities of Witwatersrand, Natal and Orange Free State, the gold medal of the Medical Research Council and the Salus (gold) medal of the Department of Health.
James Gear undoubtedly made an immense contribution to the welfare of mankind on a global level. However, beneath all this he was a man of humility, with intense compassion for his fellow human beings. Up until his last illness he was involved in seeing patients, providing an invaluable consultative service to both public and private healthcare professionals and actively working at the National Institute for Virology, the South African Institute for Medical Research and the Rietfontein Tropical Diseases Hospital in Johannesburg.
B D Schoub