John Gorman, an Australian doctor, is finally receiving recognition for his pivotal role in eradicating Rh disease, a condition that caused tens of thousands of infant deaths. His work in the 1960s led to the development of anti-D immunoglobulin (RhoGAM), a treatment that prevents Rh sensitization in Rh-negative mothers. This breakthrough has been hailed as one of the great advances in modern medicine, transforming a devastating condition into a preventable one.
The Science Behind the Breakthrough
Rh disease, or hemolytic disease of the fetus and newborn (HDFN), occurs when an Rh-negative mother carries an Rh-positive fetus. The mother's immune system can recognize the fetal Rh-positive red blood cells as foreign and produce antibodies against them. These antibodies can cross the placenta and attack the red blood cells of subsequent Rh-positive fetuses, leading to anemia, jaundice, brain damage, or even death.
Gorman, along with his colleague Freda, discovered that injecting Rh-negative mothers with anti-D antibodies after the birth of an Rh-positive baby could prevent the mother from developing her own antibodies. This passive immunization effectively eliminates the risk of Rh disease in future pregnancies. The initial trials involved injecting Rh-positive blood into volunteers at Sing Sing prison to trigger the antibody, followed by administering anti-D serum (RhoGAM) to half the group. The results were remarkable: 100% protection was observed in those who received RhoGAM.
Overcoming Obstacles and Ethical Considerations
Translating the findings from male volunteers to pregnant women required courage and careful consideration. Gorman's sister-in-law, Kath Gorman, became the first test case. She was Rh-negative, pregnant, and her husband was Rh-positive. Transporting the experimental serum from New York to England, where Kath was residing, involved navigating legal and logistical challenges. Kath received the injection shortly after the birth of her first child, and later gave birth to Angus, the world's first baby protected from Rh disease through this method.
Global Impact and Current Challenges
Australia was the first country to implement a nationwide anti-D program, providing free treatment to all Rh-negative pregnant women. This initiative dramatically reduced the incidence of Rh disease in the country. However, the problem persists in the developing world, where access to anti-D immunoglobulin is limited. It is estimated that Rh disease is responsible for 160,000 fetal and neonatal deaths and 100,000 cases of lifelong disability each year.
Gorman is now dedicated to addressing this global disparity through the World Initiative for Rh disease Eradication (WIRhE). He is also working on a new invention called Prometheus, aimed at generating revenue to fund WIRhE's programs. This involves a portfolio of global patents for new blood analyzers, with royalties directed towards eradicating Rh disease worldwide.
Former Australian Prime Minister Kevin Rudd has pledged to support Gorman and WIRhE in their efforts to expand access to anti-D treatment in developing countries, engaging with the World Health Organization and other international agencies.
