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Alfred (Al) Sommer is a prominent American ophthalmologist and epidemiologist at the Johns Hopkins Bloomberg School of Public Health. His research on vitamin A in the 1970s and 1980s revealed that dosing even mildly vitamin A deficient children with an inexpensive, large dose vitamin A capsule twice a year reduces child mortality by as much as 34 percent.[1] The World Bank and, recently, the Copenhagen Consensus list vitamin A supplementation as one of the most cost-effective health interventions in the world.[2][3]

Contents  [hide] 1 Biography 1.1 Early Life + Primary & Secondary Education 1.2 Post-Secondary & Graduate Education 1.3 Introduction to Clinical Ophthalmology 1.4 CDC, Cholera Research Laboratory & Infectious Disease Research 1.5 Incorporation of Infectious Disease Research & Ophthalmology 1.6 Continued Education 1.7 Academic Career & Johns Hopkins Affiliations 1.8 Private Life 2 Research[edit source] 2.1 Initial Study & Thesis Formulation 2.2 Vitamin A Deficiency Research 2.3 Recognition 2.4 Current Research Interests 3 Sommer Scholars 4 References

Biography

Early Life + Primary & Secondary Education Born on October 2, 1942 in New York City, Alfred Sommer characterized himself as both an inquisitive and eager student who knew from about the age of 3 that he wanted to be a physician. Sommer attended public schools for both his primary and secondary education, and he described his public school experience as top-notch because of the very supportive and encouraging teachers he was exposed to. He also disclosed that despite his intellectual curiosity, he was somewhat of a troublemaker who often spent time in the principal's office. This ultimately changed thanks to his 6th-grade teacher (who he described as the most insightful teacher he'd ever had) who previously served as a woman in the Army Corps (WAC). She immediately noticed his tendency for causing trouble and decided to discourage this behavior by assigning him additional responsibilities. These responsibilities included serving as both the newspaper and visual monitor where he was forced to distribute New York Times newspapers and magazines in addition to lugging around heavy equipment and slides. [4][5]

Post-Secondary & Graduate Education Alfred Sommer went on to attend Union College in Schenectady, New York and graduated Summa Cum Laude in 1963. Sommer disclosed that to an extent, much of his early life was "without planning or forethought." He chose to go to Union College because his big brother in his high school fraternity spoke highly of the school and was very eager to go there. In addition, Sommer believed that a small, all-male, liberal arts school like Union College would be a good fit for him. At Union College, Sommer chose to pursue both his academic passions as a dual major in both biology and history. After showcasing his academic prowess in college, Sommer didn’t want to leave New York to pursue his M.D. and thus the only medical school outside of New York that he applied to was Harvard Medical School. Sommer actually ended up attending Harvard Medical School and obtained his M.D. in 1967. He later served as a medical intern and resident at Harvard University’s Beth Israel Deaconess Medical Center (formerly Beth Israel Hospital) from 1967 to 1969.[5]

Introduction to Clinical Ophthalmology When reflecting on his initial experiences in ophthalmology as a Harvard medical resident, Sommer revealed that his first impression of the field was very underwhelming. After completing a 1 month rotation in ophthalmology under the guidance of famous and acclaimed ophthalmologist David Cogan, Sommer believed that his exposure to clinical ophthalmology (so far) had seemed very boring. He even stated that he would poke fun at the other doctors who were pursuing or had decided to pursue ophthalmology. Following his disappointing introduction to ophthalmology, Sommer instead chose to pursue internal medicine in hopes of getting involved with infectious disease research.[4]

CDC, Cholera Research Laboratory & Infectious Disease Research Considering that Sommer's time as a Harvard medical resident was during the end of the Vietnam War era, Sommer made it a priority to plan ahead and secure a job that enabled him to avoid army service. Consequently, both he and his wife decided to join the Peace Corps to avoid being drafted into Vietnam. After talking to Dr. Thomas Weller, Sommer and his wife interviewed with the Peace Corps and were both eventually accepted. However, soon after being accepted, the Peace Corps notified Sommer that the draft law had been revised and unfortunately both he and his wife Jill were now eligible for service in the Vietnam War.[4] This caught Sommer by surprise and led to his last ditch effort to avoid army service. He soon came upon a series of approximately 100 draft fulfilling positions in public health (half at the NIH and half in the CDC and academic intelligence service). Sommer said he felt useless in the laboratory and thus passed over all the available NIH research positions. Instead, he saw the opportunity to pursue CDC work in Atlanta as a win-win because it provided him the opportunity to conduct personalized disease research at a leading national research institute (CDC headquarters) while also ensuring his ineligibility for the war. Sommer then traveled to Atlanta after securing work as part of a 2 year disease research assignment. However after going to Atlanta, Sommer met Dr. Henry Mosley, whom he was able to build a strong repertoire with. At the time, Dr. Mosley was linked to disease research at the Cholera Research Lab in what was then East Pakistan, and he had previously allowed students to accompany him on this project. Consequently, Sommer was made aware of an opening at this Cholera Research lab in present-day Dhaka and eventually assumed a role there as a medical epidemiologist from 1970 to 1972.[6] Sommer provided a glowing account of his time in Dhaka as part of the Cholera Research Laboratory. He described his experience as being truly transformational because he was able to develop and pursue multiple large-scale, fascinating field studies involving cholera and other infectious diseases. While working as part of the Cholera Research Laboratory in Dhaka, Bangladesh (known as East Pakistan at the time), Sommer and his research affiliates develop and conducted a study testing the effect of supplementing newborns with 50000 IU of vitamin A on all-cause infant mortality through 24 weeks of age. The trials themselves spanned across 19 rural unions in northwest, present-day Bangladesh and were double-masked, cluster-randomized, community-based, and placebo-controlled. The primary purpose of this study was to observe the corresponding childhood mortality rates through 24 weeks of age, and the results indicated that supplementation of 5000 IU of vitamin A to the newborns significantly improved the survival of infants through the first 6 months of life. 15,902 infants were actually dosed in the study (Sommer's group actually obtained maternal consent to dose 17,116 infants), and the mortality risk of infants that were dosed with vitamin A was .85 in comparison to the subjects who served as the control. This quantitative determination signified a 15% decrease in all-cause mortality of the infants in rural Bangladesh. However, his progressing research would come to halt when a devastating cyclone hit the area and wiped out a quarter million people in one night. In response to this catastrophe, the US government pledged to provide 12 field hospitals and 25 x-ray machines to aid in the relief efforts. Sommer and some American ambassadors were assigned to the disaster sites to oversee the relief efforts, conduct studies, and help maintain the field hospitals. Due to his involvement in the Dhaka relief efforts, Sommer became a part of one of the longest articles ever published in regards to disaster relief. This comprehensive and intricate article detailed specific statistics on factors including the number of people that had died or suffered significant injury, the extent of the infrastructural damage to the area, the material possessions and resources of the people that were lost, and the funding and support required for the successful rehabilitation of the people. This published work was part of the impetus that helped catalyze an entirely new field of study and research, known today as disaster epidemiology.[4] However, the relief efforts were soon cut short when the Bangladesh War of Independence broke out. This war sent the community around Dhaka and present-day Bangladesh further backward as it damaged the infrastructure and greatly increased the number of casualties. In response to the onset of this war, Sommer and his research team were evacuated but they would later return when Bangladesh was granted independence.[4]

Incorporation of Infectious Disease Research & Ophthalmology In a personal interview conducted with Alfred Sommer himself, Dr. Sommer provided significant insight into his transition from infectious disease research to ophthalmology, citing his illuminating experience in India as a major turning point. Sommer stated that at the time, “There were ten million refugees in India and small pox had broken out in the refugee camps. Now you have ten million people, some carrying small pox and spreading it while migrating across the country to get to their home villages. So the World Health Organization decided to start an emergency small pox control program, and three additional people were sent to India and I was one of them. Even though I could not travel officially as a US government official, I was able to travel as a UN official. I knew nothing about small pox but I was sent there because I knew the countryside. One of the colleagues that I went with had spent seven years working on small pox in Nigeria so he knew everything about small pox and I knew about the country. I worked there for about three months and the whole thing just taught me how important and fantastic public health was. I began ophthalmology despite previously making fun of all my friends who did ophthalmology largely because I felt that the only time people called those in infectious disease was when patients were already in the intensive care unit or an infection of unknown cause had shown up. You always recommended the same thing to these patients which did not sound very exciting to me. I had a position at Wilmer to come back to after my work with the CDC. Because I was still interested in epidemiology while doing my ophthalmology training, I always asked more questions about clinical diseases than anybody else in my residency group.[4]

Continued Education In 1973, Sommer returned to the United States and continued his education at the Johns Hopkins School of Hygiene and Public Health where he completed his fellowship in epidemiology and obtained his Masters of Health Sciences Degree. Upon completing his Masters in Health Sciences at what is now referred to as the Bloomberg School of Public Health, Sommer spent time as a resident and fellow in ophthalmology at the Wilmer Eye Institute (associated with the Johns Hopkins School of Medicine) from 1973 to 1976. Having been founded in 1925, the internationally-renowned Wilmer Eye Clinic was associated with the Johns Hopkins Hospital and was the nation’s first university eye clinic.[5][6] During Sommer’s time at the Wilmer Eye Institute, Hellen Kellen International launched their long-term goal of providing educational resources to blind people. Therefore, before Sommer became an actual resident at the Wilmer Eye Institute they had expanded their research and project goals to include blindness prevention. Soon after, a woman introduced Sommer to the chairmen of the Wilmer Eye Institute who knew Sommer had done significant research and studies overseas. As a resident at Wilmer, Sommer often consulted with the chairman on how to go about developing and analyzing blindness prevention studies. A shared belief between Sommer and multiple ophthalmologists at the Institute was that Vitamin A deficiency was somehow involved with blindness, particularly childhood blindness. Thus, Sommer proceeded to construct and carry out studies examining the link between Vitamin A deficiency and childhood blindness. The data he obtained from this trials suggested that cases of childhood blindness were certainly more frequent in Vitamin A-deficient populations, but the real challenge Sommer faced involved developing an effective approach to combat this issue. Motivated to provide a solution to this newfound problem, Sommer created a list he described as being “all the questions you ever want to answer to prevent children from going blind because of vitamin A deficiency”, which received funding after being revealed to the public.[4]

Academic Career & Johns Hopkins Affiliations Following his time at the Wilmer Eye Institute, Sommer became the founding director of the Dana Center for Preventative Ophthalmology in 1980 and held this position until 1990 when he was promoted to dean of the Johns Hopkins Bloomberg School of Public Health. While serving as the Dean of the Bloomberg School of Public Health, Sommer successfully expanded both the faculty and student bodies and dedicated hundreds of millions of dollars (approximately 130 million dollars) to improving the school’s emphasis on research and developing world class research facilities.[7] Sommer’s visionary efforts helped the school attain the #1 spot on the U.S. News & World Report Graduate Schools of Public Health ranking, a prestigious title it still holds to this day.[8] Sommer served as dean of the Johns Hopkins Bloomberg School of Public Health until 2005,[9] when he returned to work as a professor and researcher of both epidemiology and ophthalmology. Sommers is currently working as an Epidemiology and International Health Professor at the Johns Hopkins Bloomberg School of Public Health in addition to being an Ophthalmology Professor at the Wilmer Eye Institute. Sommer also currently serves as Dean Emeritus of the Bloomberg School of Public Health.[9]

Private Life Alfred Sommer is married to Jill Sommer and together they have one son, Charles Andrew Sommer, and one daughter, Marni Jane Sommer. Sommer is also the oldest of three boys in his family, and has a brother who is 5 years younger and another brother who is 12 years younger.[4][9] Research[edit source]

Initial Study & Thesis Formulation During his fellowship at the Wilmer Eye Clinic, Sommer was introduced to the new president of the Hellen Keller Institute which had recently expanded its goal from providing educational resources to blind people to also including blindness prevention. The Institute suspected that Vitamin A deficiency was a cause of the blindness and therefore talked with Sommer about carrying out studies to prove or disapprove this claim. Soon after he found out that Indonesia would be interested in him coming to carry out the studies and was soon appointed as a Visiting Professor of Ophthalmology at the University of Padjadjaran, which is the provincial capital of West Java, Indonesia. He would then soon become the Director of The Nutritional Blindness Prevention Research Program in Bandung, and it was here that Sommer began his groundbreaking research on Vitamin A’s ability to combat blindness and disease. Alfred Sommer conducted a sequence of intricate intervention trials in Indonesia to investigate the potential link between Vitamin A deficiency and heightened child mortality rates. Sommer’s trials involved the manipulation of multiple risk factors and this led to his discovery that Vitamin A reduces resistance to multiple harmful infectious diseases including diarrhea and measles, Although these diseases aren’t considered particularly deadly in developed communities where access to advanced medical care is readily available, they can have a profound impact on both life expectancy and mortality rates in third world countries and other underprivileged communities of lower socioeconomic status. Thus, this discovery by Sommer validated his initial hypothesis which asserted the benefits of Vitamin A supplementation in limiting childhood mortality rates in third world countries.[5][6]

Vitamin A Deficiency Research At first many people in the scientific community did not believe that child mortality could be reduced by administering a two cents worth of Vitamin A every year. In order to show more evidence Sommer did more studies which all garnered the same results. By 1992, there had had been 6 well done studies from around the world, two each from Nepal, India, and Indonesia which furthered supported the claim. Following these studies there was a conference held in Bellagio, Italy where a group of scientist some coming from around the world came together and after a couple of days of discussion agreed that the administration of Vitamin A capsules to Vitamin A deficient children leads to the decrease in blindness and mortality. After this conference the scientist went to their respective homes and published the conclusions of the conference to their respective medical journals and it was after this that Alfred Sommer first garnered praise and attention for his pioneering research of the use of large and inexpensive Vitamin A capsules in an attempt to reduce the child mortality rates of Vitamin A-deficient children. The Vitamin A capsule that was the focus of Sommer’s research only needed to be administered twice a year and was proven to reduce the child mortality rate of these Vitamin A deficient children by as much as 34 percent. He also conducted studies in which he supplemented Nepalese women of childbearing age with Vitamin A/beta-carotene and observed a 45% reduction in the maternal mortality rate. Sommer furthered this study by experimenting with vitamin A supplementation in newborns, and eventually discovered that this treatment can reduce neonatal mortality by 20%. This research was especially meaningful for impoverished areas in the U.S. and worldwide that lack access to basic needs or adequate foundational resources such as clean water, staple foods, nearby medical care. He decreased child mortality rates in areas where child mortality seemed inevitable. [5][6]

Sommer’s extensive work regarding large, inexpensive doses of Vitamin A and its potential to prevent childhood, infantile, neonatal, and maternal deaths has resulted in significant strides in global health and a measurable reduction in mortality rates relating to Vitamin A-deficient patients. Many renowned scholars in both the fields of medicine and public health deemed Sommer’s research as being especially meaningful for third world countries and impoverished areas in the U.S. that lack access to basic needs such as clean water, staple foods, nearby medical care.[5][6]

Nepal Birthweight Studies Following the completion of his trademark research on Vitamin A-deficiency and its supposed link to reducing child mortality rates, Dr. Sommer traveled to southeastern Nepal to further his research by conducting micronutrient supplementation studies. Southeastern Nepal was primarily chosen because the population was largely malnourished and lacked access to both adequate medical care and nutrient-dense foods. The experiment that was conducted involved randomized double blind cluster controlled trials and was developed in order to examine the resulting infant birth weights when various combinations of micronutrients were administered to a selected group of pregnant women. In total, 4,130 infants and 4,926 pregnant women participated in this research study. The selected population of pregnant women was then randomly assigned to one of five treatment groups. Each of the five treatment groups was treated with a particular set of micronutrients: folic acid, folic acid-iron, folic acid-iron-zinc, several micronutrients administered in combination with vitamin A, or just vitamin A (served as the control). The outcomes of this study were determined by measuring birthweight, birth length, and head and chest circumference. A low birthweight baby was defined as any infant weighed less than 2500 grams. The results indicated that in comparison to the control of just vitamin A supplementation, just folic acid and folic acid-iron-zinc supplements did nothing to increase birthweights when administered to pregnant women. However, folic acid-iron supplements managed to both decrease the frequency of low birthweight babies by 9% (from 43% to 34%) and increase the average birthweight by 37 grams. Moreover when several micronutrients were administered in combination with vitamin A, the frequency of low birthweight babies decreased by 14% and the average newborn birthweight increased by 64 grams. Although both the folic acid-iron supplements and the multiple micronutrients combination managed to decrease the frequency of low birthweight babies and increase mean birthweight, Sommer and his fellow research partners noted that these treatments only increased birthweight, and head and chest circumference, not birth length.[10]

Recognition Due to his groundbreaking research, Alfred Sommer has received multiple awards including the Albert Lasker Award for Clinical Medical Research in 1997,[11] the Danone International Prize for Nutrition in 2001,[12] and the Helen Keller Prize for Vision Research[13] among other honors.[9] He was also awarded the Lucien Howe Medal by the American Ophthalmological Society and the Warren Alpert Research Prize by Harvard Medical School in 2003, in addition to the Helen Keller Prize for Vision Research in 2005 for his studies on blindness prevention. Also the 2005 PBS documentary Rx for Survival featured Sommer as a "global health champion.".[14]

Recent/Current Projects The single most intensive initiative that Alfred Sommer is currently pursuing is a proposal he started at the request of Steve Hilton six years ago. Sommer cites that a major reason for blindness in the world is unoperated cataracts that plague those who lack access to proper medical care and/or adequate nutrition in regards to their diet. He also details that this proposed pilot project intends (currently funded by Hilton and his peers) to create indigenous self-sustaining eye centers that would profit off treating both the middle and upper classes and use these profits to subsidize treatments for the poor. In addition, this project also hopes to mount outreach programs to reach people in rural villages. Dr. Sommer recently spent two to three years organizing meetings and discussing pressing issues in regards to blindness in underprivileged countries, and eventually developed a foundational plan to develop this project. Sommer found five groups who wanted to do the right thing and provide high quality care to these extremely needy people for little to no profit. This is very significant progress because without any external resources these poor individuals are helpless in their efforts to lead normal lives and eventually become permanently blind. Sommer adds that the project has just completed three years of actual implementation. He proclaims that an eye center in India pioneered this model that he put in place. Sommer also stated that he just came back from southern India 5 days ago and that Hilton has given three more years of support for this project. (This interview was conducted right after Dr. Sommer ked a CME lecture (Continuing Medical Education) at Georgetown University).

Current Research Interests Sommer’s recent research interests include the diagnosis and management of both cataracts and glaucoma, improved child survival and blindness prevention strategies, and micronutrient interventions to vision impairment, in addition to other projects in both epidemiology and ophthalmology.[9]

Departmental Affiliations Alfred Sommer is currently a professor of Epidemiology under the division of General Epidemiology and Methodology at the Johns Hopkins Bloomberg School of Public Health (primary responsibility). In addition, Sommer is part of a join affiliation between the Bloomberg School of Public Health and the Johns Hopkins School of Medicine as both a professor of International Health in the division of Global Disease Epidemiology and Control and as a professor of ophthalmology. Sommer is affiliated with the Center for Global Health and is a Distinguished Service Professor at Johns Hopkins University.

Sommer Scholars In 2004, the Johns Hopkins Bloomberg School of Public Health established a $22 million scholarship program in honor of Dr. Sommer called the Sommer Scholars. The programs aims to "recruit the next generation of public health leaders to devise new, effective interventions to improve global health."[15]

References Jump up ^ Sommer A, Tarwotjo I, Djunaedi E, West KP Jr, Loeden AA, Tilden R, Mele L. Impact of vitamin A supplementation on childhood mortality. A randomised controlled community trial. Lancet 1986; 24: 1169-1173 Jump up ^ World Development Report 1993. World Bank, 1993. Jump up ^ Copenhagen Consensus 2008. http://www.copenhagenconsensus.com/Default.aspx?ID=953 Accessed on 2009-03-19. ^ Jump up to: a b c d e f g h Personal Interview with Dr. Sommer on 5/1/17 (granted permission to use information and quotes from our conversation) ^ Jump up to: a b c d e f Day, Harry (1980–1990). "Sommer, Alfred - c.1980-1990". The Alan Mason Chesney Medical Archives. Archived from the original on 1990. Retrieved 2017-04-28. ^ Jump up to: a b c d e McCollum, Elmer (1980–1990). "Sommer, Alfred - c.1980-1990". The Alan Mason Chesney Medical Archives. Archived from the original on 1990. Retrieved 2017-04-29. Jump up ^ Shea, Dennis (May 16, 2005). "Klag Named Dean of Bloomberg School of Public Health". Headlines@Hopkins. JHU Press Releases. Retrieved 10 October 2016. Jump up ^ "Best Public Health Programs | Top Public Health Schools | US News Best Graduate Schools". grad-schools.usnews.rankingsandreviews.com. Retrieved 2016-10-10. ^ Jump up to: a b c d e Alfred Sommer Biography, Johns Hopkins Bloomberg School of Public Health. http://faculty.jhsph.edu/?F=Alfred&L=Sommer Jump up ^ Ach, Brian (September 19, 2013). "Arrivals at the Lasker Awards". Retrieved May 3, 2017. Jump up ^ Albert Lasker Clinical Medical Research Award. http://www.laskerfoundation.org/awards/1997clinical.htm Accessed on 2009-03-19 Jump up ^ Danone Institute Prize for Nutrition. http://www.danoneinstitute.org/danone_institute_prize_for_nutrition/awardees/index.php Accessed on 2009-03-19 Jump up ^ Alfred Sommer - Helen Keller Foundation (with video) Jump up ^ Rx for Survival: Global Health Champions. http://www.pbs.org/wgbh/rxforsurvival/series/champions/alfred_sommer.html Accessed on 2009-03-19. Jump up ^ New Scholarship to Recruit Public Health Leaders of The Future. http://www.jhsph.edu/publichealthnews/press_releases/PR_2004/Sommer_Scholars.html

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