Richard Alan Cash (June 9, 1941 – October 22, 2024) was an American

global health Global health is the health of populations in a worldwide context; it has been defined as "the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problems th ...

researcher, public health physician, and internist. He was a pioneer of

oral rehydration therapy Oral rehydration therapy (ORT) also officially known as Oral Rehydration Solution is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salt ...

for lethal diseases such as

cholera Cholera () is an infection of the small intestine by some Strain (biology), strains of the Bacteria, bacterium ''Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea last ...

. This simple, practical therapy is estimated to have saved over 50 million lives since.

Medical career

Cash was an alumnus of the

University of Wisconsin–Madison The University of Wisconsin–Madison (University of Wisconsin, Wisconsin, UW, UW–Madison, or simply Madison) is a public land-grant research university in Madison, Wisconsin, United States. It was founded in 1848 when Wisconsin achieved st ...

(B.S., 1963),

New York University School of Medicine The New York University Grossman School of Medicine is a medical school of New York University, a private research university in New York City. It was founded in 1841 and is one of two medical schools of the university, the other being the NYU G ...

(M.D., 1966), and

Johns Hopkins School of Hygiene and Public Health The Johns Hopkins Bloomberg School of Public Health is the public health graduate school of Johns Hopkins University, a private research university primarily based in Baltimore, Maryland. It was founded as the Johns Hopkins School of Hygiene a ...

(MPH, 1973). Cash began his international career over 40 years ago when he was assigned by NIAID of the

NIH The National Institutes of Health (NIH) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in 1887 and is part of the United States Department of Health and Human Service ...

to the Pakistan-SEATO Cholera Research Laboratory (CRL) in

Dhaka Dhaka ( or ; , ), List of renamed places in Bangladesh, formerly known as Dacca, is the capital city, capital and list of cities and towns in Bangladesh, largest city of Bangladesh. It is one of the list of largest cities, largest and list o ...

, East Pakistan (now th
ICDDR,B
in Dhaka, Bangladesh). While there, he and his colleagues developed and conducted the first clinical trials of

(ORT) in adult and pediatric cholera patients and patients with other infectious causes of diarrhea. This technology matches the volume of fluid losses from dehydration patients with the volume they consume so that the fluid replacement packets greatly reduce or completely replace IV therapy (particularly where it is not feasible or unavailable), which was then the only current treatment for cholera. Discoveries in ORT have been estimated to have saved over 50 million lives worldwide.

World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...

(WHO) estimates are that at least 60 million children have been spared painful deaths because of ORT. They also conducted the first field trials of ORT, the first community-based trials of ORT, and the first use of

amino acids Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although over 500 amino acids exist in nature, by far the most important are the Proteinogenic amino acid, 22 α-amino acids incorporated into p ...

(

glycine Glycine (symbol Gly or G; ) is an amino acid that has a single hydrogen atom as its side chain. It is the simplest stable amino acid. Glycine is one of the proteinogenic amino acids. It is encoded by all the codons starting with GG (G ...

) as an additional substrate. In the late 1970s, Cash worked with BRAC (presently the world's largest NGO in terms of programs and personnel) on their OTEP
Oral Therapy Extension Programme)
which taught over 13 million mothers and caregivers how to prepare and use ORT in the home using the "pinch and scoop" method. It is estimated by WHO researchers that, each year, around 500 million packs of the oral rehydration solution are used in more than 60 developing countries, saving over 60 million lives around the world. For demonstrating how inexpensive and simple-to-use oral rehydration therapy (ORT) could treat cholera and other diarrheal diseases, then by promoting in the developing world customized applications of oral rehydration therapy (ORT) developed by Cash and David R. Nalin (at Merck in Vaccine Development from 1983 to 2002), Cash,

David Nalin David R. Nalin (born April 21, 1941) is an American physiologist, and Pollin Prize for Pediatric Research and Prince Mahidol Award, a.k.a. Mahidol Medal winner. Nalin had the key insight that oral rehydration therapy (ORT) would work if the v ...

, and

Dilip Mahalanabis Dilip Mahalanabis (12 November 1934 – 16 October 2022) was an Indian paediatrician known for pioneering the use of oral rehydration therapy to treat diarrhoeal diseases. Mahalanabis had begun researching oral rehydration therapy in 1966 as a ...

became joint recipients of th
2006 Prince Mahidol Award
in public health for "exemplary contributions in the field of public health" and for their contributions "to the application of the oral rehydration solution in the treatment of severe diarrhea worldwide, including Thailand. On November 8, 2011, Cash was presented with the 2011 James F. and Sarah T. Fries Foundation Prize for Improving Health at the

Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the National public health institutes, national public health agency of the United States. It is a Federal agencies of the United States, United States federal agency under the United S ...

for his leadership in the development and dissemination of

Oral Rehydration Therapy Oral rehydration therapy (ORT) also officially known as Oral Rehydration Solution is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salt ...

as a practical treatment for

and other

diarrheal diseases Diarrhea (American English), also spelled diarrhoea or diarrhœa (British English), is the condition of having at least three loose, liquid, or watery bowel movements in a day. It often lasts for a few days and can result in dehydration due ...

that has saved the lives of at least 60 million children worldwide. He was a Senior Lecturer in International Health at the

Harvard T.H. Chan School of Public Health The Harvard T.H. Chan School of Public Health is the public health school at Harvard University, located in the Longwood Medical Area of Boston, Massachusetts. It was named after Hong Kong entrepreneur Chan Tseng-hsi in 2014 following a US$350 ...

in Boston.

Contributions to ethics

Cash lectured internationally and authored or co-authored a number of published papers on research ethics. He also taught a Harvard course and had long directed (until 2009) a summer intensive workshop on those issues. He won continued NIH funding for a series o
courses on research ethics in medical and health research done in resource-poor nations
that touch on over a dozen issues listed o
the public course's website
The use of case method teaching has been a critical element of all his courses. Many of the currently-used ethics case studies, the course outlines, many readings, and other course material
are available on that site
After the breakup of the

Soviet Union The Union of Soviet Socialist Republics. (USSR), commonly known as the Soviet Union, was a List of former transcontinental countries#Since 1700, transcontinental country that spanned much of Eurasia from 1922 until Dissolution of the Soviet ...

, Cash served (beginning in 2003) with the

Russian Academy of Sciences The Russian Academy of Sciences (RAS; ''Rossíyskaya akadémiya naúk'') consists of the national academy of Russia; a network of scientific research institutes from across the Russian Federation; and additional scientific and social units such ...

project on development of bioethics capacity in the

Commonwealth of Independent States The Commonwealth of Independent States (CIS) is a regional organization, regional intergovernmental organization in Eurasia. It was formed following the dissolution of the Soviet Union, dissolution of the Soviet Union in 1991. It covers an ar ...

Contributions to public health

Cash explored contrasts within and between nations in health research ethics as a PI (Principal Investigator) of a training grant from the National Institutes of Health on "Ethical Issues in International Health Research" at HSPH. For eleven years, as Director of th
Program on Ethical Issues in International Health Research
and in line with his deep commitment to capacity building in growing nations, he has conducted training workshops based on this research in a
HSPH
and in 18 nations in South America, Africa, India, and the Middle East, covering issues of informed consent, confidentiality, conflict of interest, investigator responsibilities to study populations, research in resource poor environments, and the development of ethical review committees. He has also overseen the training of 20 Fellows from Asia, and he has conducted over 30 workshops on research ethics in 12 nations.

Later public appearances

Richard Cash had been interviewed intermittently (often in remote meetings) to comment on the legacy of work he had done in the

Middle East The Middle East (term originally coined in English language) is a geopolitical region encompassing the Arabian Peninsula, the Levant, Turkey, Egypt, Iran, and Iraq. The term came into widespread usage by the United Kingdom and western Eur ...

India India, officially the Republic of India, is a country in South Asia. It is the List of countries and dependencies by area, seventh-largest country by area; the List of countries by population (United Nations), most populous country since ...

, and

Himalayas The Himalayas, or Himalaya ( ), is a mountain range in Asia, separating the plains of the Indian subcontinent from the Tibetan Plateau. The range has some of the Earth's highest peaks, including the highest, Mount Everest. More than list of h ...

Death

Cash died in Cambridge, Massachusetts on October 22, 2024 from brain cancer at the age of 83.

Accolades

* 1994 − Special Citation − 25th Anniversary of the development of Oral Rehydration Therapy (ORT) ICDDRB/Government of Bangladesh * 2006 �
2006 Prince Mahidol Award, received in January 2007 in Bangkok
* 2007 − Solomon A. Berson Medical Alumni Achievement Award, New York University School of Medicine * 2008 − Distinguished Alumni Award, New York University * 2011 − 2011 Fries Prize for Improving Health * 2018 − '50 Years of ORT: Cashing in on the Poor Man's Gatorade' − Symposium celebrating the development of ORT and the contributions of Richard Cash and

, November 19, 2018, sponsored by the Department of Global Health and Population, Harvard Global Health Institute, and

, Boston, MA. * 2025 − The Richard Cash Memorial Fund was announced on March 7, 2025, by the Department of Global Health and Population, his academic department at the Harvard T.H. Chan School of Public Health.HSPH donation page for the Richard Cash Memorial Fund
/ref>

Books and publications

Cash published over 120 peer-reviewed academic papers, spanning his work over 50 years. Some highlights include: * Oral maintenance therapy for cholera in adults. Nalin DR, Cash RA, Islam R, Molla M, Phillips RA. Lancet. 1968 Aug 17;2(7564):370-3. :This paper in

The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal, founded in England in 1823. It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication. The journal publishes ...

is the original report of Dr. Nalin and colleagues’ work with ORT. * Oral or nasogastric maintenance therapy in pediatric cholera patients. Nalin DR, Cash RA. J Pediatr. 1971 Feb;78(2):355-8. :This paper describes the use of ORT in pediatric patients. * Cash, R., Wikler, D., Saxena, A., Capron, A. <
Casebook on Ethical Issues in International Health Research
/u>, Geneva:

, 2009, 2010. :Translated into three other languages, includin
ArabicRussian
an
Spanish
; (NLM classification: W 20.5).

References

External links

"Cholera: A Not-So-Simple Solution"

HSPH Faculty Profile

Ethical Issues in Global Health Research summer intensive course at HSPH

Link to ScienceHeroes.com

Link to Cash’s biography as recipient of the Prince Mahidol Award

Against the Odds – Making a difference in global health – A Simple Solution

Woodward, Billy. "David Nalin-Over 50 Million Lives Saved." Scientists Greater Than Einstein. Fresno: Quill Driver Books, 2009

Harvard Catalyst Profile page for Richard Alan Cash, MD

10 Questions with Richard Cash − interview with Harvard Chan School basic degree candidates

Harvard edX Profile page for Richard Alan Cash, MD
{{DEFAULTSORT:Cash, Richard A. 1941 births 2024 deaths American public health doctors American ethicists Johns Hopkins Bloomberg School of Public Health alumni New York University Grossman School of Medicine alumni University of Wisconsin–Madison alumni Physicians from Boston Educators from Cambridge, Massachusetts Physicians from Cambridge, Massachusetts People from Madison, Wisconsin Harvard T.H. Chan School of Public Health faculty Harvard Institute for International Development Deaths from brain cancer in the United States Deaths from cancer in Massachusetts