David Hamilton Smith

David Hamilton Smith lived a fully engaged life as a physician, researcher, teacher, mentor, entrepreneur, conservationist, philanthropist, husband, father and grandfather. Beginning with his early days as a pediatrician and ending his life’s journey as a conservationist, Dr. Smith embodied a quiet yet bold ambition to make positive change in the world. His work leaves a sustained legacy for both public health and conservation science.

David Smith was born in 1931 in Canton Ohio to Cloyd and Mary Smith. His father was a chemistry teacher in the Canton High School district, while his mother, a college graduate, tutored children in math. David had one brother, Richard Smith, a college history professor.

After receiving his BS from Ohio Wesleyan University, Dr. Smith started his medical career at the University of Rochester where he earned a medical doctoral degree in 1958. He then went on to a three-year residency at Children’s Hospital in the Harvard Medical School. Harvard’s legendary professor, Dr. Charles Janeway, an early researcher on the human immune system, became Smith’s role model and mentor. During a period when much research and treatment focused on antibiotics, Janeway challenged his young doctors to expand their vision and think about prevention especially around Haemophilus influenzae type b, the most common cause of childhood bacterial meningitis, a devastating disease impacting around 20,000 preschool children a year in the United States with a mortality rate of 5% and leaving 30% of survivors with permanent physical and/or learning disabilities.

One day, as the class of interns made their patient rounds and observed a child suffering from the disease, Dr. Janeway urged them to work on a vaccine, stating that he thought it should be preventable. This bedside appeal launched Dr. Smith into his life’s work. “I think there are very few seminal moments like this,” Dr. Smith later said.

Dr. Smith served on the faculty of Infectious Diseases at Children’s Hospital from 1965 to 1976, including the position of Chief of that division. Very early in his career he had a world-wide reputation for cutting edge research in the epidemiology and transmission of antibiotic resistance, particularly in enteric pathogens, work which was begun in the Bernard Davis laboratory at Harvard Medical School. While there, he and Dr. Porter W. Anderson Jr. began the search for a vaccine to prevent H. influenza type b. In 1976, Dr. Smith returned to the University of Rochester to chair the Department of Pediatrics. In Rochester he also continued his research activities, bringing with him from Boston significant members of his team, Dr. Anderson and Dr. Richard A. Insel.

The vaccine they developed was so successful that field trials were cut short. However, the team hit a roadblock in bringing the drug to the public. Despite Food and Drug Administration encouragement, no pharmaceutical company was willing to manufacture the vaccine, presumably as it would render the antibiotics they were selling for the same disease unnecessary, cutting into their revenue stream. Dr. Smith addressed the problem boldly and unconventionally. In 1983, despite having no business experience, he resigned his Chairmanship of the Pediatrics Department and founded a new company he named Praxis Biologics, with a mission to manufacture and market the new vaccine.

At first Praxis operated out of a tiny spare space at the University of Rochester led by a few employees with tireless dedication. Dr. Smith recruited world class scientists to continue the research and directed field trials of the vaccine all while raising money from skeptical investors. By 1985 the first vaccine against H. influenzae type b was approved by the Food and Drug Administration for children ages 2-6, a record time from the beginning of trials in the history of the FDA. Facilitated by a breakthrough by Dr. Anderson, Praxis was then able to develop a new conjugate vaccine for children two years of age. In 1990, it was approved by the FDA and recommended for universal use – the first vaccine to be so licensed since the rubella vaccine in 1969 for measles and mumps.

“The Hib vaccine work is a wonderful success story,'' said Richard A. Insel, a professor of pediatrics at the University of Rochester and a former colleague of Dr. Smith's at the University. ''I don't think people thought it would be this successful, almost eradicating the disease.”

“All of these vaccines wouldn’t have been successful if they didn’t have a champion. David was that champion. He was the cheerleader, he was the person just driving this forward. And in the absence of such, things just don’t happen.”

In 1996 Dr. Smith and Dr. Anderson received the prestigious Albert Lasker Clinical Medical Research Award for visionary leadership in developing the Hib vaccine. As noted by the Wall Street Journal, it was the first time in its 51-year history that a Lasker prize was given to researchers who carried a scientific development from conception through to commercial production and marketing.

That same year, both also received the Pasteur Award from the World Health Organization. In just ten years after the Praxis vaccine was brought to market the number of cases of bacterial meningitis plummeted in the United States from 20,000 in 1987 to 258 in 1997. As of 2013, there were 184 countries worldwide that use Hib vaccine routinely.

Following the sale of Praxis to the American Cyanamid company in 1989, Dr. Smith shifted his focus and joined the boards of other medically-related start-ups initiated by US academic researchers to aid them in negotiating the hurdles they would face in the marketplace. He was also recruited to serve on the Boards of Environmental Defense Fund, on which he served for ten years, and the Heinz Center for Science, Economics and the Environment.

In due time Dr. Smith became involved in conservation efforts on the island of Martha’s Vineyard, Massachusetts, helping to protect wild shoreline vistas and lands with biodiversity endangered by over-development. He played a major role in the Moshup’s Trail Initiative and was the driving force in the 1997 preservation of the Polly Hill Arboretum, a 60-acre horticultural landscape in North Tisbury, MA. Dr. Smith was the recipient of The Nature Conservancy’s 1997 Conservation Achievement Award and the Governor’s Award for Open Space Preservation in Massachusetts in 1998.

In 1998, Dr. Smith, through the David H. Smith Foundation, partnered with The Nature Conservancy to establish the David H. Smith Conservation Research Fellowship program—known as “Smith Fellows”—devoted exclusively to supporting post-doctoral scientists in applied conservation research. This program is now administered by the Society for Conservation Biology.

David Smith was diagnosed in 1996 with melanoma and died in February, 1999. He was survived by his wife, three daughters, two step-daughters and eight grandchildren. His legacy continues from the generations who have been protected by the Hib vaccine to the land protections on the Vineyard and the great strides in conservation science made by Smith Fellows. In 2004, the David H. Smith Foundation was renamed the Cedar Tree Foundation and continues to employ the bold vision of its founder to make a positive impact on national environmental issues.