Professor Diana Lennon ONZM Obituary

Dinny was a world class researcher, inspiring teacher and mentor, and a superb clinician. She was passionate about children, especially those without a fair opportunity for health, particularly Māori and Pacific children. Her determination and energy to make things better for children was limitless and led to advances in clinical care, national policy change, vaccine development and rheumatic fever programmes that are some of her greatest achievements.

She graduated MBChB from the University of Otago in 1972 with the TWJ Johnson Prize in Clinical Medicine, and was awarded FRACP in Paediatrics in 1978. She took up her first research position at the University of Auckland in 1978, followed by further training in paediatric infectious diseases at the University of California, Los Angeles, from 1979 to 1981. In 1982 she was appointed Senior Lecturer with a half-time specialist paediatrician role with Auckland Hospital Board. She was promoted to Associate Professor in 1991 and Professor in 1996. She served on innumerable committees within and outside the University. She was a highly experienced specialist in Paediatric Infectious Diseases with many years of clinical service to Princess Mary Hospital, then Starship and Kidz First (Middlemore) Hospitals and provided consultative services throughout the country. Her advice was sought after, always generous and apt for the clinical care of children.

Dinny’s work was highly respected and she was honoured with the following awards:

• Plunket Woman of the Year (1992)
• Fellow of the Infectious Diseases Society of America - a peer-reviewed elevation based on scholarly achievements and leadership (1994).
• Officer of the New Zealand Order of Merit (2005) for services to science and health
• Outstanding Kidz First Achievement Gold (2006) for meningococcal work
• Hood Fellowship – University of Auckland (2007)
• Dame Joan Metge Medal of the Royal Society of New Zealand (2008)
• Vice Chancellor’s Medal for Commercialisation – University of Auckland (2013)
• Outstanding Kidz First Achievement Silver (2015) for school-based rheumatic fever prevention workNational Hauora Coalition Award (2015)

Dinny had a high profile and impressive portfolio as an academic researcher in the field of preventable infectious diseases, both in New Zealand and internationally. At the time of her death she had about 265 publications of which 192 were journal articles, and many books or book chapters, including a chapter in five editions of the leading Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. She was the principal or a named investigator on many research grants totalling millions of dollars.  But she was not one to collect and count these outputs, in fact she eschewed such processes. She was forthright about the things that mattered to her, and dismissive of those that didn’t. Far more important to her was making a difference to the health of children, which she did in spades.

Preventable Infectious Diseases, Their Causes And Solutions 

In her training Dinny developed an understanding of epidemiology and the big influences on child health. She systematically researched preventable infectious diseases affecting New Zealand children and their causes, developing appropriate solutions accessible to children. Her growth as an epidemiologist (in collaboration with the US Centers for Disease Control and Prevention) led to her confidence in developing further solutions. She was an original thinker who became a translational researcher - not just describing disease but implementing practical measures to reduce the burden of disease. Her work ensured the introduction of a vaccine against Haemophilus influenzae type b to prevent bacterial meningitis, and was key in efforts to control the meningococcal A outbreak of the 1980s. She played a lead role in addressing the prolonged meningococcal B epidemic through the 1990s to 2000s, working tirelessly at national and international levels in developing a vaccine, then setting up and leading clinical trials culminating in the mass MeNZB vaccination programme in 2004/2005, which reduced deaths and disability from meningococcal disease. She described, with others, the burden of invasive Group A streptococcal disease and post-streptococcal glomerulonephritis. More recently she co-led research into Staphylococcus aureus invasive disease, osteomyelitis, skin sepsis, and was part of a collaborative group aiming to reduce the burden of respiratory disease in South Auckland. For decades she has been a leader in national vaccination policy.In 1991, she drew attention to the huge inequities in child health with her public lecture entitled “Health in the Ghetto”. Subsequent research findings, that crowding was the greatest risk factor for meningococcal disease, led to Housing New Zealand building larger, healthier state homes. The Healthy Housing initiative in the Auckland region, which included joint health and housing interventions, was of proven benefit.

Rheumatic Fever

Throughout her career, Dinny advocated tirelessly, both nationally and globally, for rheumatic fever prevention and control. In the 1980s, she helped to develop the Auckland regional rheumatic fever register, which led to delivery of free community-based intramuscular benzathine penicillin treatment and greatly reduced rheumatic fever recurrence rates in the Auckland region - a benchmark for New Zealand practice.  In 2006, she was co-lead author of New Zealand's first evidence-based guideline for the diagnosis and management of rheumatic fever, updated in 2014 with the sore throat algorithm. She helped develop diagnostic criteria appropriate to high-incidence settings such as New Zealand.

She initiated and led the randomised controlled trial of primary prevention of rheumatic fever with sore throat school programmes, which has been described as the most innovative rheumatic fever research for over 50 years. Due to her continued championing of this work the government of the time was persuaded to invest in the rheumatic fever prevention programme, which led to the 2012 Better Public Service targets, resulting in reduced rates of rheumatic fever. She led an international workshop that provided “Advice to the Ministry of Health” on control of rheumatic fever by 2020.

Dinny’s work on rheumatic fever culminated in global advocacy work with international collaborators to reduce the impact of this disease in other settings, both through delivery of penicillin prophylaxis and vaccine development. She was co-signatory to the 2015 Addis Ababa Communique on the eradication of rheumatic heart disease in Africa. Finally she was immensely proud, that in 2017, New Zealand co-sponsored a successful bid for the adoption of a resolution on rheumatic fever and rheumatic heart disease at the 71st World Health Assembly in May 2018.

Health Professional Education

Dinny has had a profound influence on countless health professionals through her mentoring and teaching. Dinny knew that it was vital that medical students learn to recognise unwell children, and that this teaching was reinforced for postgraduate doctors, especially in general practice. Dinny was the academic leader of the Diploma of Paediatrics for many years following its establishment, and continued academic oversight. She supported youth health teaching and research. To help paediatric registrars with their basic training, in 1988 she established the residential course for FRACP trainees, which continues to be highly successful.  She supervised many masters and doctoral students, paediatric registrars, summer students and colleagues, and many others benefitted from her direct support and encouragement in training and beyond.She respected all child health professionals and particularly recognised the value of nurses, supporting their crucial role in health care delivery, not only within the hospital but in the community. Dinny recognised that nurses are key to reaching children where they live and go to school. Paediatric nurses have been vital to the success of the rheumatic fever prevention programme.

Pacific Colleagues

Dinny actively supported colleagues in the Pacific Islands, especially the Cook Islands, Fiji, Samoa, Tonga and Vanuatu. She supported and attended Pasifika Medical Association conferences, facilitated training opportunities, advised on rheumatic fever control strategies and infectious diseases. She supported colleagues in Samoa and Tonga to develop and strengthen their rheumatic fever services. She successfully advocated for training positions for Samoan registrars in New Zealand and supervised Pacific PhD students.

Dinny was a feminist and set an example in her empowerment of women. Her appointment as one of the first women Professors of Paediatrics in New Zealand was fitting, and she was an inspirational role model for many. Many have deeply appreciated Dinny’s support over a long period of time.

At this time we send deepest sympathy to her family - her husband John Ormiston, children Harry and William, and their families. Her family was the centre of her world, and our hearts go out to them.

Diana Lennon was a truly remarkable woman. She has left an inestimable legacy. The world is a better place because of her life and we will miss her deeply.

Kua hinga te totara i te wao nui a Tane                  

The totara has fallen in the forest of Tane

Professor Innes Asher