How will the Nobel scientists transform medicine?

This week, the Nobel Prize committee announced that the 2015 prize for medicine will be shared between three scientists, honouring their roles in two discoveries that have transformed global health. The achievements of this year’s recipients are a reminder of how scientific discovery can change the world – and the work it takes to make that happen.

One of the discoveries in the spotlight this week was that of ivermectin, a broad-spectrum anti-parasitic drug that William Campbell and Satoshi Omura discovered from bacteria found in soil. The other was Chinese researcher Tu Youyou’s discovery of artemisinin, a highly effective anti-malarial drug now used to treat hundreds of millions of people every year.

In humans, ivermectin is used to prevent and treat river blindness (also called onchocerciasis) and lymphatic filariasis: two among a number of communicable, often disabling infections collectively known as neglected tropical diseases (NTDs). More than a billion people are affected by these diseases, trapping communities in cycles of poverty.

A remarkable discovery

This shared Nobel is a tremendous and fitting honour for two path-breaking scientific achievements. As the Nobel committee said in announcing the award, “the consequences in terms of improved human health and reduced suffering are immeasurable”.

What is even more remarkable about the story of ivermectin in particular, however, is that its discovery sparked something even bigger. Campbell, a doctor working at the pharmaceutical company Merck at the time, was quick to realize this new drug’s potential: he knew that if it reached enough people, it could make a huge difference to life in parts of Africa and Latin America, and potentially put river blindness and lymphatic filariasis on a path to elimination.

Merck’s CEO, Roy Vagelos, saw the drug’s potential too. In 1987, the year ivermectin was approved, Vagelos announced that Merck would make the drug free to those who couldn’t pay, vowing to donate as much as was needed, for as long as it was needed.

I’ve seen first-hand how free ivermectin has had an enormous impact on public health. As the coordinator of the African Programme on Onchocerciasis Control for 15 years at the World Bank, working with the World Health Organisation, I not only saw case numbers drop precipitously; I met people who no longer suffered from these diseases, people who had been able to return to villages abandoned because of river blindness.

Merck’s commitment also set a precedent. In the following years, other companies made major commitments to donate drugs against NTDs, easing limitations on drug supply: a major step towards ending these diseases. Now, these commitments together make up the largest drug donation programme in the world: more than 1.3 billion treatments, worth more than $3 billion, are delivered every year.

How to win the fight

Ending these diseases, though, will take more than drug donations. In January 2012, 13 pharmaceutical companies, including Merck, joined a range of other partners including the Bill & Melinda Gates Foundation to make an unprecedented commitment to support the control, elimination or eradication of 10 neglected tropical diseases by 2020, as recommended by WHO. We’re having impact: Latin America has nearly eliminated river blindness, and disability related to lymphatic filariasis has been reduced by more than half globally since 2000, thanks to a range of tools including ivermectin. But where the need is greatest, so is the challenge: the communities worst affected by these diseases are often so poor they don’t have the mechanisms to give away free drugs.

Getting this far has taken true partnership. The countries most affected by these diseases came up with new, innovative plans to end NTDs. USAID, DFID and other public and private donors made large financial commitments to ensure drugs reach those who need them. Japan, France and others continue to invest in research into new tools; G7 research ministers are meeting this week to decide how best to continue their support.

There is a lot still to do if the world is to reach the WHO’s goals, now just five years away. All donors must step up to ensure the programme is fully funded. NTD control is one of the best buys in global health: meeting the WHO’s 2020 targets for just five NTDs would yield an estimated $565 billion in productivity gains between 2015 and 2030. Yet there is an annual funding gap of $200-300 million, meaning that too many people in some of the world’s poorest communities are still missing out on these life-changing treatments.

The story of ivermectin is a reminder of the power of research. Now we must show the vision to finish what these brilliant scientists started. We must invest and innovate to ensure their discoveries reach everyone who needs them. Then we truly will, in the words of Alfred Nobel, have conferred the greatest benefit on mankind.

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Author: Donald Bundy is Senior Adviser and Deputy Director, Neglected Tropical Diseases, Bill & Melinda Gates Foundation

Image: A health worker checks a blood sample for malaria in the only hospital in Pailin in western Cambodia January 28, 2010. REUTERS/Damir Sagolj