I suspect this is the first of a series of posts this week on the 2015 Nobel Prizes. On Monday the prize for physiology and medicine was announced and I rather like it; let me tell you who got it and for what before I explain why.
As is common the prize was split between a couple of different people. One half went jointly to William C. Campbell and Satoshi Omura for their work on developing a drug to treat roundworm parasites and the other half went to Youyou Tu for her work on developing a treatment against malaria.
Satoshi Omura is a microbiologist who fastidiously studied bacteria found in the soil looking for species that produced compounds with antibacterial properties; he came across streptomyces and noticed they fit the bill rather well. He then cultured many thousands of different stains looking for the most effective ones and narrowed it down to the fifty best performers. William C. Campbell is an expert in parasite biology who took these cultures and noticed that they were especially effective against the roundworm parasite which causes highly debilitating diseases like elephantiasis and filiriasis, also known as river blindness. He successfully isolated the compound Avermectin which was tweeked in the lab to form the drug Ivermectin. The work of these two pioneers has led to the near eradication of roundworm based diseases in human populations.
In the 1960s we were losing the fight to malaria. Youyou Tu looked to traditional Chinese medicines to begin the fight back. She conducted large screens of herbal remedies in infected animals to find the compounds that would work best and eventually found a compound in Artemisia annua that looked promising. The new compound was named Artemisinin and it worked fantastically well in both animals and humans. The drug attacks the parasite when it is in an early stage of development which is why it is so effective and a whole new class of anti-malarials was born.
Now, these people were all instrumental in discovering treatments for parasitic illnesses that have killed and disabled tens of millions of people in the last century alone. The benefits to mankind of these Nobel laureates are immeasurable and are more than worthy of recognition; but that’s not why I’m excited by the announcement. Apart from both being in the unglamourous and underpublicised field of parasitology the twin recipients also have something else in common. They both started from ‘natural’ or ‘herbal’ beginnings.
‘But Jason,’ I hear you cry. ‘You and all the other scientists hate everything to do with natural herbal nonsense’. Well, this is simply not true. There are in-numerous examples of herbal and natural remedies that have been effectively used over the years. If something appears vaguely efficacious then people are likely to use it. Eventually, scientists will get around to doing a (hopefully) high quality trial of whatever the active ingredient is and, if it passes muster, it will be warmly welcomed into the pharmacopoeia. This has been going on for over a century and long may it continue. But medical professionals have a responsibility to their patients to treat them whilst incurring as little risk as possible. This is why we have to check to see if it truly does work, if it does we then need to isolate the active ingredient, then we need to purify it and work out the correct dose for a given problem and carefully study if there are any adverse side effects. If all this can be done then we package it up, ship it out and patients can receive their treatment.
This is how it should be. What would be irresponsible and potentially even dangerous would be if we carried on mashing up leaves and getting people to ingest the concoction when we don’t know what dose we’re giving to people, when we don’t even know what the thing is that we’re trying to give, it could be any one of the thousands of compounds in a leaf. Don’t fall the Natural Fallacy. Natural is not synonymous with good or better or safe. ‘Natural medicine’ has and will continue to have a huge role in healthcare, but it has to play by the rules.