“Don’t be afraid of hard work. Nothing worthwhile comes easily. Don’t let others discourage you or tell you that you can’t do it.”
- Gertrude Elion, recipient of 1988 Nobel Prize for Physiology or Medicine for developing the first antiviral drug
“She’s so resourceful, she could start a lab on a desert island.”
- Patrice Courvalin, PhD supervisor, describing Emmanuelle Charpentier recipient of 2020 Nobel Prize in Chemistry
We all know that “bad news sells.” On a daily basis, we are bombarded by it. But why are we drawn to bad news? In his 2018 book Factfulness: Ten Reasons We’re Wrong About the World and Why Things Are Better Than You Think, Swedish physician Hans Rosling, Professor of International Health at the Karolinska Institute and one of the most highly regarded leaders in the field of global health this century, described what he called our “negativity instinct”: the tendency of Homo sapiens to notice the bad more than the good. Dr. Rosling’s contention is that we humans seem to thrive on bad news.
There is, however, good news out there; news that we may have missed or glossed over due to the ongoing blitz of grim news. And in this time of COVID-19 we all need some good news. So, in this week’s Germ Gem post, I am focusing on some very good news related to the field of infectious diseases.
Nobel Prizes. Last week was Nobel week. Three virologists, Harvey Alter, Michael Houghton, and Charles Rice, shared the Nobel Prize for Physiology or Medicine for their research leading to the discovery of hepatitis C. Often called “the hidden epidemic,” about 71 million people worldwide have chronic liver disease due to hepatitis C, and some 400,000 people die each year from cancer of the liver and other complications of this infection.
Early in my career, two viruses were known to cause viral hepatitis: hepatitis A (called “infectious hepatitis”), which is acquired by consuming contaminated water or food, and hepatitis B (“serum hepatitis”), a largely blood-borne pathogen. Basic research led to effective vaccines against both of these viruses. A third virus, however, was still out there. Originally, called non-A, non-B viral hepatitis, it was known to be responsible for a huge number of cases of hepatitis (acquired by drug use, blood transfusion, or sexually). Because of the work of Drs. Alter, Houghton, and Rice, the virus was identified as hepatitis C, diagnostic tests were developed, and almost miraculously curative therapies were developed.
Many lessons can be learned from the story of hepatitis C’s discovery. First and foremost, I believe, is the great pay-off of fundamental or basic science research. Such research, however, takes time. “It’s a long story, a 50-year saga,” Alter said of the route to finding this virus and being able to cure people of it. And their work is not yet complete. Houghton, who is now working on a vaccine against the virus, opined, “You need a vaccine to prevent infection, not just drugs to treat it.”
A second Nobel Prize (this one for Chemistry) that also had its roots in infectious diseases has profound implications for many areas of human medicine. It was awarded to the microbiologist Emmanuelle Charpentier and biochemist Jennifer Doudna for developing the precise genome-editing technology CRISPR (“clustered regularly interspaced short palindromic repeats”). This award should come as no surprise to regular readers of Germ Gems as the gist of the technology and the prediction that a Nobel Prize was imminent were the subject of my November 11, 2019 Germ Gem post: “CRISPR: Everything you wanted to know but were afraid to ask.”
The inspiration for this gene editing tool came from their observation that some bacteria use CRISPR to protect themselves from viruses called bacteriophages. CRISPR has enormous potential for treating a range of medical conditions that have a genetic component, including cancer, sickle cell anemia, muscular dystrophy, Huntington’s disease, and even high cholesterol. Since 2014, scientists have engineered CRISPR-based gene drive systems that would eradicate a mosquito species that carries the parasite that causes malaria, a disease that afflicts hundreds of millions of people a year and kills close to half a million, most of whom are children in Sub-Saharan Africa.
Kudos to the National Institutes of Health (NIH). As is the case for many thousands of scientists and clinical researchers every year, the NIH funded all the Nobel Prize awardees mentioned above. The NIH traces its roots to 1887, when a one-room laboratory was created within the Marine Hospital Service, a predecessor agency to the U.S. Public Health Service. It is now the premier research institution in the world. Last year the NIH received $41.68 billion in federal funding. It is arguably one of the most consistently valuable investments of American taxpayers.
And there’s more good news: Dr. Anthony Fauci, whose name we have all come to know during the COVID-19 pandemic, recently received the “Federal Employee of the Year Award.” Dr. Fauci, who is Chief of the National Institute of Allergy and Infectious Diseases at the NIH, and NIH director, Dr. Francis Collins, are leading America’s remarkable scientific response to the COVID-19 pandemic. Their leadership should be celebrated by all Americans, and, for that matter, by the whole world.
This is again a masterly piece of educational writing and positivism, which we all need in these times. Looking forward to the next ones