The 40 year wait
In 1973, after rigorously testing 6,000 fungal broths, Dr Akira Endo and his team in Tokyo finally discovered a miraculous molecule which prevented bacteria from producing cholesterol in their cell walls. In doing so they paved the way for the development of one of the world’s most effective modern drugs. Theirs was far from a chance discovery – it was the result of an insightful and systematic search for a natural substance which could counter the effects of cholesterol, a known risk factor for arterial and heart disease. The discovery gave rise to the super-drugs which we know as statins, drugs which have revolutionised medicine and saved the lives of millions.
Not all science progresses in this way. History is littered with examples of serendipity where fundamental science has fortuitously given rise to great but unwitting progress: penicillin, Pasteur and viagra, all testify to the power of the prepared mind - and plain good fortune.
Both the systematic and serendipitous findings of science share a common disability: the time it takes to generate benefit. It is undoubtedly true that society benefits from new knowledge alone. If anyone doubts this argument, take a look at the publication published two years ago by the Academy for Social Science, ‘Making the Case’. As educated people, I doubt there is anyone who fails to admit what a better and more human society ours is as a result of the progress made in the social sciences. Making the Case shows that progress in prisons, child care, women’s rights, poverty and many other areas have been brought about by new knowledge which changed our awareness of the human condition and the forces around it. It has however taken decades, not least of all, it is arguable, because of the endearing British trait of never doing anything for the first time. One could also argue, in the same vein, that the most profound changes in our thinking about ageing have occurred because of progress in fundamental science – we no longer think of an allotted lifespan of three score years and ten; ageing is now conceived as a life-long and malleable process and best of all, it is no longer considered as a necessary descent into disability and decrepitude. Knowledge, as they say, is power. But its application has been slow.
In Britain, there are currently 12 million people with chronic long-term illness, many of them in middle age. I met an alarming statistic recently, conveyed to me by the President of the European Society of Geriatric Medicine: in middle age, if you have one diagnosed condition, it doubles the risk of Alzheimers by the age of 65; two conditions, double it again. And three conditions, it doubles further. I think you get the picture. At the same time the Government spends billions each year on biomedical science. By osmosis as it were, much of this excellent science eventually filters down into medical practice. But progress is painfully slow and there are volumes of findings riding the shelves of university libraries and in the restricted readership of the medical journals. By contrast, not only is there comparatively little spent on knowledge transfer but there are few incentives for academic researchers to invest time, energy and resources into translating their work. So it is that for the first time, the universities are now being compelled to focus on research impact rather than research quality alone.
Discovered in the 1970s, trialled in the eighties and nineties, and prescribed widely only now, patients have waited 40 years to reap the benefits of Akira Endo’s work. The millions of people whose only hope is science cannot wait the decades it needs to translate the existing volumes of knowledge or for breakthroughs to be exploited by serendipity. Progress is measured in decades. And medicine funeral by funeral.
Age UK is meeting the challenge of the 40 year wait. We support and applaud the excellent research carried out in fundamental, curiosity driven research. But our mission is to improve the lives of older people and so we are investing our limited resources into funding translatory research. If we are successful, even in a minor way, we shall provide hope for those millions of older people who do not have 40 years to wait.