Healthcare

GLOBAL INVESTOR 2.12 —
Photo: Cédric Widmer
In the first decades of the 20th century, a series of scientific discoveries
significantly expanded therapeutic options. The chemical industry
discovered aspirin (1899) and, in 1910, salvarsan, the first drug
against syphilis. In the 1930s, thanks to the work of Gerhard Domagk
at Bayer and the group of Ernest Fourneau at the Pasteur Institute
in Paris, sulfonamides offered effective treatment against a variety
of infectious diseases, in particular human African trypanosomiasis
– sleeping sickness – and leprosy. Working in the laboratory of
John Macleod in 1921, Frederick Banting and Charles Best isolated
insulin, which enabled immediate treatment of diabetics. Following
Karl Landsteiner’s discovery of blood groups in 1901, the first blood
bank was created by the Mayo Clinic in 1935. In 1928, Alexander
Fleming discovered that the mold destroying bacterial samples he
was working with contained penicillin. Its active agent was later
isolated in 1941 and tested on a small group of patients. The results
were striking, and large-scale production of penicillin became a priority
for the chemical war industry, along with DDT against the transmission
agents of malaria and typhus. In 1943, Selman Waksman isolated
another product from fungus, streptomycin. Its clinical effectiveness
against tuberculosis was quickly established, signaling, at long last,
control of the primary infectious disease of industrialized, urban society.
During and after the Second World War, a veritable explosion of science
and technology brought even greater change to medicine and public
health. Technology began to play an increasingly important role in
medical practice owing to medical imaging, microsurgery, intensive
therapy, transplantation, prostheses, immunosuppression and chemoand
radiotherapy for cancer. New disciplines, in particular molecular
biology, immunology and neurobiology, revised the theoretical understanding
of medicine.
At the beginning of the 20th century, Sigmund Freud’s discovery
of the unconscious profoundly altered thinking about psychiatric disorders
and spurred new therapeutic methods. The development of
neuroleptics resulted in drug treatments for these illnesses.
Epidemiology, which studies patterns of disease in populations,
also expanded considerably during the mid-20th century due to innovative
methods of investigation. The prototypes were the Framingham
Heart Study in the 1940s and, more recently, the MONICA Project,
sponsored by the WHO, which involves 41 collaborating centers around
the world. Both followed large groups of men and women to determine
the causes and risk factors of cardiovascular disease. Beginning in
1950, a study by Richard Doll and Austin Hill established the causal
link between cigarette smoking and lung cancer. The search for causal
links between different factors and diseases is also the aim of
so-called evidence-based medicine, which takes into account the
best clinical, scientific and epidemiological data in medical decision
making.
In the area of policy, two events signaled the postwar future, with
the creation in 1948 of the National Health Service in the United
Kingdom and WHO, which was the fruit of an international collaboration
in health that began with the first international health conference
in Paris in 1859. For the very first time in history, health was defined
as a fundamental right of individuals, and one of the essential components
of the stability and well-being that are the goals of humanity.
Bernardino Fantini
The molecular revolution of the 1950s and 1960s, which culminated
in the complete sequencing of the human genome in 2003, brought >