William Haseltine
William Haseltine is a scientist, businessman and philanthropist. For much of the '70s, '80s and '90s he was a professor at Harvard Medical School, where he researched cancer and HIV/AIDS. He is also the founder of several companies, including Human Genome Sciences, where he served as Chairman and CEO. He is President of the William A Haseltine Foundation for medical Sciences and the Arts. He lives in Washington DC and Manhattan and travels widely.
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Mar 30 2009, 2:02PM
Confronting Alzheimer's
At the same time, a broader vision emerged. The recipient of the Chairman's Leadership Award, French President Nicolas Sarkozy (represented by his ambassador), was honored for his $2.4 billion dollar strategic plan to establish a new Alzheimer's research foundation, improve diagnosis, enhance care, and change perceptions about the disease. As president of the European Union, Sarkozy put Alzheimer's patients on the European agenda. The award's presenters called upon President Obama to exert similar leadership in the fight against Alzheimer's disease here in the United States.
In fact, earlier that same day, a congressional Alzheimer's Study Group had released a final report calling for just such a plan. The Study Group, established in June of 2007 by the Congressional Task Force on Alzheimer's disease, is chaired by Newt Gingrich and Bob Kerrey. The group's conclusion is sobering:
Despite the grave implications of the mounting Alzheimer's disease crisis for America's future, the Federal Government has no comprehensive strategy to guide its efforts against this disease. There is no integrated statement of the vision, assumptions, objectives, strategies, measures of success, assignment of responsibilities, timelines, and anticipated resource requirements to guide and explain the Federal Government's overarching efforts to address the Alzheimer's crisis. In fact, our review indicates that there exists nothing even close.
The Study Group report presents the chilling statistics of the disease. Over 5 million people in the United States and more than 30 million people worldwide are living with Alzheimer's. The numbers are projected to rise dramatically, more than doubling to 13 million by 2050. Alzheimer's is primarily a disease of the elderly: it affects fewer than 2 percent of those between the ages 65-74, but 20 percent of those between 75 and 85, and more than 40 percent of those 85 and older. The problem will soon be compounded by the aging of the U.S. population. By 2050, 90 million people are expected to be over 65, and more than 50 million over 75. According to the report, Alzheimer's disease is now the sixth most rapidly growing cause of death in the United States.
The costs are also staggering. This year the federal government will spend more than $100 billion on Alzheimer's treatment through Medicare and Medicaid programs. Following current trends, the total spent by the federal government between now and 2050, measured in today's dollars, will be $20 trillion, $1 trillion of which will be spent in 2050 alone. These figures do not include the cost to family members who will bear so much of the caregiving responsibility. On average there are two family caregivers per patient. The Study Group estimates that each family will spend about $215,000 to care for a patient with the disease--about $40,000 to purchase on medications and services and $175,000 on uncompensated caregiving. The real cost to society over the next 40 years will be about $100 trillion. In the words of the Study Group, "Unless we take decisive action now, the Alzheimer's crisis could very easily surpass even the current economic crisis in the damage it inflicts on individuals and our economy."
Mar 23 2009, 4:55PM
E. O. Wilson, Explorer
At this year's event, 1,000 current members, in costumes ranging from black tie to beaded buckskin, were there to celebrate the joys of exploration and pay tribute to the winners of the Club's honors. The hors d'oeuvres provided ample opportunity for culinary exploration. Alligator was served--roasted for the bold and as a Cajun stew for the less adventurous. Scorpion canapés, cricket pate, and a variety of sandwiches and sweets topped with toasted worms and garnished with fried larvae were crunchy delights. I missed the baked tarantula but did sample the stuffed eyeballs. While we dined, musicians played original compositions and brilliant lights swarmed the ceiling. Jim Fowler, a longtime member of the Explorer's Club, was there with his customary menagerie of exotic animals, including four rare species of owl, a hyperactive kangaroo, an acrobatic two-toed sloth, and a variety of engaging New World monkeys.
The festive mood framed serious discussions on exploration and the environment. This year's theme was The Balancing Act: Exploring Biodiversity, and E. O. Wilson, the recipient of the Explorer's Medal, delivered the keynote address. Wilson, a noted Harvard professor and Pulitzer Prize winner, spoke of his boyhood respect for Carl Linnaeus and other great explorers of the natural world. He recounted his early travels upon untrodden soil deep in the mountains of Sarawak and Borneo. He reminded us that the exploration of this planet's surface geography is coming to an end--that by the end of this century, every centimeter on the land would be mapped and known. The future of exploration, he insisted, lies in the living world all around us and beneath our feet.
He began with the terrestrial. New mammals, birds, and reptiles remain to be discovered. He argued that about half of all living species would be driven to extinction within this century by the destruction of their natural habitats by the hand of man--either directly or through climatic changes driven by global warming. Many species, he warned, could be lost forever before we have a chance to know them.
He continued with the small, describing the most prevalent animal species on the planet: the humble nematode, a tiny soil roundworm. Nematodes play a critical role in soil biology, providing the rich earth that sustains plant and animal life, and there may be more than one million different species of them. "So abundant are these humble worms," Dr. Wilson said, "that if the soil were stripped away, earth, as seen from space, would be blanketed by a haze of roundworms."
He concluded with the microscopic. We humans might be accurately described as nine parts bacteria to one part animal--we comprise a trillion different cells but are home to more than ten trillion bacteria. There is more bacterial diversity in one person's oral cavity or shoe than there is among plants and animals in a tropical rainforest. And yet, we know so little about these organisms. As for the fungi that live about us, only a few of what are sure to be hundreds of thousands of species are known.
Finally, Dr. Wilson led us to the greatest unknown: the world living deep beneath our feet. We now know that our biosphere extends at least 2 1/2 miles below the surface of the earth. Photosynthesis--light captured by bacteria, algae and plants--fuels life at the earth's surface, but high-energy chemicals, forged in the crucible of the deep, are converted to usable energy by subterranean bacteria. Taken together, these tiny creatures weigh many times more than all the biomass on the surface of the earth. As Dr. Wilson mused, "Should surface life be destroyed one day by an act of man or nature, these organisms would rise to the surface, evolve, and once again produce a rich diversity of plant and animal life."
Knowledge of our microbial companions immediate practical value as well: by understanding the inner workings of these organisms, we can harness the power of their transformative chemistry. I have firsthand experience with this particular field of exploration. During the 1990s, I helped to create a new biotechnology company, then called Diversa, to tap the power of microorganisms for new chemicals and fuels. Today, the study of soil bacteria and fungi are at the forefront of our efforts to create renewable biofuels. And the tools for discovery have evolved tremendously over the past several years. Thanks to rapid advances in technology--driven by our desire to understand ourselves--it is now possible to decipher DNA rapidly. The entire DNA text, or genome, of a plant or animal can be determined in a matter of weeks, a fungus in days, and a bacterium in mere hours. And the efficiency of our instruments is increasing.
Thanks to such advances, Dr. Wilson has been able to launch a comprehensive encyclopedia of life, one that describes not only the physical descriptions and habitats of all species on earth but their genomes as well. This bio-encyclopedia, already online in its early stages at www.eol.org, will function much like Wikipedia, drawing on many sources for photos of animals, descriptions of habitats, research data on behavior, biochemical analysis, and DNA sequence data. The fruition of this great project will take many generations, but it may hold the key to the continuation of life on earth. It is a great and worthy field for future explorers.
Mar 19 2009, 11:05AM
George Costakis and the survival of Russian art
Costakis was born in and raised in Russia. Born in 1913, he was too young to participate in the avant garde movement. Rather, he discovered his love of panting and collecting as a teenager and began seriously collecting the Constructivists in the 1950s and 1960s. During his time as the director of personnel at the Canadian embassy, he amassed the world's largest collection of early 20th century Russian artists. His small Moscow apartment, literally stuffed with their work, became a Mecca for visiting scholars. He left for Greece in 1974, taking half his collection with him. The remainder was donated to the Tretyakov Gallery in Moscow. In 1997, more than 1250 of these works were purchased by the Greek government. They are now part of the permanent collection of the State Museum of Contemporary Art in Thessalonica.
The exhibit at the Maillol Museum is a feast for the eye. This collection is about art for art's sake; political narrative is absent. The curator, Yves Koby, presents the depth, breadth, and complexity of the Russian avant garde movement, arranging more than 100 beautiful canvases and drawings in roughly chronological order. More than 20 artists are represented, many unknown to the non-specialist.
There are some real surprises. Ivan Klioune emerges as a talent equal to that of Popova and Rodchenko. His inventive canvases combine strong form with delicate shadings uncommon among his contemporaries. Nikritine large figures in black and grey serve as powerful expressions of angst and agony. A large 1943 painting by Rodchenko could be mistaken for a later Jackson Pollack drip painting.
The exhibit at the Tate Modern is also a blockbuster, a comprehensive summation of the works of two exceptional artists. Popova and Rodchenko were great friends and colleagues who worked closely together to form the core of the avant garde movement. Together with Rodchenko's wife, Varvara Stepanova, they established an intellectual, creative, and social focus for the movement. The exhibit, which is housed in spacious galleries, can be viewed as symphony with two interweaving themes: the simple, abstract forms of Rodchenko and the lyrical curves, colors, and textures of Popova. Rodchenko uses a limited range of pure color on flat surfaces. Popova's works are hard edged, and geometrical--he works with a range of subtle color, adding granularity with marble powder and sometimes emphasizing the texture of a raw plywood surface. Both are interested in reinventing painting, a goal this is nowhere more explicit than in three Rodchenko canvasses hung side by side in pure blue, red, and yellow. The artist himself described these works as the end of painting.
As at the Maillol, the backbone of the Tate exhibit is drawn from Costakis' collection. The majority of the works are either on loan from the Tretyakov Gallery in Moscow or the Modern Museum in Thessalonica. Nonetheless, the Tate curators, working with their Russian counterparts, have made what appear to be heroic efforts to locate and place on view works that have been tucked away in obscure provincial galleries. Paintings are credited to the Iaroslasvl State Art Museum, Ivanovo Regional Art Museum, The Museum of Fine Arts: Tula, and the Vasnelsova Regional Art Museum. Viewing all of these works side by side, one is struck by Costakis' foresight and care. The paintings and drawing credited to the Costakis collection are in excellent condition, contrasting with the relatively poor state of most of those from the Russian museums.
Both of these exhibits highlight the creative energy unleashed by the Russian Revolution, a force that redefined modern art design. Art in the first half of the 20th century was powerfully shaped by Constructivism and Supremicism in the East and by Cubism, Futurism, and Surrealism in the West. But it is with a sense of shock that we recognize the impact of the early Russian painting on postwar American art--including Abstract Art, Abstract Expressionism, and Minimalism.
The exhibits are also a chilling reminder of the repressive political forces that emerged with Stalin's rise to power in 1925 and snuffed out this bright creative flame. Before 1925, creativity in Russian art was exuberant. After 1925, those artists who survived either fled to the west, worked as propagandists for the state, adopted the style of Social Realism, or stopped working altogether. We must thank the memory of George Costakis for preserving this fragile flower of the human spirit.
Mar 17 2009, 10:20AM
Paris is still dancing
Mar 14 2009, 1:17PM
"Constructive biology" will reshape biotech
Dr. Keasling's group has an innovative approach: rather than solving one problem at a time, they seek to create a set of genetic tools that can be used as interchangeable genetic switches to regulate genes. This approach is very much like that of the electronics industry: using standardized components to build diverse products, A small group of like-minded scientists, working at other universities including MIT and Stanford, have since dubbed this new field "synthetic biology." I prefer the less threatening and more descriptive name "constructive biology."
Mar 11 2009, 7:15AM
Why big pharma mergers magnify failures
The fact that so many companies are now merging reflects the failure of each company to discover and develop its own replacement pipeline. To maintain growth, a pharmaceutical company must either produce enough new products to replace those that have gone off-patent or acquire rights to distribute drugs created by others. This is clearly not happening on a large enough scale. A small number of patented drugs, each with annual sales of $1 to $5 billion, accounts for most of the profits of the large pharmaceutical companies, and these profits are vanishing as the patents expire. Meanwhile, the number of new drugs approved for sale annually has steadily decreased over the past 15 years.
Mar 9 2009, 10:03AM
Stem cells and beyond
Mar 3 2009, 7:04AM
Renewing Florida
Florida has decided to make a Texas-style bet on biotechnology. The strategy: entice world-class centers of biomedical research to establish local campuses. The Scripps Research Institute, where I am an adjunct professor, was the first taker: the La Jolla-based Institute was promised more than $500 million in state and county funds to launch a campus near Palm Beach. After several years of intense public discussion, a site was selected
Feb 25 2009, 6:28PM
An Early End to the HIV/AIDS Pandemic?
Preliminary reports on Obama's first budget, to be unveiled tomorrow, suggest that funding for international AIDS programs will be held flat, despite campaign-trail promises to ramp up U.S. commitment. Yet now more than ever, investment in the cause can make a difference.
Earlier this week, I met with three colleagues--Robert Gallo, Max Essex, and Robert Redfield--who have been at the forefront of AIDS research for the last 25 years. It was the four of us who in the early '80s helped define the viral nature of the disease, developed the basis for the first diagnostic test, and established a fundamental understanding of the virus, which led directly to the development of effective treatments. We hadn't been together in one place in about a decade, and as we got to talking at Bob Gallo's Institute of Human Virology in Baltimore, we realized we shared a surprising conclusion: The tools to end the AIDS epidemic may well be at hand.
Paradoxically, this realization emerges at a low point in our hopes for an HIV/AIDS vaccine. The dramatic failure of the most-promising-seeming vaccine last year dashed such prospects, and sent the community of researchers back to the laboratory. Nevertheless, the epidemic could still be arrested or substantially slowed using diagnostic tests and anti-viral drugs already in existence--saving tens of millions of lives worldwide.
Epidemic control begins with knowing who is infected, so the first step is to detect all those who carry the virus. The means to monitor the progress of the disease are widely available. Reliable, inexpensive diagnostic tests exist and are being used in rich and poor countries alike. And thanks to anti-discrimination policies and the availability of effective, affordable treatments, barriers to testing are falling. In some regions, such as southern Africa, where infection rates exceed 25 percent of the adult population, testing of everyone between the ages of fifteen and fifty might be recommended. Elsewhere, as in the United States and Western Europe, testing could be more focused.
The second step is to treat all those infected with combinations of anti-HIV drugs. Advances in this area have been nothing short of spectacular. More than twenty-five new drugs are currently available, and still more are in the pipeline. When I began my work, HIV infections were almost always fatal. Today, most of those infected with HIV, if carefully treated, can expect to live many decades in relatively good health. Although it is too early to know for sure, it seems likely that the majority of those carrying the virus can expect a normal lifespan.
The effectiveness of the first therapies was limited by the rapid emergence of viruses within each patient that were resistant to a single drug. The solution was to develop sets of drugs, each acting on a different part of the virus. At present, drugs that inhibit six different steps required for virus growth are available. Using combinations of these drugs greatly slows the development of drug resistance. And when resistant viruses do emerge, different combinations of these drugs are often effective. Such progress is a triumph of modern medical science.
Initially, effective HIV/AIDS treatments were available only to those living in wealthy countries. The cost of drug therapy ranged from $10,000 to $15,000 dollars a year in rich and poor countries alike. Today, combination therapy is available in some countries for as little as $75 a year. And agencies such as the Global Fund and the U.S.-sponsored PEPFAR program provide drug treatment free of charge to many less developed countries. Thanks to this dramatic reduction in cost, more than 3 million people in poorer countries are currently receiving treatment through these and other programs. With continued support, that number will grow.
Despite such progress, however, the epidemic is outrunning treatment. The World Health Organization estimates that there are now about 35 million people infected with HIV, the great majority of them living in sub-Saharan Africa and South Asia. It is also estimated that 2 to 3 million new people are infected with HIV each year. Thus, an effective method for preventing new infections is badly needed, which is why the failure of the HIV/AIDS vaccine trials was so tragic.
In the near term, our hope for preventing new infections arises from recent observations regarding the effectiveness of diagnosis and treatment in limiting transmission: It has been found that anti-HIV/AIDS drugs reduce the spread of the virus in several circumstances. About one third of children born to infected mothers become infected with HIV. In some instances, this transmission occurs before birth, in other instances, during birth trauma. Still others are infected through breast feeding. But evidence suggests that treating the mother with anti-HIV/AIDS drugs can dramatically reduce all three types of transmission.
Preliminary studies by Max Essex, working with a team at Harvard and in Botswana, seem to show that infection of newborns falls to undetectable rates if mothers are treated with combination therapy for the six months before and after birth, providing that the child is weaned at six months. If transmission by such intimate contact as mother to child can be reduced to near zero, it seems likely that other forms of transmission can also be reduced. Several additional studies document the effectiveness of treatment in substantially reducing sexual transmission of the virus in both heterosexual and homosexual couples. Effective treatment may even reduce infections that occur via blood directly, either by transfusion or by sharing blood-contaminated needles.
How does anti-viral therapy work to reduce transmission? The ability of a person to transmit the HIV virus to another through sex or blood, or from mother to child is correlated with the amount of virus in the body--the higher the concentration of the virus, the more efficient the transmission. Effective anti-viral treatments reduce the amount of virus in the body, thereby diminishing the likelihood of transmission: the more complete the viral suppression, the lower the odds of transmission. To summarize, not only does treatment with anti-HIV drugs prolong life, it also reduces, or may in some cases eliminate, the spread of the virus from one person to another.
History has shown that epidemics can be controlled, even in the absence of a vaccine. Both syphilis and tuberculosis were pandemic at the end of the nineteenth century, and both epidemics were controlled by effective diagnosis and treatment. So, too, might the current HIV/AIDS pandemic be slowed until vaccines are someday available.
I recommend that WHO, PEPFAR and the Global Fund begin studies to assess the effectiveness of universal testing and early treatment for the prevention of HIV transmission. The joint collaboration between Harvard Medical School and the Government of Botswana, now in the advanced planning stages, is one such study. Others should follow soon.
Meanwhile, we should also continue our efforts to control the epidemic via other means: both the fundamental and practical studies needed to create an effective HIV/AIDS vaccine should be accelerated; countries and regions should increase their efforts to promote condoms and educate the public regarding the risks of infection; and programs to encourage male circumcision, shown to reduce the risk of HIV infection, should also be implemented where appropriate.
But the continued and rapid spread of HIV infection demonstrates that such measures are not sufficient to stop the epidemic. Something more is needed. I believe that our best hope now lies in universal detection and universal treatment of all those currently HIV positive. It is time to begin. We cannot afford to wait.
Feb 24 2009, 6:14PM
Haunting Images
Last week, I witnessed a foreboding image of another sort as I stood in an unfurnished five-bedroom apartment on the 50th floor of a newly constructed building in Dubai. Neither the thick coating of desert dust nor patchy repairs concealed the two-foot-high watermark from a mysterious interior flood. Still newer towers of raw concrete loomed outside the window, some complete but unoccupied, others seemly arrested in mid-ascent, 60 to 70 floors above the sand. The view offered tiny vertical slices of sea, fragments of Palm Island and the newly opened Atlantis Hotel. Built with optimism and imagination, surrounded by the hope of glided glamour, these edifices now stand abandoned.
Like the hole seared into the World Trade Center, the view from that empty dusty apartment in Dubai now seems to beg for divination. I know that the proximal cause of this vista is the burst financial bubble, just as I knew it was denotation of a truck bomb that left the jagged crater in the center of New York City. But the ultimate consequences are still hidden from view. If our economic crisis caused this crash on this distant shore, what additional damage will it wreak upon the structures of nations and societies? Who will suffer where, when, how? Ten years on, how will we interpret this new and haunting image?
Feb 24 2009, 9:03AM
High tech at risk
The United States leads the world in scientific and technical innovation. As long as the government continues to invest in research (and it seems as if at least for now it shall), we can continue to lead the world for many years to come. The success of our economy and our competitive advantage relies in large measure on our ability to translate innovation to commerce. Interruption of the flow of invention to new business opportunities and to increases in productivity may convert short term troubles to long term failures.
Copyright © 2009 by The Atlantic Monthly Group. All rights reserved.