Nobel Prize for anti-parasite drug discoveries

Image copyrightScience Photo Library

The Nobel Prize for physiology or medicine has been split two ways for groundbreaking work on parasitic diseases.

William C Campbell and Satoshi Ōmura found a new way of tackling infections caused by roundworm parasites.

Youyou Tu shares the prize for her discovery of a therapy against malaria.

The Nobel committee said the work had changed the lives of hundreds of millions of people affected by these diseases.

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Media captionSecretary of the Nobel Academy at Karolinska Institutet Urban Lendahl made the announcement

The mosquito-borne disease malaria kills more than 450,000 people each year around the world, with billions more at risk of catching the infection.

Parasitic worms affect a third of the world's population and cause a number of illnesses, including river blindness and lymphatic filariasis.

Deadly parasites

After decades of limited progress, the discovery of the two new drugs - ivermectin for river blindness and lymphatic filariasis, and artemisinin for malaria - was a game-changer.

Image copyrightCDC

Efforts to eradicate malaria had been failing - older drugs were losing their potency - and the disease was on the rise.

Prof Youyou Tu, who in the 1960s had recently graduated from the Pharmacy Department at Beijing Medical University, looked to traditional herbal medicine to find a potential therapy.

She took an extract from the plant called Artemisia annua, or sweet wormwood, and began testing it on malaria parasites.

The component, later called artemisinin, was highly effective at killing them.

Image copyrightReuters

Image captionYouyou Tu is Chief Professor at the China Academy of Traditional Chinese Medicine

Today, the drug is used around the world in combination with other malaria medicines. In Africa alone, this is saving more than 100,000 lives every year.

Tu is the 13th woman to win this Nobel Prize.

She shares the award with two men who found a treatment for another parasite - roundworm.

Their research led to the development of a drug called ivermectin, which is so successful that roundworm diseases are on the verge of eradication.

Satoshi Ōmura, a Japanese microbiologist, focused on studying microbes in soil samples. He selected a number of promising candidates that he though might work as a weapon against diseases.

Irish-born William C Campbell, an expert in parasite biology working in the US, then explored these further and found one was remarkably efficient against parasites.

Image copyrightTrinity College Dublin

Image captionDr Campbell now works at Drew University in the US

The active ingredient, avermectin, went on to become a drug known as ivermectin which is now used to treat river blindness and lymphatic filariasis.

River blindness is an eye and skin disease that ultimately leads to blindness. Lymphatic filariasis, also known as elephantiasis, causes painful swelling of the limbs. Both affect people living in some of the poorest countries in the world.

'Out of the blue'

Dr Colin Sutherland, of the London School of Hygiene and Tropical Medicine, said it was immensely gratifying that the achievements in tackling these important diseases had been recognised.

"It's come out of the blue but we are very excited that the committee recognised the importance of parasitic diseases."

The Nobel committee said: "The two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually.

Image copyrightReuters

Image captionSatoshi Ōmura has discovered more than 470 compounds during his career as a scientist

"The consequences in terms of improved human health and reduced suffering are immeasurable.''

Omura told Japanese broadcaster NHK: "I have learned so much from microorganisms and I have depended on them, so I would much rather give the prize to microorganisms.

"This is kind of a low-profile research area, but microorganisms are extremely important for humans. They can be our partners. I hope the area gets more attention because of the prize so that it can further contribute to human beings."

Previous winners of the Nobel Prize for physiology or medicine

Image copyrightSCOTT CAMAZINE/SCIENCE PHOTO LIBRARY

Image captionLast year's winners helped us to understand the brain's orienting 'GPS'

2014 - Three scientists - John O'Keefe, May-Britt Moser and Edvard Moser - fordiscovering the brain's navigating system.

2013 - James Rothman, Randy Schekman, and Thomas Sudhof for their discovery of how cells precisely transport material.

2012 - Two pioneers of stem cell research - John Gurdon and Shinya Yamanaka - were awarded the Nobel after changing adult cells into stem cells.

2011 - Bruce Beutler, Jules Hoffmann and Ralph Steinman shared the prize after revolutionising the understanding of how the body fights infection.

2010 - Robert Edwards for devising the fertility treatment IVF which led to the first "test tube baby" in July 1978.

2009 - Elizabeth Blackburn, Carol Greider and Jack Szostak for finding thetelomeres at the ends of chromosomes.

Nigeria will need three years without polio cases to be declared free of the disease

Image copyrightWHO/T.Moran

Image captionNigeria will need three years without polio cases to be declared free of the disease

Nigeria has been removed from the list of polio endemic countries in what is being regarded as a "milestone" on the quest to eradicate the disease.

The announcement by the World Health Organization (WHO), was made at a meeting of the Global Polio Eradication Initiative (GPEI) in New York.

It follows Nigeria going more than a year without a case of wild - naturally occurring - polio.

Three years without cases are required before it can be declared polio free.

The decision means there are just two endemic countries - Pakistan and Afghanistan - where transmission of the paralysing virus has never been interrupted.

Jean Gough, Unicef country representative in Nigeria, told me: "This is an important milestone, but it is too early to celebrate. We need to continue the efforts at every level if polio is to be eradicated."

Polio is spread by poor sanitation and contaminated water and usually affects children.

The virus attacks the nervous system and can cause irreversible paralysis - usually of the legs - within hours.

Image copyrightGetty Images

Image captionThis Egyptian stele (an upright stone carving) dating from 1403-1365 BC shows a priest with a walking stick and foot, deformities characteristic of polio. The disease was given its first clinical description in 1789 by the British physician Michael Underwood, and recognised as a condition by Jakob Heine in 1840. The first modern epidemics were fuelled by the growth of cities after the industrial revolution.

GPEI was established in 1988 when tens of thousands of children in more than 125 countries were paralysed by polio each year.

Partner organisations include the WHO, Rotary International and the Bill and Melinda Gates Foundation.

Challenge

Nigeria's progress against polio has been hard-fought.

In 2003, some northern states boycotted the oral polio vaccine for nearly a year after scare stories that it caused sterilisation.

It led to the virus spreading to many countries that had been declared polio free.

In 2013 nine vaccinators were shot dead in Kano. But instead of being a deterrent, it galvanised support at every level.

The Nigerian government declared polio a national health emergency and greatly increased the number of vaccinators.

And community and religious leaders voiced their support.

As a result, the number of families refusing to have their children immunised has decreased sharply.

Boko Haram

The success has come despite the Islamist militant insurgency in north-east Nigeria.

Earlier this month Unicef said half a million children had fled attacks by Boko Haram over the past five months.

Vaccine teams have been focussing attention on displaced families who have moved elsewhere in Nigeria, as well as fleeing to neighbouring countries like Cameroon, Chad and Niger.

I last visited Kano in northern Nigeria in 2005 and met Aminu Ahmed, and his son Umar - both of whom have been paralysed by polio.

Image copyrightFergus Walsh

Image captionAminu Ahmed and his son Umar both have been paralysed by polio

Like other children, Umar did not get the drops of polio vaccine and was infected, partially paralysing his right leg.

His father - who runs a charity making hand-operated tricycles for polio sufferers - has become a campaigner for polio immunisation.

I went back to meet the family. Umar is doing well at school and he now joins his father in persuading families to be immunised.

Aminu Ahmed told me: "Ten years ago, it was very common to see families saying no to the vaccine - now they all want it.

"We say you do not want your children to be unable to walk, like me."

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Polio progress

Image captionBy 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.

Image captionIn 2015, polio remains endemic in only two countries - Pakistan and Afghanistan. No new cases have been reported in Africa for the past year.

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Wild polio

Nigeria, like the rest of the world, is switching from the oral polio vaccine, given in two drops into the mouth, to an injectable, inactivated form of polio vaccine (IPV).

The oral vaccine, which contains a weakened vaccine virus, can in extremely rare cases, cause a form of polio - circulation vaccine-derived poliovirus (cVDPV).

There has been one case of cVDPV in Nigeria this year.

I met the family of the last child to be infected with wild polio.

Isau was 16 months old when he was infected in July 2014.

His right arm lies lifeless at his side - the muscles have withered and he cannot use them.

His mother, Kanduwa Ahmadu, has just given birth to another boy. She told me: "I will make sure my baby son gets all the doses of polio vaccine he needs. I know that life will be very hard for Isau."

It's more than a year since there has been a case of wild polio in Africa.

Eradicating the disease from the continent would be a huge achievement.

But health officials fear a resurgence of the disease unless efforts are continued to immunise every child.

India was declared polio free last year.

So far this year there have been 41 cases of wild polio worldwide, compared to 200 at the same point last year.

Care system gets 'biggest shake-up in 60 years'

By Nick TriggleHealth correspondent

• 1 April 2015
 
• From the sectionHealth

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Media captionDebra Hoomans, who cares for her husband, says there is "not the support"

Care in the UK

• Care in the UK: The costs you face
• How the care system works across the UK
• How the cap on care costs works
• Does the (care) cap fit?

Major changes to the care system in England are being introduced in what is being dubbed the biggest shake-up for 60 years.

The Care Act 2014 includes rights for those receiving care and those who provide it to their loved ones.

It includes standards for access to services from care homes to help in the home for tasks such as washing and dressing.

Meanwhile, NHS and care budgets are being merged in Scotland.

The Public Bodies (Joint Working) Act has been described as the most substantial reform north of the border for a generation.

It effectively forces councils and the NHS to work together to provide more streamlined services.

That aim is also a major topic of debate in England in the election campaign with the Conservatives, Labour, Liberal Democrats, UKIP and Greens all having plans for greater integration.

Policy guide: Health and care

This issue includes NHS funding, GP access and social care, particularly of older people.

But the changes coming into force in England on Wednesday apply only to the care system for older people and younger adults with disabilities.

Four major changes are being introduced:

• The creation of national eligibility criteria establishing for the first time when someone should be entitled to help - to date, it has been up to councils to set their own criteria
• A duty on councils to offer schemes by which those who need to pay for residential care can get a loan from their local council, which is then paid back from their estate after death
• Giving carers for the first time the same right to assessment and support as the people they care for; before, they had to provide "substantial care on a regular basis" to get an assessment
• Those who pay for care themselves will be entitled to go to councils to get advice and information about the care system.

To help protect people's assets, a cap on care costs they have to pay for - set at £72,000 for the over-65s - will kick in from April next year. How the cap works for younger people has still to be finalised.

Today's changes, however, still mark a major milestone in care services, which experts say have hardly changed since the current system was created along with the NHS after the Second World War.

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BBC Cost of Care project

The BBC has launched an online guide to the care system for the over-65s. The "care calculator" covers residential care and the support provided in people's own homes, for tasks such as washing and dressing.

Users can submit their postcode and find out how much each service costs where they live in the UK.

There is also a dedicated BBC Cost of Care website, with news stories, analysis and video.

• The care calculator
• Cost of Care website
• How the systems differ in the UK
• England's care cap explained

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David Pearson, president of the Association of Directors of Adult Social Services, said the changes were "probably the most significant development" since 1948.

But he said there were still issues to resolve on the underfunding of the system. Unlike the NHS, the care system budget has been cut in real terms this Parliament.

Izzi Seccombe, leader of Warwickshire council, who chairs the Local Government Association's Wellbeing Board, agreed with both points.

"Councils simply cannot afford any more financial burdens when social care services are already chronically underfunded," she said.

Janet Morrison, of the charity Independent Age, said the Care Act had the "potential to revolutionise" services.

But she said: "With a rapidly ageing population, we need an honest debate during and after the election about the true costs of care."

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