Health past, health present, health future – the impact of medical research
Facts, figures and quotes from Leon Rosenberg and Funding First 
	ASMR Medical
Research 
Week®
June 1-8, 2002  	
Sourced from Albert and Mary Lasker Foundation, http://www.laskerfoundation.org/reports/reports.html
Life expectancy in America in 1900 was less than 50 years. Today it is 77.
In the first 50 years of the 20th Century this was largely due to reduction in infant mortality linked to improved diet, sanitation, effective weapons against infectious disease.
In the second half of the 20th Century the gains are mostly in declining mortality amongst the elderly, with life expectancy improving from 69 years in 1965 to 76 in 1996.
Death rates from heart disease and strokes have plummeted since the 1960s
But mortality from cancer, diabetes, liver and kidney disease have hardly changed.
Where have we come from?
•	The human genome has been sequenced and assembled.
•	Cells in the human brain, once thought to be rigidly programmed during early childhood, are flexible after all. Adult brain cells can be taught new tricks.
•	It is possible to make human tissues in the laboratory that will grow into new blood vessels, skin, and cartilage. The future will see more of this.
•	Stem cells from embryonic tissue offer great potential for therapy. Equally exciting, stem cells, taken from our own adult organs, will be the seeds for tissue and organ regeneration.
•	Gene therapy will work in time. 
Where are we now?
10 leading US causes of death in 1995 (Rates per 100,000)
1.	Diseases of the heart: 281
2.	Cancers: 205
3.	Stroke: 60
4.	Pulmonary diseases: 40
5.	Accidents: 34
6.	Pneumonia and influenza: 32
7.	Diabetes mellitus: 23
8.	HIV/AIDS: 16
9.	Suicide: 12
10.	Chronic liver disease: 10
Source: National Center for Health Statistics, 1997
Drop in death rates for diseases treated with drugs
(Source and time frame- from Funding First)
80% 	Early Infancy Diseases
76% 	Rheumatic Fever and Rheumatic Heart Disease
68% 	Atherosclerosis
67% 	Hypertensive Heart Disease
61% 	Ulcer of Stomach and Duodenum
41% 	Ischemic Heart Disease
41% 	Ischemic Heart Disease
31% 	Emphysema
22% 	Hypertension
Prevalence and cost of untreated disease in the United States
Uncured Disease	Approximate Prevalence	Approximate Annual Economic Cost (billions)	
Heart Disease 	56,000,000 	$128 	
Cancer 	10,000,000 	104 	
Alzheimer's Disease	4,000,000 	100 	
Diabetes 	16,000,000 	92 	
Arthritis 	40,000,000 	65 	
Depression 	17,400,000 	44 	
Stroke 	3,000,000 	30 	
Osteoporosis 	28,000,000 	10	
Where are we going?
The plagues and diseases we will control include:
•	Neurodegenerative diseases like Parkinson’s and Alzheimer’s disease
•	Spinal cord injury
•	Heart disease and stroke
•	Diseases of the immune system, including arthritis
•	Cancer
•	Skeletal disorders
•	Liver disease
•	Lung disease
•	Psychiatric diseases such as schizophrenia and bipolar disorder.
What’s the least we can expect from medical progress over the next 25 years?
•	Alzheimer’s disease and osteoporosis are strong candidates for disease prevention.
•	Many chronic diseases, including Parkinson’s disease and arthritis, will be brought under control.
•	Improved treatment of inherited disease such as sickle cell anemia can be ensured.
•	Many cancers may well be put into the category of curable diseases.
•	The clinical problem of chronic inflammation in the lungs that defines cystic fibrosis may be solved.
•	Individuals at risk for cardiovascular disease will be identified and targeted for specific preventive intervention, improving the quality and length of their lives.
•	Both neurology and psychiatry will proceed at an unprecedented pace, resulting by 2020 in more personalized therapies for brain related disorders, such as depression and schizophrenia.
•	Stem cells will provide a way to treat spinal cord injury and, perhaps, stroke. 
•	By 2025, engineered tissues—to replace blood vessels, restore vision, repair the bladder and grow liver tissues—may effectively eliminate the long waiting lists for specific organ transplantation.
•	Non-invasive surgery may be the norm in 2025 through advances in bioengineering and imaging technologies.
•	A new age of antibiotic discovery will revolutionize our ability to deal with resistant infections.
•	Drug development and success against challenging medical problems such as obesity will be accelerated as intensive research locates drug “platforms,” areas where specific pathways for complex diseases and multiple targets for drug therapies will be found.
Quotes
Sourced from Funding First documents.
“It is not just that there is more to do, there is everything to do. Biological science, with medicine bobbing somewhere in its wake, is under way, but only just under way.”
Biologist Lewis Thomas, Late Night Thoughts on Listening to Mahler's Ninth Symphony
Basic research is scientific capital...more and better scientific research is one essential to the achievement of our goal of full employment.
Vannevar Bush, Science: The Endless Frontier
“If you think research is expensive, try disease.” 
Mary Lasker
We cannot be a strong nation unless we are a healthy nation.”
Franklin D. Roosevelt
“During the 21st Century, many of the diseases that haunt humankind will be brought under control.”
The journey from discovery of DNA’s double helix to the gene tech revolution took 50 years. What will the next 50 years bring?
20th Century challenge: eradicating infectious disease – done in large measure
21st Century challenge: eradicating infectious disease – the bacteria are fighting back and the leading cause of death worldwide remains infectious disease.
Growing implantable tissues, and even whole organs, now seems entirely feasible.
“Improvements in health account for almost one-half the actual gain in American living standards in the past 50 years.”
“The health of nations is more important than the wealth of nations”
Will Durant
Fundamental research in genetics and molecular biology more than 30 years ago laid the groundwork for today’s research into the inherited mutations that contribute to cancer, birth defects, epilepsy, Alzheimer’s and Parkinson’s disease. 
Medical research is at a momentous crossroads. Only recently have we acquired a deep understanding of genetics, the immune system, and the behaviour of both normal and abnormal cells. Dazzling work in molecular biology has yielded new insight into virtually all human disease. This knowledge evokes the promise of early therapeutic intervention and even prevention, as well as the expectation that much of the cost and suffering of disease might be alleviated. The fulfilment of this promise is the unfinished business of medical science and the challenge for the turn of the century and beyond.
We cannot conquer what we will not fight.

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