As a chemist at one of the United States’s top medical firms, Helen Lee devised a way to screen blood for a common but deadly virus. The day her test hit the market, blood banks clamoured for it, making her bosses $1-million overnight.
She was well rewarded. Before long, the company, Abbott Laboratories in Chicago, made her head of a team of scientists and handed her a budget exceeding $20-million a year to play with. The group went on to make groundbreaking discoveries, promising to generate the kinds of profits that make shareholders clasp their hands with anticipation.
A scientist could be forgiven for revelling in the achievement, but Lee and a handful of others were uncomfortable. The tests they developed were cutting edge. They were also expensive, relied on highly sophisticated equipment and demanded well-trained lab technicians. They were tests that would never benefit the people most affected by disease. They were all but worthless to the field hospitals dealing with runaway HIV in developing countries, and to inner-city clinics of the West that draw blood and take smears for HIV and chlamydia only to file the results away because sometimes the patients don’t return.
The uneasiness that took root encouraged Lee to try a drastic change of tack. She suggested refocusing the group’s work to develop medical tests that could be used in the most desperate of places, tests that were cheap and simple to use, that didn’t rely on specialised expensive equipment and that didn’t even need a reliable electricity supply or running water. It was a suggestion that didn’t get far.
”We realised pretty quick it wasn’t going to happen. There’s no money in it and big companies are not interested in it. It’s not their raison d’être,” says Lee.
Brick wall
Faced with a brick wall from industry, Lee and three fellow researchers left Abbott and Chicago to follow their ideal. Their move ended in a room in Addenbrooke’s hospital at Cambridge University, but it was the beginning of what was to be a remarkable journey.
”The first thing I had to do was fix a Venetian blind and buy some lab stools. We had an empty lab, a lot of belief and $300 000. It was a leap of will rather than a leap of faith,” says Lee.
The plan was simple. Instead of using their expertise to make money for shareholders, they would develop tests that were needed urgently by medics, but that no one else saw profits in, tests specifically aimed at picking up quickly those diseases that caused most devastation in the bleakest of settings.
At first, the challenge looked as if it might be too great. Lee’s team was forced back to the drawing board to work out simple but reliable new ways of detecting viruses and bacteria in drops of blood and urine. Other tests were needed to pick up antibodies, a sure sign that the body has raised its defences to tackle a threatening infection.
”For four or five years, we had nothing but failure. We had absolutely nothing to show for our work. We found out that innovation is not just about being clever. You need to be smart, but it’s about dealing with failure. Until you’ve got something that works, anyone can say you’ve failed and they’re right,” says Lee.
Lee’s group, which has since grown to a dozen, slowly developed ways of simplifying complex medical tests that could then be tailored to pick up different infections by tuning them to detect specific proteins, strands of genetic material and other molecules unique to the viruses and microbes that caused the diseases in their sights. Along the way, doctors from the charity Médecins sans Frontières (MSF) gave them frank but invaluable advice on what was needed most urgently and the harsh conditions the tests would be used in.
The group’s efforts focused on producing rapid tests so that field doctors know within minutes if a patient is infected with a disease, instead of having to send a vial of blood to a dedicated laboratory and await a result, sometimes weeks later. The speed of the results can make a huge difference.
Trachoma, an eye infection caused by the chlamydia bacterium, can spread through entire communities if not picked up quickly, causing widespread blindness.
Urgent need
Nowhere are such tests needed more urgently than in the hospitals that deliver babies of women who have HIV. Estimates suggest that 90% of children infected with HIV are infected by their mother’s blood and if left untreated, half do not reach their second birthday.
A simple test can allow doctors the opportunity of using anti-retroviral treatment to minimise the chance of a baby being born with the virus and to treat babies early.
Developing a simple HIV test is a huge challenge that the group is near to completing. The current tests need more than a dozen chemicals and only work properly if kept cool.
”If you’re going to ship a test kit to South Africa and then have it travel by truck to Zimbabwe, it’s going to get hot in the sun, and that will ruin it,” says Lee.
To solve the problem, her team managed to tweak the chemicals so instead of having to refrigerate the tests, they can withstand temperatures of more than 45 degrees Celsius.
”These aren’t the kinds of breakthroughs that get you publications in big journals, but without them you simply do not have a useable test,” she says.
The group has now set up a company called Diagnostics for the Real World and is about to embark on trials organised by MSF that will test the cheap, rapid test kits for HIV, chlamydia and trachoma in hospitals around the world.
If the trials go well, the fruit of eight years’ work will begin to trickle out to those communities that take the brunt of the world’s diseases. Then, says Lee, the group will set themselves a new task, to hand over production and distribution of the tests, to enable the most in need to help themselves. — Guardian Unlimited Â