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Dr David Horrobin, then Director of the Efamol Research Institute in Canada, writing in the New
Scientist in 1982, said; "Lay organisations whether charities or governments, do not fund medical
research for the sake of culture. They provide money because they believe that practical benefits
will follow. It is gradually dawning on the donors that for the past 20 years practical benefits
have not followed. During that time there have been no substantial improvements in morbidity or
mortality from major diseases that can be attributed to public funding of medical research. The much
vaunted successes in some relatively rare cancers, such as Hodgkins' disease, derive from
refinements of discoveries that were made in the mid-1950s. The only substantial advances have come
from the pharmaceutical industry. Even there, the foundation is so shaky that the two biggest
successes, the beta blockers (now widely used in treating hypertension) and the histamine-2
anatagonists (effective against stomach ulcers), had to come from the mind of one man, Jim Black".
Horrobin is not alone in his assessment and neither have things changed materially in the decade
since he wrote these words. Take the fight against cancer, for example. In the new England Journal
of Medicine in 1986, Dr John Bailar of the Harvard Medical School and Dr Elaine Smith of the
University of Iowa Medical Centre asked what progress we have made against cancer in the three
decades from 1950 to 1982? Their conclusion was that;
"We are losing the war against cancer, notwithstanding progress against several uncommon forms of
the disease, improvements in palliation, and extension of the productive years of life. A shift in
research emphasis, from research on treatment to research on prevention, seems necessary if
substantial progress against cancer is to be forthcoming."
The two researchers found that in the United States from 1950 to 1982 the overall rate of death due
to cancer had actually increased by 8.5 per cent and this during a period of unprecedented
expenditure on research and clinical investigation.
These findings, of course, contrast sharply with the picture painted by governments and by some
research funding agencies, and the results were hotly disputed. But the U.S. General Accounting
Office, in April 1987, published figures that confirmed there had been little or no improvement in
patient survival for the 12 most common cancers from 1950 to 1982, despite expenditure of $1,000
million a year on research.
The picture is no different in the United Kingdom. There has been some welcome progress in
understanding how cancer attacks the body and a few of the more uncommon forms have shown dramatic
evidence of improved treatment, such as leukemias and non-Hodgkin's lymphoma. But there has been
almost no change in very common and widespread forms of the disease such as cancer of the breast and
lungs in women, or prostate and bladder in men. At the same time, the incidence of cancer has
increased considerably, offsetting the gains that have been made.
Amongst British men, for instance, there were 2,721 deaths per million from cancers of all types
between 1971-1975: compared with 2,970 deaths per million in 1981-1985, an increase of 9 per cent.
For women, the increase over the same period was even higher, at 14 per cent.
In the February 1991 Journal of the Royal Society of Medicine, Dennis Burkitt, who discovered the
link between cancer and lack of dietary fibre, wrote that, 'Little real success has been achieved,'
and that 'most cancer research is misdirected.' Burkitt called for a new strategy focussing on
prevention because, 'medicine has waged a major war against cancer, concentrating on earlier
diagnosis and improved therapy. The war is not being won.'
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