This month in pharma...

This month's journey through the history of pharmaceuticals and healthcare takes us back centuries to a time when George II was on the British throne (having fought off a brief Jacobite uprising), Dutch scientist Antonie van Leeuwenhoek had only recently been the first man to record bacteria and blood cells through the use of microscopes and issues of market access and value-based pricing were not quite the hot topics of discussion that they are today.

For it was on May 17, 1749, that Edward Jenner, the man responsible for the smallpox vaccine, the first medical use of the technique to prevent disease that revolutionised healthcare practice for the next 250 years, was born.

The son of a vicar, Jenner was from Berkeley, England, and grew up at a time when smallpox was rife in Europe. At age 14, he took his first step into medicine and began an apprenticeship to be a surgeon before becoming a doctor in his home town.

During his youth, Jenner experienced variolation, which is the infection of a subject with smallpox, or the variola virus, in a controlled manner so as to minimise the severity of the infection and also to induce immunity against further infection.

It had been a practice first recorded in China in the 16th century and was introduced to the UK in the early 18th century by English aristocrat Lady Mary Wortley Montagu who had seen physicians carrying out the procedure in Istanbul.

Through Montagu's influence, the popularity of variolation spread throughout the royal families of Europe, leading to uptake in the general population. It was a dangerous procedure though, with mortalities still common among those children and young adults exposed to the virus in this way.
Thoughts at the time speculated about the role of cowpox, a mild viral infection of cows that milkmaids could catch, resulting in a few days' illness and no long-term effects, in being able to prevent the onset of the far more serious smallpox virus.

Indeed, it has been suggested Jenner's work was influenced by Benjamin Jesty, who, upon noticing that employees at his farm who contracted cowpox seemed to be immune to smallpox, purposely infected his wife and two sons with the less severe virus to achieve the same effect.
Jesty received a rather hostile reception for his ideas, however, and it was Jenner who would go on to test the hypothesis and publish his work, after exposing James Phipps, the eight-year-old son of his gardener, to cowpox.

A few weeks after Phipps recovered from the effects of the infection, Jenner exposed the boy to smallpox through variolation, discovering that a form of resistance had been developed.

It may not have been a clinical trial to please Ben Goldacre and pass the rather more strict regulations found in the EU's Clinical Trials Directive, but it was one that fired the imagination and seemed a miracle solution to an epidemic problem.

Jenner went on to carry our further experiments and supply cowpox samples across the country, with the smallpox vaccination (named after 'vacca' – the Latin for cow) eventually being made compulsory in 1853.

His legacy carried on into the 20th century, with the World Health Organisation launching a campaign in 1967 to eradicate the disease worldwide, before the last natural case was treated in 1980.

Vaccination and immunisation have grown beyond just smallpox however, with the field now a key part of the profile of many pharmaceutical companies, and recent epidemics such as swine flu demonstrating their continued importance.

Statues now commemorate Jenner's memory in Tokyo and London, and many honour him as the man who has saved more lives than anyone else who has ever lived.

The Author
Tom Meek, assistant web editor at PMGroup