A natural product is a chemical produced by nature, like penicillin, and then developed into a medicine. Nature is a very, very creative chemist!

 

Everyone knows the amazing story of Alexander Fleming, a British scientist and Nobel laureate. A pack-rat by nature, Fleming let his petri dishes pile up in the corner of his laboratory. When it finally came time to clean up, he noticed that some of the dishes were contaminated with mold and that the surrounding bacteria had died.  He figured that the mold made something that killed bacteria. He was right!  After much work, penicillin was identified, produced in bulk by American pharmaceutical companies, and used to save the lives of countless WWII GIs.

 

Fast forward to the present. Campbell, working at the Merck Research Laboratories in Rahway, NJ, was interested in treating roundworm infections. In the tradition of Fleming, he asked whether organisms grown from soil might make an antibiotic capable of killing the pests. Looking through the microscope, his staff finally found an extract that paralyzed the wriggling worms. After much work, the active ingredient was identified and called "avermectin." Merck scientists learned how to make and manufacture avermectin and a number of derivatives, leading to a number of important products for protection of livestock and domesticated animals such as HeartGard� for dogs. It was later found that ivermectin, a derivative of avermectin, cured River Blindness, a horrible worm infection that has blinded thousands of victims in Africa, Latin America, and Yemen. Former President Jimmy Carter has championed the cause to eradicate the disease with ivermectin supplied gratis by Merck. I had the pleasure of knowing Dr. Campbell during my years in the Merck Rahway lab. He was quiet and unassuming and universally respected by his colleagues for his monumental achievement. In my practice, I have used ivermectin to cure lice and scabies - it is very safe and very effective!

 

But the story gets better! The soil organism that produced avermectin came to Rahway, NJ, from __________ (Ans: Japan!). Satoshi Omura, the Japanese awardee, was famous for traveling the world and scooping soil samples into his pants pocket before returning home. He cultured many different species of Streptomyces from the soil samples and shared them with Merck. Streptomyces were already known to produce streptomycin, the antibiotic discovered by Selman Waksman at Rutgers University for which he received the Nobel in 1952. Streptomycin is credited with closing the sanitariums for tuberculosis. Merck's relationship with Omura and his Kitasato University made the discovery of avermectin possible!  We need to learn the lessons taught by this great example of international cooperation!

 

Now comes the great discovery of Youyou Tu!  You have heard of the antimalarial known as quinine, a natural product isolated from the bark of the chinchona tree, and the first important medicine to cure malaria. It was first discovered by the indigenous peoples of Peru and Bolivia and brought to Europe by the Jesuits. GIs in Vietnam came down with chloroquin-resistant malaria. Tu and colleagues found a natural product that killed these chloroquin resistant parasites, called artemisinin. Don't try to pronounce it! It works and so far, resistance has been rare!

 

What to take away from these amazing natural product discoveries? The food and vitamin industries have applied the "natural" label indiscriminately. Please remember that the Nobel was awarded to scientists who did the heavy lifting of identifying the active ingredient. In every case, the complex mixture was analyzed to find the substance with curative properties. Some say that we should use complex mixtures but I suggest otherwise. Unless the manufacturer can point to the active ingredient and demonstrate its medicinal properties, think twice before buying complex mixtures just because they are "natural."

 

I applaud those who continue to explore nature for new cures. They are the heirs to the wonderful legacy of Fleming! But let's hold them to the exemplary examples of Campbell, Omura, and Tu before we accept their breakthrough claims!

In the wake of Pope Francis' historic and inspiring visit to the United States, we hear that Horizon Blue Cross Blue Shield of New Jersey has excluded most New Jersey Catholic hospitals from their new Omnia insurance network! Where were they when Pope Frances enunciated what it means to be a modern citizen, committed to the advancement of all?

 

As detailed by Sister Patricia Codey in a guest column in the Star Ledger on October 7, Catholic hospitals serving the poor and marginalized in some of New Jersey's largest cities have been relegated to "tier 2" status. These include hospitals like St. Peters University Hospital in New Brunswick and St. Francis Medical Center in Trenton, hospitals that achieve high grades both in terms of quality and affordability. As Sister Codey points out, patients will be forced to go to other hospitals resulting in a breach in their continuity of care while at the same time making it more difficult for these critical institutions to meet their payrolls and retain their excellent staffs.

 

This move on the part of Horizon, which has been anything but transparent, confirms that their priorities are guided by profit, not the welfare of those they serve. Shame on them!

 

Fall reminds us of our predecessors, especially those who worked and suffered to advance the common good. May we be worthy of their tireless efforts and work together, as advised by Pope Francis, to make the world a better place!