Global Public Health Leader Receives Prestigious Lasker Award for Public Service

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NEW YORK -- The 2001 Lasker Medical Research Awards were announced today. The Mary Woodard Lasker Award for Public Service in Support of Medical Research and the Health Sciences will honor William H. Foege of Emory University for his courageous leadership in improving worldwide public health, and his pivotal role in eradicating smallpox and preventing river blindness.

The Albert Lasker Awards for Medical Research, the nation's most distinguished honor for outstanding contributions to basic and clinical medical research, will be presented to three scientists who pioneered the use of mouse embryonic stem cells to create animal models of human disease, and to the founder of in vitro fertilization, a life-giving technology that continues to benefit thousands of couples who otherwise could not conceive.

Often called "America's Nobel's," the Lasker Award has been given to 63 scientists who went on subsequently to receive the Nobel Prize, including four in the last three years.


The Awards will be presented at a luncheon ceremony on Friday, September 21st at the Pierre Hotel in New York City.

"The Mary Woodard Lasker Award for Public Service in Support of Medical Research and the Health Sciences honors a tireless leader in public health whose work has led to the saving of millions of lives," said Daniel E. Koshland, Jr., Lasker Board member and Chairman of the Selection Committee. "Foege helped to unravel the mysteries of Toxic Shock Syndrome and Reyes Syndrome, issued early warnings about AIDS, and played a pivotal role in eradicating smallpox and preventing river blindness. As Director of the Centers for Disease Control from 1977-1983, he was guided by a humanitarian vision that all people – regardless of economic status, nationality, or age – should live long and healthy lives. His lifelong commitment to improving worldwide public health pays tribute to the legacy of Mary Lasker, in whose name this award is given."

The 2001 Albert Lasker Award for Basic Medical Research is shared by Mario Capecchi of the University of Utah, Martin Evans of Cardiff University (Wales), and Oliver Smithies of the University of North Carolina for the development of a powerful technology for manipulating the mouse genome with exquisite precision, which allows the creation of animal models of human disease – the so-called "knockout mice."

The 2001 Albert Lasker Award for Clinical Medical Research is presented to Robert G. Edwards of the University of Cambridge (England) for the development of in vitro fertilization, a technological advance that has revolutionized the treatment of human infertility.

Dr. Joseph L. Goldstein, Nobel Laureate in Medicine (1985) and Chairman of the international jury of researchers which selects recipients of the Lasker Awards for Basic and Clinical Research, explained the significance of this year's Awards with the following comments:

Advances in biology and medicine often depend on the development of new technologies, such as recombinant DNA (for sequencing the human genome) and the heart-lung machine (for open-heart surgery). This year's Lasker Awards honor the development of two technologies with comparable revolutionary impact.

The Basic Award honors three individuals who developed a technology, based on mouse embryonic stem cells, that allows the creation of designer strains of mice in which virtually any gene can be disabled or "knocked out." Using this knockout technology, researchers have now produced animal models for hundreds of human diseases – from A to Z (from atherosclerosis to Alzheimer's). These new laboratory models enable academic scientists to test new ideas and the pharmaceutical industry to test new drugs in ways that were not hitherto possible. Knockout mice also are providing the first clues to fundamental biological questions, such as how the brain develops in the embryo and how the immune system defends the body against invaders.

The Clinical Award honors the scientist who developed in vitro fertilization, a technology that has resulted in close to one million children for couples who were considered infertile. The first "test-tube" baby, conceived in 1978, laid the groundwork for numerous refinements and innovations in reproductive health, and it also paved the way for human embryonic stem cell research, providing the platform for the promising advances that are being heralded today."


The Lasker Awards, first presented in 1946, are administered by the Albert & Mary Lasker Foundation. In her work spanning five decades as the nation's foremost citizen-activist on behalf of medical research, the late Mary Lasker is widely recognized for her singular contribution to the growth of the National Institutes of Health, and her unflagging commitment to government funding of medical research in the hope of curing devastating diseases.

Lasker Award recipients each receive a citation highlighting their achievements, and an inscribed statuette of the Winged Victory of Samothrace, the Albert and Mary Lasker Foundation's traditional symbol of humankind's victory over disability, disease and death.

The list of the 2001 Lasker Award recipients with their current professional and institutional affiliations is included with the full press kit. All press materials are available via downloading from www.laskerfoundation.org. Additional materials include:

· additional biographical materials;
· photographs of the Awardees;
· videotaped interviews with the Awardees;
· links to websites for additional information about the Awardees and their work.

A full description of the work of Dr. Foege follows.



THE MARY WOODARD LASKER AWARD
FOR PUBLIC SERVICE IN SUPPORT OF MEDICAL RESEARCH
AND THE HEALTH SCIENCES

Presented to: William H. Foege

For his courageous leadership in improving worldwide public health, and his pivotal role in eradicating smallpox and preventing river blindness

This year's Lasker Public Service Award honors a public health physician who pioneered a new technology to eradicate disease and who has been a key figure in getting the fruits of medical research into the public health programs in developed and underdeveloped countries. With gusto and audacity, William Foege has led battles against recalcitrant microbes and tackled mysterious diseases. He played a crucial role in purging smallpox from Earth and has since guided projects aimed at eradicating other devastating infectious diseases.

Under Foege's direction, the CDC unraveled the medical enigmas of Toxic Shock Syndrome and Reyes Syndrome, and issued early warnings about how AIDS spreads. After completing his work for the government, he signed on with several nonprofit groups aimed at improving health worldwide, especially for children. Currently the Presidential Distinguished Professor at Emory University's Rollins School of Public Health, Foege gravitates toward monumental challenges; when he arrives, his drive to solve problems and his relentless optimism allow him to surmount them.

Isolate and conquer

By imagining that he was a virus, Foege beat smallpox at its own game. He outsmarted the lethal microbe by zeroing in on its next potential victims – and inoculating them with a protective vaccine. This triumph provided the blueprint that public health workers used to obliterate smallpox from the planet.

In December of 1966, Foege was running a medical center in West Africa and awaiting a large shipment of smallpox vaccine. As a consultant to the CDC, he was planning a massive immunization campaign. The goal: Inoculate as many people as possible. This strategy was expensive, but conventional public health wisdom said it was the only choice; even with 90% coverage, outbreaks still occurred.

But the germ beat the vaccine shipment. One day, Foege got word that smallpox had hit a remote region in Eastern Nigeria. He needed to act immediately to prevent an epidemic, but adequate supplies were months away. He pretended he was the virus and schemed about how to ensure his own propagation. Then he realized the key: Strike susceptible people as quickly as possible. With this insight, he knew he needed to find those individuals – before the virus did. The race was on.

Every day at 7 p.m., the coalition of missionaries that peppered the region tuned in their ham radios to make sure no one had fallen ill or needed anything. That evening, Foege joined them. With maps laid out in front of him, he divided up the area around the outbreak. The next day, each missionary sent runners to the surrounding villages, hoping to locate smallpox cases. By that night's radio call, the group had pinpointed the virus.


Foege's medical team distributed a portion of the precious vaccine to those villages. The shot wouldn't cure people who already were sick or who were well on their way to symptoms. It would, however, protect the next generation of potential victims – individuals who hadn't yet been in contact with the virus or who had been exposed very recently.

But that was only the first step. People who carried the microbe but who still felt healthy would travel to other places and expose a new round of people. To figure out where the virus would show up next, the team analyzed market patterns. Every five days, the area's inhabitants gathered to buy or sell goods at designated locations. Each of these markets served different villages, so Foege's team members could trace routes the virus might take. They identified geographic areas at highest risk and made tactical strikes with the remaining vaccine.

Two weeks later, they knew they had contained the outbreak. By building a moat of resistance around the infected people, Foege had caused transmission to sputter out even though he had vaccinated only 7-8 percent of the area's population.

He subsequently used this new strategy – called "surveillance and containment" – to fight smallpox in West Africa. The scheme wiped out the scourge in 3 years and 5 months – more than 1-1/2 years quicker than planned and under budget.


After these successes, Foege took the helm of the CDC's smallpox eradication program to combat the disease worldwide. The World Health Organization soon "borrowed" him to work on the problem in India, where the virus raged uncontrollably. In October of 1973, his team conducted its first surveillance. In May of 1974, Foege sent a telegram to WHO headquarters; it said that in one state alone, the group had discovered 10,600 cases in a single week. By continually improving surveillance and vaccination strategies, they had stamped out the virus completely a year later.

In 1977, the world bid goodbye to naturally transmitted smallpox. By tracking the virus and targeting only people who had likely been exposed, Foege and the method he developed broke the chain of transmission that extended back to the very first human case in the time of Ramses V, about 1000 BCE. Foege raised his glass in celebration of this tremendous achievement, but the heady joy had ebbed years earlier. Since his first "surveillance and containment" efforts had succeeded, he knew this success was possible; after that, it was just a matter of follow through. Foege had already moved on to new challenges.


Mysterious medical problems

By that year, he had returned to the U.S. and begun directing the CDC. In May of 1980, the agency received reports about a disturbing new phenomenon. A rash of previously healthy young women were showing up in emergency rooms in shock – with high fevers, racing pulses, and dangerously low blood pressures. Medical intervention saved many of them, but some died. At first, no one could explain this frightening trend.

Under Foege's direction, the CDC identified a risk factor for so-called "Toxic Shock Syndrome" – a new type of tampon, which provided an unusually fertile breeding ground for a toxin-producing bacterium. The manufacturer yanked the tampons from the market, and incidence of the illness plunged.

New medical riddles continually popped up to challenge Foege. In the early 1980s several studies reported cases of Reyes Syndrome – a childhood illness characterized by liver failure, trouble staying alert, and coma – associated with flu or chicken pox and aspirin. Preliminary evidence connected the disease with the aspirin rather than the infections, but the numbers weren't high enough to nail down the potential link.


Foege struggled about how to proceed. Children were dying, but he couldn't pin the blame on aspirin. He asked the American Academy of Pediatrics and others for advice. On one hand, he had a responsibility to tell the public what the studies were showing; on the other hand, he didn't want to alarm parents if the painkiller posed no hazard. Furthermore, aspirin manufacturers got wind of Foege's discussions and put enormous pressure on him not to release the results. He received phone calls at home; people told him that the CDC enjoyed a good reputation and it would be too bad if he ruined it. The manufacturers also claimed to have new information that would quash the connection with aspirin – but they never produced convincing data.

Although the studies weren't air tight, Foege decided that the public should know what the CDC knew. He released the information. Subsequently, the agency started a study with enough people to produce clear-cut results – but they aborted it early because preliminary data established that the syndrome was related to aspirin.

AIDS followed. Even before scientists had isolated the virus, his agency devised guidelines about how to foil transmission, based on epidemiological observations: avoid high-risk sexual practices and transfusions with blood products.

Foege extended the CDC's reach beyond infectious disease. He brought accidental injuries, homicides, and suicide as well as chronic diseases into the purview of the agency. By including these phenomena, he expanded the CDC's mission to include a wider swath of public health issues.


New hats, new bugs

After his tenure with the CDC ended in 1984, Foege began directing both the Carter Center and a United Nations Task Force for Child Survival. Under his leadership, the Carter Center has spearheaded efforts to obliterate River Blindness. It has deployed a drug that destroys the immature form of the River Blindness parasite to endemic regions of Africa and Central America. The medicine is reaching 25 million people a year; it not only is saving them from blindness, but is allowing them to reopen fertile lands next to streams that had been abandoned because of the high incidence of disease. Foege has also targeted Guinea worm – a water-born parasite that grows to lengths of two or three feet within its victims. This parasite is about to disappear from the world, largely because of the Carter Center's activities.

For the last several years, Foege is working as Senior Medical Advisor for the Global Health Program of the Bill & Melinda Gates Foundation to help the organization meet its objectives. This organization is striving to deliver vaccines to all children of the world, develop new vaccines against AIDS, tuberculosis, and malaria, and come up with tools to thwart diseases such as sleeping sickness that don't lend themselves to vaccination. These efforts are affording children born in poor countries new possibilities of reaching adulthood, a potential not imagined a few years ago.

With his vision and inspiring leadership, William Foege is championing the fight against forgotten diseases in the developing world. He continues to usher the planet toward his goal – a state of global health equity.