A doctor who travels through two eras

Professor Anthony Stephen is 55 years old and is a little white old man.

Although he looks ordinary, he is the top infectious disease expert in the United States.
His titles include professor at Harvard Medical School, director of the Harvard Institute of Epidemiology, member of the U.S. Academy of Sciences, vice president of the International Union Against Tuberculosis and Lung Disease (IUATLD), and so on.

A top expert of his level will naturally be sought after by pharmaceutical companies, and he also needs to transform his research results into clinical drugs and experience.

Therefore, in the past few years, one of the most important research topics led by Professor Anthony is the triple drug therapy of "anezolid + streptomycin + glucagon" for the treatment of pulmonary tuberculosis.

Tuberculosis is the number one infectious disease threatening humanity, causing millions of deaths worldwide every year.

Almost all capable countries are researching tuberculosis, and everyone is racing against time to see who can conquer tuberculosis first.

It might be imagined that the first doctor to conquer tuberculosis would personally receive unparalleled honor and go down in the annals of medical history.

The first pharmaceutical company to produce tuberculosis drugs will also gain access to a huge market worth tens of billions of dollars a year.

At the same time, the first hospital, organization, institute, or even country to announce the conquest of tuberculosis will gain great international reputation.

High risk and high profit. Although tuberculosis is a sword of Damocles hanging over humanity's head, it is also a tempting apple hanging on the tree. It depends on who can pick it first.

Obviously, as the most famous infectious disease expert in the United States, Professor Anthony really wants to reap this fruit.

To this end, with the sponsorship of AbbVie Pharmaceuticals, he spent hundreds of millions of US dollars and spent a full five years to develop a triple therapy for tuberculosis in India, using two new anti-tuberculosis drugs, anezolizumab and ganguromine.

Today was the research team's first secret summary meeting, but the result made him very desperate.

Professor Anthony let go of his hair, took the report data from the assistant, and asked unwillingly:

“Why is the cure rate only 32%? Could it be due to racial differences?”

Assistant Blake shrugged:

"I'm sorry, Professor. Whether it's human experiments in our country or in India, the data is not much different. The difference is that we in the United States have only conducted 1000 drug experiments, while India has conducted 9000 experiments."

If a drug is to be marketed, the safety and effectiveness of the new drug or therapy in humans must be evaluated in advance. Depending on the purpose and scope of the trial, a Phase IV clinical trial is required.

For example, Phase I clinical trials first use the drug on a small number of subjects, generally only 10-30 people, in order to preliminarily evaluate the safety and tolerability of the drug.

This first group of people being swabbed are the most dangerous because the new drug is being used on humans for the first time. Humans are completely different from laboratory mice, so the uncontrollable risks are very high, and the mortality and disability rates are very high.

Therefore, the subjects can receive a large sum of money in advance, and generally, no one will participate in such a life-threatening experiment unless they are desperate.

Of course, given the nature of pharmaceutical companies in Europe and the United States, if you don't want to spend money, you can just find some homeless people on the street, lonely elderly people and orphans in welfare homes, illegal immigrants, etc.

What if it’s even more cruel and requires healthy adults to conduct the experiment?
Then go to war-torn areas, or South America or Eastern Europe to capture a group of healthy young people, prepare a medical ship on the high seas to conduct experiments, and throw those who die directly into the sea to feed the sharks.

If the subjects are not dead, no matter what the final result of the test is, these people will be killed to silence them, and then their organs will be removed and their bodies will be fed to sharks.

Of course, you will never see this in the media, as people still have to maintain their hypocrisy and good image.

If the Phase I clinical trial is passed, then Phase II will be carried out. At this time, the number of swab subjects will need to be expanded, generally around 100 to 300 people.

The purpose is to preliminarily evaluate the effectiveness and safety of the drug. This stage also provides a basis for the design and dosage regimen of subsequent Phase III clinical trials.

The first two phases have been passed, and the next step is Phase III clinical trial.

In this phase, the new drug or therapy is used in a larger group of people, such as 1000-10000 people, to further evaluate its effectiveness and safety.

This stage is an important basis for drug registration applications, so Phase III clinical trials are very important, and most new drugs fail at this stage.

For example, the reason why Chinese patent medicines have not been able to enter the U.S. market is because they cannot pass the FDA review, and most of them dare not conduct clinical trials.

The only brave one was the "Compound Danshen Drops", which passed Phase I and Phase II clinical trials, but ultimately failed to pass Phase III and collapsed halfway, and all previous investments were wasted.

There was also the mask disease period, and some indescribable vaccine. At that time, all vaccines from pharmaceutical companies around the world had not passed Phase III clinical trials.

For example, Pfizer in the United States set up a special vaccine branch, which was launched directly on the market without even conducting Phase III clinical trials. After making enough money, it was afraid of being held accountable, so it directly cancelled the branch. Its method was extremely despicable.

Because Phase III clinical trials involve many subjects, theoretically a large sum of money needs to be paid to the first subject, so the investment is huge.

But you need five thousand or ten thousand living people to conduct the experiment. It is obviously impossible to capture homeless people or prisoners of war because the risk of exposure is too great. Once exposed, there will be no recovery.

Therefore, each pharmaceutical company or experimental team will think of another way, which is to find subjects in the third world.

For example, in India, Africa and other countries, human lives are not valuable here anyway.

More sophisticated pharmaceutical companies will also pay. For example, in the United States, a subject will be given $10, but in poor countries, only $1000 may be enough, which saves a lot of money.

Of course, there are also unscrupulous pharmaceutical companies or poor domestic traitors who have embezzled this money. In this case, they will use deception or even coercion to make the people unknowingly become guinea pigs.

For example, the Black Gold Rice incident that was exposed in India that year was that a genetically modified company provided experimental food and then used elementary school students as guinea pigs.

Are there many such cases? In fact, there are many. It is impossible for a traitor to enter the campus. Some people in India are extremely evil.

Another thing is that in hospitals in third world countries, doctors will tell patients that their disease is incurable, but they have a special medicine in hand that they would like to try.

Of course, patients are willing to give it a try as if they were grabbing a life-saving straw.

Okay, you want to give it a try. One course of treatment will cost tens of thousands or hundreds of thousands of dollars, but if you are not dead after taking N courses of treatment, you can take the medicine for free afterwards.

However, while you are taking the medicine, you must regularly check this indicator, do that examination, and then give all the results to the doctor in exchange for follow-up medication.

We won’t tell you all of them, but when encountering this kind of thing, patients should be careful, because you may have been sold and become a guinea pig, while still counting money for others.

The triple therapy tuberculosis experimental team of Harvard Medical School is also conducting a Phase III clinical trial in India, testing the drug on 9000 tuberculosis patients in India.

Unfortunately, the results were not ideal. The cure rate of 32% meant that the triple therapy of anezolid + streptomycin + glycidylamine had failed.

Although experimental data can be falsified, the 14% serious adverse reactions and the 4.4% mortality rate cannot be ignored in any way.

Asan’s life is worthless, once he dies, he dies.

However, the lives of ordinary people in European and American countries are very precious. After all, the lawyers here are more difficult to deal with. If you lose the lawsuit, the compensation is an astonishing amount of tens of millions.

(In 2004, a Los Angeles court ordered Philip Morris, the owner of the famous cigarette brand "Marlboro", to pay a smoker $280 billion in compensation for fraud and liability accidents because the old lady had lung cancer due to smoking.)
Just as everyone in the institute was reviewing why the experiment failed, a dusty middle-aged white man walked in from outside.

"Hey guys, I'm not late am I?"

The visitor was Theodore, a partner of Anthony's tuberculosis research group and a professor at Harvard Medical School. Professor Anthony looked at him and complained as if he had found someone to talk to:
"Theodore, you actually didn't have to rush back in time. I have bad news for you. Our project has failed. Fuck, we have to start all over again. How many five years do we have left?"

Professor Theodore had just returned from a World Organization meeting in Geneva and came to the institute as soon as he got off the plane.

"Anthony, are you still unwilling to accept the reality? I have known for a long time that our experiment in India has failed. When I was in charge of the project at Calicut Hospital in India, I personally rescued no less than 100 test subjects, and I also dissected 50 of them.

Such a high rate of adverse reactions and mortality means that our experiment is over. I am mentally prepared, but so what? In addition to paying the Indians, we still have a total of 3000 million US dollars left, which is enough for us to make a fortune. "

According to international unwritten rules, sponsors will generally give a medical research team a "sponsorship" for the purpose of researching a certain topic.

After completing the project, the scientific research team can put the remaining funds into their own pockets. How much money they can leave depends on whether your experiment goes smoothly and whether you save scientific research funds.

AbbVie Pharmaceuticals has sponsored Harvard Medical School with a $100 million grant to study the effectiveness and safety of two new drugs, anezolizumab and gambutolamine, in the treatment of tuberculosis.

Now the project has failed, but 30 million US dollars have already entered the pockets of the scientific research team members led by Professor Anthony and Professor Osido through various means of false accounting.

This is the same principle as when director Peter Chan falsified accounts and charged investors $6000 for a straw hat.

So for Osido, the best thing is that the project is successful, and he can gain both fame and fortune.

If the project fails, it doesn't matter much. 3000 million US dollars will be distributed to each team, and he, as the person in charge, can at least get 1000 million. Just collecting a "profit" is not bad. What else does he want?
Professor Anthony was obviously not satisfied with this answer:

"Everyone likes money, but we are infectious disease experts. I really want us to be the first team in the world to conquer tuberculosis. This way we can not only be famous all over the world, but also have as much research funding as we want in the future. This is the success in life."

Professor Theodore sat down, put a briefcase on the table and patted it twice:
"Anthony, I have to tell you another very sad news. Your dream of being the first to conquer tuberculosis has been shattered."

Professor Anthony sat up straight at once:

"What? Someone has conquered tuberculosis? Damn it, which team? Is it Cambridge Medical School? Or Sorbonne University Medical School? Or Silver's team at Columbia University? I know they have never given up on surpassing us."

Professor Theodore shrugged:

"You are all wrong. This was accomplished by a medical team that you would never have guessed. Moreover, their national news agency has publicly announced that they are the first in the world to conquer tuberculosis."

Professor Anthony was stunned after hearing this, and shouted unwillingly:
"How is it possible? How come I haven't seen this kind of sensational news? There's no news at all. I'm the vice president of the International Union Against Tuberculosis and Lung Disease. There's no reason for me not to know about it.

Theodore, which country, which medical school, or which pharmaceutical company? Is this fake news? Many people often lie and conceal information in order to defraud research funds. This is definitely an academic scandal. "

Professor Theodore chuckled, opened his briefcase and took out some documents.

"I have a few papers here. Please take a look at them first and use your smart minds and sharp eyes to evaluate whether these papers are true or false. Finally, I will announce which country has conquered tuberculosis."

Professor Anthony took one of the documents, and then other team members in the office also picked up the documents and started reading.

Because this was a "closed-book exam", Professor Anthony studied it very carefully. The title of the paper in his hand was "Pharmacological Actions and Dosage Schemes of Tuberculosis Drugs".

"Fuck! There's a new tuberculosis drug out there. I didn't even know it was Epyridamole tablets? What the hell is that name?"

Professor Theodore knocked on the table and said, "Read on, read on quickly."

"Strongly binds to the β-oxygen unit of the DNA-dependent RNA polysaccharide enzyme, inhibits bacterial RNA synthesis, and prevents the RNA transcription process..."

"Inhibits the synthesis of mycolic acid in sensitive bacteria and causes cell wall rupture..."

"It penetrates into phagocytes and enters the body of Mycobacterium tuberculosis, causing it to lose its amide group and convert into pyrazinoic acid..."

The more Professor Anthony read the paper, the more questions popped up in his mind:
"That's not right. How can a pill have so many pharmacological effects? Either this paper is fake, or this drug is not a single medicine, but a compound medicine made up of multiple drugs."

At this time, Assistant Blake also screamed:
"Oh my god, this paper says that the medical research team has treated 5000 patients, with a cure rate of 92%, a 6% improvement rate, and only a 2% mortality rate. How did they do that?"

Professor Anthony was startled, put down the paper in his hand, and snatched the information from Blake.

After a long while, the old professor began to speak sweetly again:

"Fuck, don't even mention the amazing cure rate. Just look at the mortality rate. Only two cases were caused by adverse drug reactions. The rest were almost all caused by underlying diseases. There was even one case of drowning while fishing."

Carol, another female assistant, also found it difficult to calm down at this time:
"Professor, please take a look at this paper. It seems that this medical team has done very in-depth research on tuberculosis. They even proposed to classify tuberculosis into five types based on the location of the lesion and the condition of the disease.

They are primary pulmonary tuberculosis, secondary pulmonary tuberculosis, cavitary tuberculosis, miliary tuberculosis, and tuberculous pleurisy.

They also gave a detailed theory to explain why they classified it this way. If this paper is true, then their clinical and theoretical research is definitely at the forefront of the world, and we will have no food to eat in the future. "

Another assistant also screamed:

"My paper is titled 'Clinical Research on Refractory Pulmonary Tuberculosis'. We can't even conquer basic tuberculosis, but they are already studying refractory, stubborn, and multi-drug resistant tuberculosis?"

Professor Anthony read one paper after another, and suddenly, he leaned back on his chair and threw the materials in his hand into the air.

"I don't believe it. I absolutely don't believe it. If there really is a medical team that has carried out such in-depth research, how could I not know about it at all?"

Suddenly, Professor Anthony jumped up like an angry lion, grabbed Professor Theodore's neck, shook him fiercely, and asked viciously:

"Who is it? Tell me which medical team it is? Tell me this is not true!!!"

"Let go, let go, you lunatic," Professor Theodore quickly pushed Professor Anthony aside, straightened his collar, and took out a newspaper from his briefcase.

Everyone in the office gathered around and looked at the newspaper in surprise.

"What kind of newspaper is this? It looks like Japanese."

"Stupid, this is Chinese."

"What does a Chinese newspaper have to do with a tuberculosis paper? Don't tell me that the Chinese were the first to conquer tuberculosis."

Professor Theodore snapped his fingers:
"Ladies and gentlemen, you guessed it right. The content published in this newspaper is the good news about China's conquest of tuberculosis. You see, the front-page headline is the good news.

Did you see the photo on the front page? The doctors in the photo are the scientific research team that conquered the treatment of tuberculosis. They are from the Peking Infectious Disease Hospital, and the person in charge is the young man in the photo, Lin.

In addition, the second page of the newspaper was filled with interviews with Lin, detailing how Lin led his team to invent the drug and how they developed an effective treatment plan.

And you can see pages three and four, which contain five papers, which are the materials I just distributed to you. However, these papers are all in Chinese, and I also have a complete English translation."

Anthony opened his mouth wide, not knowing how to describe his feelings, so he asked back:
"Theodore, let's not talk about the authenticity of this newspaper and these papers. Where did you get this information?" (End of this chapter)