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Early Chinese, Hindu, and Mediterranean civilizations created medicine from plants, animals, and minerals

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Shennong (the Divine Farmer) invented the acupuncture technique, developed herbal medicine and classified over 365 different medicinal plants and herbs. Circa 2800 B.C.

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In Ancient Greece, Hippocrates (c. 460 B.C) applied rationality and logic to the practice of medicine and believed sickness was caused by how the individual lived rather than some divine punishment

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The first pharmacopeia is published by Greek botanist and physician Dioscorides, titled "De Materia Medica (c. 50 A.D.)

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Greek Physician Galen (c. 129 A.D) made remarkable contributions to the study of human anatomy and believed "For optimum health... exercise, a balanced diet, good hygiene, and bathing" were essential

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Records of people during the medieval period using herbs for supposed healing purposes. Some indeed had healing purposes and are still used today

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Merck started as a minor apothecary shop for 150 years until Emmanuel Merck began manufacturing and selling alkaloids in 1827

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Pfizer was founded in 1849 as a fine chemical business, however during the American Civil War, demand for painkillers and antiseptics were high and Pfizer briskly expanded by filling that void

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During the interlude between the World Wars, Insulin and Penicillin was invented and was mass produced during World War 2 by Pfizer, Squibb  and Merck

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Post World War 2- pharmaceutical companies grew increasingly wealthy thanks to government subsidiaries and their products

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In 1961, the Thalidomide scandal caused an increase in regulations and testing before licensing and forced manufacturers to disclose any potential side effects

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Persian physician, Rhazes (865- 923 A.D) identifies the disease Smallpox and suggest it's caused due to an infection in the blood. He's credited with the invention of ethanol and sulfuric acid and revolutionized how diseases were diagnosed

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Zacharias Janssen invents the compound microscope (c. 1590)

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1796- Edward Jenner introduces the first vaccine for Smallpox. Since the discovery, similar concepts has been used to make other vaccines for Tuberculosis and Cholera

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Rene Lannaec invents the stethoscope (c. 1816)

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Individuals relied on themselves to remain mentally active and socially engaged.

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The method of communication was rotary dial or landline telephone.

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Before video games, kids played outside from sunup to sundown and parents trusted them to return home.

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The television displayed in black and white and other indoor activities included Jacks, Paper dolls, Go Fish, Sorry!, and Operation.

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No distractions such as electronics during dinner time.

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Without Edward Jenner's invention of the vaccine, many people, myself included, could potentially die from a manifold of deadly diseases such as tuberculosis, smallpox, tetanus/lockjaw and other preventable diseases.

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The modern pharmaceutical industry began as small apothecary shops distributing and manufacturing drugs such as morphine and quinine in the 19th century

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The emergence of modern pharmaceutical giants such as Merck, Eli Lilly, Pfizer and Squibb coincided with the rise of pharmaceutical chemistry

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Pharmaceutical firms cooperated with academic labs to research a way to kill bacteria or other invasive microbes using synthetic chemicals. This idea was first postulated in 1906 by German Nobel-prize winner and physician, Paul Ehrlich

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This led to the discovery of N-acetyl-p-aminophenol, an ingredient in Tylenol, aspirin, and the vaccines for diphtheria and tetanus

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The demand for medicine to treat pain, infectious diseases, heart conditions, and other ailments were high

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As more potent drugs were manufactured and distributed, the pharmaceutical preparation shifted from the drugstore to the factory. This lowered operational costs and smaller domestic companies were monopolized by foreign companies

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Food and beverages spoiled quickly and their shelf lives were quite short. Charles Pfizer and Charles Erhardt began to produce citric acid, making their business incredibly successful. Citric acid can be found in products from sodas and juices to candy and ice cream

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World War 1 hampered the supply line of natural fruits. Pfizer decided to hire chemist James Currie, who successfully used the mold "Aspergillus niger" to produce citric acid

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Pfizer sold the product to Coca-Cola to make their products refreshing and balanced

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The belief at that time was that profit and research should not intertwine and “[0]nly from laboratories free from any relation with manufacturers that real pharmaceutical advances can be expected.” (AMA's Council on Pharmacy, 1915)

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Humanity was plagued with conflicts in the wake of the 20th century such as World War 1 (claimed over 16 million lives) and infectious diseases such as the Spanish Flu (estimated death toll is between 30-100 million), polio, smallpox, and syphilis

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Eli Junior, grandson of pharmaceutical conglomerate Eli Lilly believed “Ideas don’t cure people. Drugs cure people. That’s why we must bring the research scientists and the drug manufacturers together.”( 1918)

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An example of this was when pharmaceutical mogul Eli Lilly was tasked with the mass production of insulin in 1922

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New York governor Charles Evan Hughes's daughter, Elizabeth was diagnosed with diabetes. He was a close associate with John D. Rockefeller Jr., who made remarkable financial contributions to the University of Toronto, where insulin was invented. This connection allowed his daughter to be the third patient to be ever treated for diabetes

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This established the precedent in which academic institutions were partnering with pharmaceutical companies to manufacture vast quantities of medicine

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An investigation by the House Oversight Committee found that big pharma intentionally gouged the prices of drugs in the U.S and discounting that same drug else where (e.g. insulin in America is 8x more expensive than it is from Canada)

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https://www.britannica.com/technology/pharmaceutical-industry/Transitions-in-drug-discovery

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In the late 19th and early 20th centuries, a number of social, cultural, and technical changes of importance to pharmaceutical discovery, development, and manufacturing were taking place. One of the most important changes occurred when universities began to encourage their faculties to form a more coherent understanding of existing information. Some chemists developed new and improved ways to separate chemicals from minerals, plants, and animals, while others developed ways to synthesize novel compounds. Biologists did research to improve understanding of the processes fundamental to life in species of microbes, plants, and animals. Developments in science were happening at a greatly accelerated rate, and the way in which pharmacists and physicians were educated changed. Prior to this transformation the primary means of educating physicians and pharmacists had been through apprenticeships. While apprenticeship teaching remained important to the education process (in the form of clerkships, internships, and residencies), pharmacy and medical schools began to create science departments and hire faculty to teach students the new information in basic biology and chemistry. New faculty were expected to carry out research or scholarship of their own. With the rapid advances in chemical separations and synthesis, single pharmacists did not have the skills and resources to make the newer, chemically pure drugs. Instead, large chemical and pharmaceutical companies began to appear and employed university-trained scientists equipped with knowledge of the latest technologies and information in their fields.

As the 20th century progressed, the benefits of medical, chemical, and biological research began to be appreciated by the general public and by politicians, prompting governments to develop mechanisms to provide support for university research. In the United States, for instance, the National Institutes of Health, the National Science Foundation, the Department of Agriculture, and many other agencies undertook their own research or supported research and discovery at universities that could then be used for pharmaceutical development. Nonprofit organizations were also developed to support research, including the Australian Heart Foundation, the American Heart Association, the Heart and Stroke Foundation of Canada, and H.E.A.R.T UK. The symbiotic relationship between large public institutions carrying out fundamental research and private companies making use of the new knowledge to develop and produce new pharmaceutical products has contributed greatly to the advancement of medicine.

Establishing the fight against infectious disease

Early efforts in the development of anti-infective drugs

For much of history, infectious diseases were the leading cause of death in most of the world. The widespread use of vaccines and implementation of public health measures, such as building reliable sewer systems and chlorinating water to assure safe supplies for drinking, were of great benefit in decreasing the impact of infectious diseases in the industrialized world. However, even with these measures, pharmaceutical treatments for infectious diseases were needed. The first of these was arsphenamine, which was developed in 1910 by the German medical scientist Paul Ehrlich for the treatment of syphilis. Arsphenamine was the 606th chemical studied by Ehrlich in his quest for an antisyphilitic drug. Its efficacy was first demonstrated in mice with syphilis and then in humans. Arsphenamine was marketed with the trade name of Salvarsan and was used to treat syphilis until the 1940s, when it was replaced by penicillin. Ehrlich referred to his invention as chemotherapy, which is the use of a specific chemical to combat a specific infectious organism. Arsphenamine was important not only because it was the first synthetic compound to kill a specific invading microorganism but also because of the approach Ehrlich used to find it. In essence, he synthesized a large number of compounds and screened each one to find a chemical that would be effective. Screening for efficacy became one of the most important means used by the pharmaceutical industry to develop new drugs.

The next great advance in the development of drugs for treatment of infections came in the 1930s, when it was shown that certain azo dyes, which contained sulfonamide groups, were effective in treating streptococcal infections in mice. One of the dyes, known as Prontosil, was later found to be metabolized in the patient to sulfanilamide, which was the active antibacterial molecule. In 1933 Prontosil was given to the first patient, an infant with a systemic staphylococcal infection. The infant underwent a dramatic cure. In subsequent years many derivatives of sulfonamides, or sulfa drugs, were synthesized and tested for antibacterial and other activities.

The first description of penicillin was published in 1929 by the Scottish bacteriologist Alexander Fleming. Fleming had been studying staphylococcal bacteria in the laboratory at St. Mary's Hospital in London. He noticed that a mold had contaminated one of his cultures, causing the bacteria in its vicinity to undergo lysis (membrane rupture) and die. Since the mold was from the genus Penicillium, Fleming named the active antibacterial substance penicillin. At first the significance of Fleming's discovery was not widely recognized. It was more than 10 years later before British biochemist Ernst Boris Chain and Australian pathologist Howard Florey, working at the University of Oxford, showed that a crude penicillin preparation produced a dramatic curative effect when administered to mice with streptococcal infections.

The production of large quantities of penicillin was difficult with the facilities available to the investigators. However, by 1941 they had enough penicillin to carry out a clinical trial in several patients with severe staphylococcal and streptococcal infections. The effects of penicillin were remarkable, although there was not enough drug available to save the lives of all the patients in the trial.

In an effort to develop large quantities of penicillin, the collaboration of scientists at the United States Department of Agriculture's Northern Regional Research Laboratories in Peoria, Ill., was enlisted. The laboratories in Peoria had large fermentation vats that could be used in an attempt to grow an abundance of the mold. In England the first penicillin had been produced by growing the Penicillium notatum mold in small containers. However, P. notatum would not grow well in the large fermentation vats available in Peoria, so scientists from the laboratories searched for another strain of Penicillium. Eventually a strain of Penicillium chrysogenum that had been isolated from an overripe cantaloupe was found to grow very well in the deep culture vats. After the process of growing the penicillin-producing organisms was developed, pharmaceutical firms were recruited to further develop and market the drug for clinical use. The use of penicillin very quickly revolutionized the treatment of serious bacterial infections. The discovery, development, and marketing of penicillin provides an excellent example of the beneficial collaborative interaction of not-for-profit researchers and the pharmaceutical industry.

Discovery and development of hormones and vitamins

The vast majority of hormones were identified, had their biological activity defined, and were synthesized in the first half of the 20th century. Illnesses relating to their excess or deficiency were also beginning to be understood at that time. Hormones, produced in specific organs, released into the circulation, and carried to other organs, significantly affect metabolism and homeostasis. Some examples of hormones are insulin (from the pancreas), epinephrine (or adrenaline; from the adrenal medulla), thyroxine (from the thyroid gland), cortisol (from the adrenal cortex), estrogen (from the ovaries), and testosterone (from the testes). As a result of discovering these hormones and their mechanisms of action in the body, it became possible to treat illnesses of deficiency or excess effectively. The discovery and use of insulin to treat diabetes is an example of these developments.

In 1869 Paul Langerhans, a medical student in Germany, was studying the histology of the pancreas. He noted that this organ has two distinct types of cells-acinar cells, now known to secrete digestive enzymes, and islet cells (now called islets of Langerhans). The function of islet cells was suggested in 1889 when German physiologist and pathologist Oskar Minkowski and German physician Joseph von Mering showed that removing the pancreas from a dog caused the animal to exhibit a disorder quite similar to human diabetes mellitus (elevated blood glucose and metabolic changes). After this discovery, a number of scientists in various parts of the world attempted to extract the active substance from the pancreas so that it could be used to treat diabetes. We now know that these attempts were largely unsuccessful because the digestive enzymes present in the acinar cells metabolized the insulin from the islet cells when the pancreas was disrupted.

One of the first successful attempts to isolate the active substance was reported in 1921 by Romanian physiologist Nicolas C. Paulescu, who discovered a substance called pancrein in pancreatic extracts from dogs. Paulescu found that diabetic dogs given an injection of pancrein experienced a temporary decrease in blood glucose levels. Although he did not purify pancrein, it is thought that the substance was insulin. That same year, working independently, Frederick Banting, a young Canadian surgeon in Toronto, persuaded a physiology professor to allow him use of a laboratory to search for the active substance from the pancreas. Banting guessed correctly that the islet cells secreted insulin, which was destroyed by enzymes from the acinar cells. By this time Banting had enlisted the support of Charles H. Best, a fourth-year medical student. Together they tied off the pancreatic ducts through which acinar cells release the digestive enzymes. This insult caused the acinar cells to die. Subsequently, the remainder of the pancreas was homogenized and extracted with ethyl alcohol and acid. The extract thus obtained decreased blood glucose levels in dogs with a form of diabetes. Banting and Best worked with Canadian chemist James B. Collip and Scottish physiologist J.J.R. Macleod to obtain purified insulin, and shortly thereafter, in 1922, a 14-year-old boy with severe diabetes was the first human to be treated successfully with the pancreatic extracts.

After this success other scientists became involved in the quest to develop large quantities of purified insulin extracts. Eventually, extracts from pig and cow pancreases created a sufficient and reliable supply of insulin. For the next 50 years most of the insulin used to treat diabetes was extracted from porcine and bovine sources. There are only slight differences in chemical structure between bovine, porcine, and human insulin, and their hormonal activities are essentially equivalent. Today, as a result of recombinant DNA technology, most of the insulin used in therapy is synthesized by pharmaceutical companies and is identical to human insulin ( see below Synthetic human proteins).

Identification of vitamins

Vitamins are organic compounds that are necessary for body metabolism and, generally, must be provided from the diet. For centuries many diseases of dietary deficiency had been recognized, although not well defined. Most of the vitamin deficiency disorders were biochemically and physiologically defined in the late 19th and early 20th centuries. The discovery of thiamin (vitamin B ₁) exemplifies how vitamin deficiencies and their treatment were discovered.

Thiamin deficiency produces beriberi, a word from the Sinhalese meaning "extreme weakness." The symptoms include spasms and rigidity of the legs, possible paralysis of a limb, personality disturbances, and depression. This disease became widespread in Asia in the 19th century because steam-powered rice mills produced polished rice, which lacked the vitamin-rich husk. A dietary deficiency was first suggested as the cause of beriberi in 1880 when a new diet was instituted for the Japanese navy. When fish, meat, barley, and vegetables were added to the sailor's diet of polished rice, the incidence of beriberi in the navy was significantly reduced. In 1897 the Dutch physician Christiaan Eijkman was working in Java when he showed that fowl fed a diet of polished rice developed symptoms similar to beriberi. He was also able to demonstrate that unpolished rice in the diet prevented and cured the symptoms in fowl and humans. By 1912 a highly concentrated extract of the active ingredient was prepared by the Polish biochemist Casimir Funk, who recognized that it belonged to a new class of essential foods called vitamins. Thiamin was isolated in 1926 and its chemical structure determined in 1936. The chemical structures of the other vitamins were determined prior to 1940.

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pharmaceutical industry - Transitions in drug discovery

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In the late 19th and early 20th centuries, a number of social, cultural, and technical changes of importance to pharmaceutical discovery, development, and manufacturing were taking place. One of the most important changes occurred when universities began to encourage their faculties to form a more coherent understanding of existing information.

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https://www.proclinical.com/blogs/2020-8/why-are-pharmaceutical-companies-important#:~:text=Pharmaceutical%20companies%20boost%20the%20global,asset%20to%20the%20global%20economy.

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https://abcnews.go.com/Health/TenWays/story?id=3605442&page=1

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10 Health Advances That Changed the World

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From vaccines to clean water, health advances have changed the world.

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https://www.europeanbusinessreview.com/6-ways-x-rays-have-helped-us/

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https://www.medicalnewstoday.com/articles/323538#infectious-diseases

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Modern medicine, or medicine as we know it, started to emerge after the Industrial Revolution in the 18th century. At this time, there was rapid growth in economic activity in Western Europe and the Americas.

During the 19th century, economic and industrial growth continued to develop, and people made many scientific discoveries and inventions.

Scientists made rapid progress in identifying and preventing illnesses and in understanding how bacteria and viruses work.

However, they still had a long way to go regarding the treatment and cures of infectious diseases.

During the 19th century, the way that people were living and working was changing dramatically. These changes affected the risk of infectious diseases and other conditions.

Industry: As more manufacturing processes became mechanized, various work-related diseases became more common. These included lung disease, dermatitis, and "phossy jaw," a type of jaw necrosis that affected people working with phosphorous, usually in the match industry.

Urban sprawl: Cities started to expand rapidly, and certain health problems, such as typhus and cholera, became more common as a result.

Travel: As people traveled between various parts of the world, they carried diseases with them, including yellow fever.

Meanwhile, scientific advances at that time started to make new treatments possible.

Scientific breakthroughs: As "germ theory" developed, scientists began to test and prove the principles of hygiene and antisepsis in treating wounds and preventing infection. New inventions included the electrocardiograph, which records the electrical activity of the heart over time.

Communications: As postal services and other communications improved, medical knowledge was able to spread rapidly.

Political changes: Democracy led to people demanding health as a human right.

The 19th and 20th centuries saw breakthroughs occurring in infection control. At the end of the 19th century, 30 percent of deaths were due to infection. By the end of the 20th century, this figure had fallen to less than 4 percent.

Louis Pasteur (1822-1895), a chemist and microbiologist from France, was one of the founders of medical microbiology.

As a professor of chemistry at the University of Lille, he and his team had the task of finding solutions to some of the problems that were affecting local industries.

Pasteur showed that bacteria caused wine, beer, and milk to go sour. Boiling and cooling a liquid, he explained, would remove the bacteria.

Together, Louis Pasteur and Claude Bernard (1813-1878) developed a technique for pasteurizing liquids.

Claude Bernard was also the first scientist to suggest using "blind" experiments to make scientific observations more objective.

Later, after investigating an epidemic among silkworms in the silk industry in the south of France, Pasteur determined that parasites were the cause. He recommended only using silkworm eggs that were healthy and had no parasites. This action resolved the epidemic, and the silk industry recovered.

Pasteur was sure that pathogens attack the body from the outside. This was the germ theory of disease. However, many scientists could not believe that microscopic beings could harm and even kill people and other comparatively large species.

Pasteur said that many diseases, including tuberculosis (TB), cholera, anthrax, and smallpox, happen when germs enter the body from the environment. He believed that vaccines could prevent such diseases and went on to develop a vaccine for rabies.

Florence Nightingale (1820-1910) was a British nurse, statistician, and writer. She did pioneering nursing work while caring for wounded soldiers during the Crimean War.

Nightingale was from a well-connected family. At first, they did not approve of her studying nursing. However, her parents eventually agreed that she could take a 3-month nursing course in Germany in 1851. By 1853, she was the superintendent of a women's hospital in Harley Street, London.

The Crimean War broke out in 1854. Sidney Herbert, the Minister for War, asked Nightingale to lead a team of nurses in the military hospitals in Turkey. She arrived in Scutari, Turkey in 1854 with 34 nurses whom she had trained.

Nightingale was shocked by what she saw. Exhausted medical staff members were tending to wounded soldiers in unbearable pain, many of whom were dying unnecessarily, while the officials in charge remained indifferent. A lack of medication and poor hygiene standards led to mass infection.

Nightingale and her team worked tirelessly to improve hygiene and provide patient services, including cooking facilities and a laundry. Under her influence, the fatality rate fell by two-thirds.

In 1860, Nightingale founded a training school for nurses in London. Nurses who trained there went on to work all over the United Kingdom.

They took with them everything that they had learned about sanitation and hygiene, proper hospital planning, and the best ways to achieve health.

Nightingale's work also marked a turning point for women, who took on a more significant role in medical care.

Many of her practices still apply today.

1800: British chemist and inventor Humphry Davy described the anesthetic properties of nitrous oxide, known as laughing gas.

1816: Rene Laennec, a French doctor, invented the stethoscope and pioneered its use in the diagnosis of chest infections.

1818: James Blundell, a British obstetrician, performed the first successful blood transfusion on a patient who had hemorrhaged.

1842: Crawford Long, an American pharmacist and surgeon, was the first doctor to give a patient inhaled ether anesthesia for a surgical procedure.

1849: Elizabeth Blackwell, an American, became the first fully qualified female doctor in the United States and the first female to be on the U.K.'s Medical Register. She promoted the education of women in medicine.

1867: Joseph Lister, a British surgeon and a pioneer of antiseptic surgery, successfully used phenol - then known as carbolic acid - to clean wounds and sterilize surgical instruments, resulting in a reduction in postoperative infections.

1879: Pasteur produced the first laboratory-developed vaccine, which was against chicken cholera.

1881: Pasteur developed an anthrax vaccine by attenuating the anthrax bacterium with carbolic acid. He demonstrated its effectiveness to the public using 50 sheep. All 25 of the unvaccinated sheep died, but only one vaccinated sheep perished, probably from an unrelated cause.

1882: Pasteur managed to prevent rabies in Joseph Meister, a 9-year-old boy, using a postexposure vaccination.

1895: Wilhelm Conrad Röntgen, a German physicist, discovered X-rays by producing and detecting electromagnetic radiation in this wavelength range.

1897: Chemists working in the German company Bayer AG produced the first Aspirin. It was a synthetic version of salicin, which they derived from the plant species Filipendula ulmaria (meadowsweet). Within 2 years, it became a global commercial success.

1901: Karl Landsteiner, an Austrian biologist and physician, identified the different blood types and classified them into blood groups.

1903: A Dutch doctor and physiologist called Willem Einthoven invented the first practical electrocardiogram (ECG or EKG).

1906: Frederick Hopkins, an English biochemist, discovered vitamins and suggested that vitamin deficiencies were the cause of scurvy and rickets.

1921: Medical scientists Sir Frederick Banting, a Canadian, and Charles Herbert Best, an American-Canadian, discovered insulin.

1923-1927: Scientists discovered and used the first vaccines for diphtheria, pertussis (whooping cough), tuberculosis (TB), and tetanus.

1928: Sir Alexander Fleming, a Scottish biologist and pharmacologist, discovered penicillin, which came from the mold Penicillium notatum. This discovery changed the course of history, saving millions of lives.

1929: The German doctor Hans Berger discovered human electroencephalography, making him the first person to record brain waves.

1932: Gerhard Domagk, a German pathologist and bacteriologist, developed a cure for streptococcal infections and created Prontosil, the first antibiotic on the market.

1935: Max Theiler, a South African microbiologist, developed the first successful vaccine for yellow fever.

1943: Willem J. Kolff, a Dutch doctor, built the world's first dialysis machine. He later pioneered artificial organs.

1946: American pharmacologists Alfred G. Gilman and Louis S. Goodman discovered the first effective cancer chemotherapy drug, nitrogen mustard, after noticing that soldiers had abnormally low levels of white blood cells following exposure to nitrogen mustard.

1948: American chemists Julius Axelrod and Bernard Brodie invented acetaminophen (paracetamol, Tylenol).

1949: Daniel Darrow recommended using oral and intravenous rehydration solutions to treat diarrhea in infants. With Harold Harrison, he created the first electrolyte-glucose solution for clinical use.

1952: Jonas Salk, an American medical researcher and virologist, invented the first polio vaccine. Salk was hailed as a "miracle worker," because polio had become a serious public health problem in the U.S. after World War II.

1953: Dr. John Heysham Gibbon, an American surgeon, invented the heart-lung machine. He also performed the first ever open-heart surgery, repairing an atrial septal defect, also known as a hole in the heart.

1953: Swedish physicist Inge Edler invented medical ultrasonography (echocardiography).

1954: Joseph Murray carried out the first human kidney transplant, which involved identical twins.

1958: Rune Elmqvist, a doctor and engineer, developed the first implantable pacemaker. He also developed the first inkjet ECG printer.

1959: Min Chueh Chang, a Chinese-American reproductive biologist, carried out the in vitro fertilization (IVF) that later led to the first "test tube baby." Chang also contributed toward the development of the combined oral contraceptive pill, which the FDA approved in 1960.

1960: A group of Americans developed the technique of cardiopulmonary resuscitation (CPR). They tested it successfully on a dog first, and the technique saved a child's life shortly afterward.

1963: Thomas Starzl, an American physician, performed the first human liver transplant, and James Hardy, an American surgeon, carried out the first human lung transplant.

1963: Leo H. Sternbach, a Polish chemist, discovered diazepam (Valium). Throughout his career, Sternbach also discovered chlordiazepoxide (Librium), trimethaphan (Arfonad), clonazepam (Klonopin), flurazepam (Dalmane), flunitrazepam (Rohypnol), and nitrazepam (Mogadon). John Enders and colleagues developed the first measles vaccine.

1965: Harry Martin Meyer, an American pediatric virologist, co-developed the rubella vaccine. It became available in 1970.

1966: C. Walton Lillehei, an American surgeon, carried out the first successful human pancreas transplant. Lillehei also pioneered open-heart surgery, as well as new equipment, prostheses, and techniques for cardiothoracic surgery.

1967: Christiaan Barnard, a South African cardiac surgeon, carried out the first human-to-human heart transplant. Maurice Hilleman, an American microbiologist and vaccinologist, produced the first mumps vaccine. Hilleman developed over 40 vaccines, more than anybody else.

1971: Raymond Vahan Damadian, an Armenian-American medical doctor, discovered the use of magnetic resonance imaging ( MRI) for medical diagnosis. In the same year, Sir Godfrey Hounsfield, a British electrical engineer, presented the computed tomography (CT or CAT) scan machine that he had developed.

1978: Doctors recorded the last fatal case of smallpox.

1979: George Hitchings, an American doctor, and Gertrude Elion, an American biochemist and pharmacologist, made important breakthroughs with antiviral medications. Their pioneering work eventually led to the development of azidothymidine (AZT), an HIV drug.

1980: Dr. Baruch Samuel Blumberg, an American doctor, developed the hepatitis B diagnostic test and vaccine.

1981: Bruce Reitz, an American cardiothoracic surgeon, successfully performed the first human heart-lung combined transplant procedure.

1985: Kary Banks Mullis, an American biochemist, made improvements to the polymerase chain reaction (PCR), making it possible to generate thousands and possibly millions of copies of a specific DNA sequence.

1985: Sir Alec John Jeffreys, a British geneticist, developed the techniques for DNA fingerprinting and profiling that forensic departments now use worldwide. These techniques also resolve problems not relating to crime, such as paternity disputes.

1986: Eli Lilly launched fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI) class antidepressant that doctors prescribe for several mental health problems.

1987: The U.S. Food and Drug Administration (FDA) approved the first statin, lovastatin (Mevacor). Statins can reduce LDL cholesterol levels by up to 60 percent, reducing the risk of heart disease and stroke.

1998: James Alexander Thomson, an American developmental biologist, derived the first human embryonic stem cell line. He later found a way to create stem cells from human skin cells.

2000: Scientists completed the draft Human Genome Project (HGP). The project involves collaborators from around the world.

It aims to:

determine the sequence of chemical base pairs that make up DNA

identify and map all 20,000-30,000 or so genes of the human genome

The project may lead to the development of new medications and treatments to prevent or cure genetically-based diseases.

2001: Dr. Kenneth Matsumura created the first bio-artificial liver. This could lead to scientists creating artificial livers for transplantation or other techniques that enable a damaged liver to renew itself.

2005: Jean-Michel Dubernard, a French transplant specialist, carried out a partial face transplant on a woman whose face became disfigured as a result of a dog attack. In 2010, Spanish doctors carried out a full-face transplant on a man who had been in a shooting accident.

Research continues to move medical science forward. Some of the areas that scientists are working on now include:

Targeted cancer therapy: Doctors are starting to use a new class of drug called biologics to treat cancer and other diseases. Unlike conventional chemotherapy, which can destroy fast-growing healthy cells, these drugs target specific proteins on cancer cells and cause less damage to the whole body.

HIV treatment: The effectiveness of HIV treatment is now such that people who take the medication regularly will not pass on the virus. The amount of the virus in their blood, known as viral load, is almost zero.

Stem cell therapy: Scientists are working on making human tissue and even whole organs from stem cells. This technique could one day help in treatments ranging from wound healing to prosthetics and replacement livers.

Gene therapy: A type of genetic engineering known as CRISPR gene editing may make it possible in the future to prevent genetic and inherited conditions, such as heart disease, leukemia, cystic fibrosis, and hemophilia.

Robotics: Robotics and remote-controlled tools can already help surgeons carry out certain types of procedure. One day, surgeons may carry out all operations by controlling the movements of a surgical robot while looking at a monitor. This could enable greater precision and remove some of the risks of human error.

On a different scale, medical supply companies have already used drones to deliver medicines to remote areas of the world.

While modern medicine continues to make headway, some significant challenges remain.

One is the upsurge of antibiotic resistance, partly in response to the overuse of antibiotics and also because pathogens, or germs, are adapting to resist them.

Another is the increase in pollution and environmental hazards.

While the 20th century saw a massive drop in fatalities from infection, future centuries could see that number rise again.

It is not yet time to sit back and relax.

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Modern medicine: Infectious diseases, timelines, and challenges

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Medicine has made huge strides in the last 200 years. Antibiotics, antiseptic, and vaccines are relatively recent inventions, and yet scientists are now able to create new tissue from just cells. Read our overview of some of the significant changes in medicine since the 18th century.

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Detailed information on herbal medicine and warnings for use of herbal supplements, including Black cohosh, Echinacea, Evening primrose, Feverfew, Garlic, Gingko biloba, Ginseng, Goldenseal, Green tea, Hawthorn, Saw palmetto, and St. John's wort.

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Published Online

February 7, 2006

Last Edited

May 1, 2019

Since time immemorial Indigenous peoples in Canada have been using plants and other natural materials as medicine. Plant medicines are used more frequently than those derived from animals. In all, Indigenous peoples have identified over 400 different species of plants (as well as lichens, fungi and algae) with medicinal applications. Medicine traditions - the plants used, the ailments treated, protocols for harvesting and application, and modes of preparation - are similar for Indigenous peoples across the country. In many Indigenous communities, there are recognized specialists trained in traditional medicine, and their practice often reflects spiritual aspects of healing as well as physical outcomes. In many cases, the therapeutic properties of Indigenous medicines are attributable to particular compounds and their effects on the body, but in other instances, their application is little understood by western medical practitioners. Within Indigenous communities, specific methods of harvesting and preparation of medicines are considered intellectual property of particular individuals or families.

Since time immemorial Indigenous peoples in Canada have been using plants and other natural materials as medicine. Plant medicines are used more frequently than those derived from animals. In all, Indigenous peoples have identified over 400 different species of plants (as well as lichens, fungi and algae) with medicinal applications. Medicine traditions - the plants used, the ailments treated, protocols for harvesting and application, and modes of preparation - are similar for Indigenous peoples across the country. In many Indigenous communities, there are recognized specialists trained in traditional medicine, and their practice often reflects spiritual aspects of healing as well as physical outcomes. In many cases, the therapeutic properties of Indigenous medicines are attributable to particular compounds and their effects on the body, but in other instances, their application is little understood by western medical practitioners. Within Indigenous communities, specific methods of harvesting and preparation of medicines are considered intellectual property of particular individuals or families.

Content Disclaimer: The information provided here is not intended as medical advice. The use of any medicines should be done in consultation with a trained physician or healthcare provider. As well, The Canadian Encyclopedia recognizes and respects that the rights to specific medicinal teachings are community-held and does not claim ownership over the below knowledge.
History of Indigenous Medicine

The use of medicinal plants has been a part of people's healing traditions worldwide, probably from humans' earliest beginnings. Among Indigenous peoples in Canada, the origin of some medicinal applications is chronicled in stories, such as in the Siksika (Blackfoot) narrative of how a woman named Last Calf, who had tuberculosis, gave food to a beaver, who in turn gifted her with a vision of a cure for her ailment. She was told to boil the pitch of the lodgepole pine ( Pinus contorta)in water and drink the infusion, while singing a special song. After following these instructions, Last Calf was cured.

When Europeans and other newcomers arrived in Canada, they quickly learned about and adopted many of the plant medicines used by Indigenous peoples. One famous example is how French explorer Jacques Cartier and his crew, suffering from scurvy when they were overwintering at Stadacona (now Quebec City) in 1536, were saved by local Haudenosaunee. The Haudenosaunee brought them a coniferous tree (which Cartier named "tree of life") and told them how to prepare it as a medicine. In turn, Indigenous peoples in Canada learned to use medicines from Europe and other parts of the world, such as the latex of the common dandelion ( Taraxacum officinale) to remove warts, or the fragrant pineappleweed ( Matricaria discoidea) to make a medicinal tea.

New diseases were also introduced by the Europeans. Smallpox, measles, tuberculosis, and some venereal diseases were not originally known or widespread in Canada, but soon after European contact, spread in epidemic proportions among the Indigenous populations. Existing medicines were applied to treat these new ailments, and in some cases new medicines were developed. For example, sweetflag ( Acorus americanus),already an important medicinal plant of the boreal forest region and eastern Canada, was used to treat smallpox. Barestem lomatium ( Lomatium nudicaule), called q'əxmín in a number of West Coast languages, was used to treat tuberculosis, and came to be known as "Indian consumption plant." Diabetes has become prevalent among Indigenous populations, and traditional medicines, such as the inner bark of devil's-club ( Oplopanax horridus, a shrub in the ginseng family, Araliaceae), have been adapted to treat this new disease.

How Are Indigenous Medicines Used?

For Indigenous peoples in Canada and elsewhere in the world the line between food and medicine is blurred. There is a notable overlap between plant species that are edible and those with recognized medicinal qualities.

All different parts of plants - roots and underground parts, bark, leaves, buds, flowers, fruits, and sap or pitch - have had recognized medicinal uses, and there are many different modes of preparing and applying them. Medicinal plants contain a range of diverse organic compounds, including alkaloids, glycosides, tannins, flavonoids, resins and volatile, or essential oils. The quantities of these compounds vary with the lifecycle stage, plant part, location, and genetic makeup of the plant, as well as what the weather was like recently and which plants are growing nearby. The specific compounds may interact in different ways to produce therapeutic effects.

Medicinal plants are treated with great reverence and respect, in acknowledgement of their gifts and service to people. Healers carefully prepare themselves for their work, and follow strict cultural protocols relating to harvesting, preparing and administering their medicines. Although some types of healing require particular spiritual preparation, traditionally healers and shamans in Canada have not relied on mind-altering plants or mushrooms to the same extent as in parts of central and South America. Healers do undergo particular purification rituals to give them special energy that often involve fasting and taking certain preparations of plants as emetics or purgatives said to give them the powers required to do their work. There is often no strict division between physical and spiritual aspects of healing.

Common Medicinal Plants in Canada

The following table provides examples of some well-known medicinal plants, widely used by Indigenous peoples in Canada, and listed in alphabetical order of their scientific names.

Plant

Applications and Notes

Abies species (true firs family)

Contains a range of aromatic compounds, resins, tannins and volatile oils. Liquid pitch from bark blisters, bark needles and cones are used; pitch and needles used as poultice for sores, wounds, bruises, cuts, sprains, burns, bites, and infections; pitch and tea of bark or branches used to treat sore throat, coughs, colds, tuberculosis, digestive tract ailments, and as tonic and purgative; pitch also used in eye medicine, hair tonic, and deodorant; incense from boughs used to treat headaches, lung problems, and for spiritual protection.

Species used include amabilis fir ( A. amabilis), balsam fir ( A. balsamea) grand fir ( A. grandis), subalpine fir ( A. lasiocarpa); used across Canada by virtually every Indigenous group where any of these species occur.

Achillea millefolium ( yarrow)

Contains aromatic compounds including menthol and thujone; leaves, roots and flowers all used; leaves chewed for colds and coughs; leaves or roots used as a poultice for sores, cuts (said to stop bleeding), abscesses, burns, boils, skin rashes, and broken bones; also for bronchitis and coughs; leaves or whole plants soaked in water to make a shampoo; tea of the leaves drunk as a blood purifier, for diarrhoea, stomach cramps, vomiting, nausea, colds, coughs, sore throat, headache, toothache, fever, convulsions, and rheumatism; used as diuretic and for liver troubles; plants used in childbirth, lactation and for gynaecological problems; also for insect bites and as a smudge or solution, for repelling insects and as a scent and air freshener.

One of the most widely used medicinal plants in the world; used by virtually all Indigenous peoples across Canada.

Acorus americanus (American sweetflag)

(photo by Jack Greenlee, US Forest Service/Wikimedia CC)

Plants contain a complex mix of aromatic and other compounds; used in traditional medicine by both First Nations and early settlers; thick root systems (rhizomes) are the main medicinal part; used as a panacea and to treat a broad spectrum of ailments: upset stomach, sore throat, colds and coughs, respiratory and lung ailments like pneumonia, toothache, earache, heart disease, headache, cramps, sore chest, cholera, and smallpox. It was also taken by women after childbirth. Today, powwow singers nibble on the rhizomes to enhance their voices.

An important medicine for Cree, Mi'kmaq, Algonquin and Haudenosaunee among other Indigenous peoples; it was widely traded and transplanted along trade and settlement routes across Canada.

Alnus species ( alders)

The bark of alders is the main medicinal component; infusion or decoction of the bark of various species (e.g. A. incana, A. rubra) used as an emetic, laxative and diuretic, and for toothache, internal bleeding, haemorrhaging lungs, cramps, coughs, and tuberculosis; also used as a wash or salve for skin ailments, mouth sores and infections.

Alder species were used as medicines by Indigenous peoples across Canada, wherever alders are found; researchers have found strong antibiotic properties in alder bark extracts, effective against a range of bacterial pathogens.

These aromatic shrubs or herbaceous perennials are widely used, as infusions or inhalants, to treat colds, coughs, and respiratory ailments. They are also prepared as washes or poultices for wounds, skin irritations and infections, blisters, sprains, sores and swellings, or as a bathing solution for rheumatism, arthritis and muscular aches and pains. Several species are also burned on ceremonial occasions as protective smudges or incenses. Some of the key species used include field wormwood ( A. campestris), "caribou leaves" ( A. tilesii), northern wormwood ( A. frigida), wild tarragon ( A. dracunculus), white sagebrush ( A. ludoviciana), and big sagebrush ( A. tridentata).

There are over 20 species of Artemisia native to different regions of Canada, and many of them are used medicinally. They contain a range of aromatic compounds that give them their distinctive fragrance; some are considered too strong to be taken internally.

There are two species of wild ginger native to Canada: A. caudatum in the west, and A. canadense in the east. Both are similar and used in similar ways by Indigenous peoples within their range. They contain essential oils (including asarone) that give the plants their spicy flavour and fragrance and are said to have antibacterial properties.

Cornus sericea (red-osier dogwood, or "red willow")

(photo by Matt Lavin/Flickr CC)

This shrub, especially its inner bark in the form of a poultice or infusion, is used to treat a range of afflictions from wounds, sores, cuts and infections, to toothache, liver troubles, colds, coughs, tuberculosis and chest congestion, as well as paralysis. It is said to stop bleeding and alleviate pain. An infusion of the inner bark is used by some as an eyewash for sore eyes. It is also drunk by athletes and those in training as an emetic and strengthener.

Red-osier dogwood is used medicinally by Indigenous peoples across Canada, with many anecdotal accounts of efficacy.

Heracleum species contain furanocoumarins, compounds that are phototoxic, causing blistering and irritation of the skin in the presence of ultraviolet light (e.g. sunlight). They should be used only with great care and expertise.

Juniperus species ( junipers)

(photo by Nikita Tiunov/Flickr CC)

Junipers are widely known as sources of flavouring and incense in many parts of the world. The round, berry-like seed cones are particularly potent, but the boughs with or without these cones are strongly aromatic due to resins and volatile oils. (Note: the essential oils of junipers can be toxic and possibly carcinogenic.) Infusions or decoctions of juniper are taken to treat coughs, lung disease, tuberculosis, stomach pains, indigestion, vomiting and kidney troubles among other ailments. Juniper is also used as a bathing solution, inhalant or in sweatbathing to alleviate arthritic and rheumatic pains, chest pains, headaches, wounds, sprains and as a shampoo. Juniper is also burned as an incense for ceremonial protection, and is used as a cleansing wash to protect against illness or any evil influences.

There are five species of juniper native to Canada: two ( J. communis, J. horizontalis) are shrubs with a wide range, including in the boreal forest, and three ( J. maritima on the west coast, J. scopulorum in the western interior and J. virginiana, in southeastern Canada) are small trees. Junipers are sometimes also called redcedar, not to be confused with trees of the genus Thuja.

Mentha arvensis (field mint)

(photo by Andrey Zharkikh/Flickr CC)

The minty smell of this and other mint species is due to menthol and other volatile oils. Many Indigenous peoples turn this plant into a beverage, but also drink it as a medicinal tea to treat colds, coughs, chest pains, stomach pains and heart ailments. It is also believed to help prevent illness, such as flu.

This mint is circumpolar in distribution and can be found in marshes and other wet places across Canada.

In some places devil's-club has become quite rare and there are concerns around its commercialization. The green inner bark of the stems and roots is the most common part used.

Picea species ( spruces)

Spruces are used medicinally by virtually all Indigenous peoples in Canada. The aromatic pitch and gum are particularly well known as medicinal salves, applied externally as a poultice for cuts, wounds, and infections, as well as for sore throats, heart trouble, rheumatism, back ache, and stomach troubles. Spruce gum is chewed as a laxative and taken by women as a postpartum medicine. Spruce gum and spruce bark are also used to treat colds, coughs, influenza and as a general tonic. The inner bark, as well as being edible, has been taken as a laxative. A medicinal tea can be made from the green needled twigs, and people sometimes chew on the very young buds and shoots, which are a good source of vitamin C. Spruce boughs are also used for ritual protection and purification. Sometimes people maintain "pitch trees" over generations.

There are five species of spruce native to Canada: P. glauca (white spruce) and P. mariana (black spruce) grow across Canada in the boreal forest; P. rubens (red spruce) grows in eastern Canada and P. sitchensis (Sitka spruce) and P. engelmannii (Engelmann spruce) in western Canada. These species sometimes hybridize.

Populus balsamifera; (cottonwood or balsam poplar)

The fragrant, resinous buds are used widely to make healing salves, applied to open sores, wounds and infections. An infusion of the buds is drunk for coughs, sore throats, and tuberculosis. The roots, bark and leaves are also used medicinally. For example, the Nuxalk of BC use the leafy branches in a sweatbath to treat body and lung pains, and the Algonquin make a healing salve from the roots as well as the buds.

The inner bark of cottonwoods has been used as a food by some Indigenous peoples. Cottonwood, like willows, contains the analgesic salicin.

Prunus species ( cherries)

(photo by Ryan Hodnett/Flickr CC)

Cherry bark, leaves, unripe fruits and pits contain cyanide-producing glycosides, and can be harmful if taken in excess. Nevertheless, cherry bark, as an infusion, is well known to Canada's Indigenous peoples as a remedy for coughs, bronchitis, and colds, and has also been used to treat heart trouble, blood poisoning, infections, tuberculosis and smallpox. It is also used as a general tonic.

There are several species of cherry native to Canada, the most common being choke cherry ( P. virginiana) and pin cherry ( P. pensylvanica); both are used medicinally.

This plant was once used as a pharmaceutical to treat high blood pressure, but was replaced by drugs with more predictable and consistent physiological effects.

Commercial Uses of Indigenous Medicines

Of the approximately 400 species of medicinal plants, lichens, fungi and algae documented as used by Indigenous peoples in Canada, few have been exhaustively analysed chemically or tested in clinical trials. However, a number of the plants used medicinally by Indigenous peoples in Canada have been adopted more widely and incorporated into western medicine. In the past century, for example, cascara bark ( Rhamnus purshiana) from British Columbia was harvested commercially for the pharmaceutical industry for use as a laxative medicine. Other plants like kinnikinnick, or uva ursi ( Arctostaphylos uva-ursi), wild ginger ( Asarum caudatum), blue cohosh ( Caulophyllum thalictroides), goldthread ( Coptis trifolia), echinacea ( Echinacea purpurea) and witchhazel ( Hamamelis virginiana) have also harvested commercially, and, more recently, with the discovery of the anticancer drug Taxol in the bark of Pacific yew ( Taxus brevifolia), yew bark was heavily exploited, leading to a decline in the populations of this slow-growing and relatively uncommon tree of western Canada. Another valued medicinal plant, roseroot ( Rhodiola rosea), of northern Canada has been recently highlighted as an "adaptogen," a medicine to help the body resist stress and increase energy, endurance and strength. Plants growing under particular environmental conditions, such as mineral rich soils, are also being highlighted for their healing qualities. In fact, many herbal medicines are being "rediscovered" for their healing and health-maintaining properties, and research on their phytochemical properties, efficacy and applications is ongoing.

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Share Citation Suggest an Edit Published Online February 7, 2006 Last Edited May 1, 2019 Since time immemorial Indigenous peoples in Canada have been using plants and other natural materials as medicine. Plant medicines are used more frequently than those derived from animals.

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The 21st century pharmaceutical and biotech sector has come a long way from its roots in 19th century pharmacy. pharmaphorum looks at its evolution over the centuries.
The roots of the pharmaceutical industry lie back with the apothecaries and pharmacies that offered traditional remedies as far back as the middle ages, offering a hit-and-miss range of treatments based on centuries of folk knowledge.

But the industry as we understand it today really has its origins in the second half of the 19th century. Whilst the scientific revolution of the 17th century had spread ideas of rationalism and experimentation, and the industrial revolution had transformed the production of goods in the late 18th century, the marrying of the two concepts for the benefit of human health was a comparatively late development.

Merck in Germany was possibly the earliest company to move in this direction. Originating as a pharmacy founded in Darmstadt in 1668, it was in 1827 that Heinrich Emanuel Merck began the transition towards an industrial and scientific concern, by manufacturing and selling alkaloids.

Similarly, whilst GlaxoSmithKline's origins can be traced back as far as 1715, it was only in the middle of the 19th century that Beecham became involved in the industrial production of medicine, producing patented medicine from 1842, and the world's first factory for producing only medicines in 1859.
America's pharmaceutical founding fathers
Meanwhile in the USA, Pfizer was founded in 1849 by two German immigrants, initially as a fine chemicals business. Their business expanded rapidly during the American civil war as demand for painkillers and antiseptics rocketed.

Whilst Pfizer was providing the medicines needed for the Union war effort, a young cavalry commander named Colonel Eli Lilly was serving in their army. A trained pharmaceutical chemist, Lilly was an archetype of the dynamic and multi-talented 19th century American industrialist, who after his military career, and trying his hand at farming, set up a pharmaceutical business in 1876. He was a pioneer of new methods in the industry, being one of the first to focus on R&D as well as manufacturing.

Another military man in the drugs business was Edward Robinson Squibb, who as a naval doctor during the Mexican-American war of 1846-1848 threw the drugs he was supplied with overboard due to their low quality. He set up a laboratory in 1858, like Pfizer supplying Union armies in the civil war, and laying the basis for today's BMS.

"Whilst Pfizer was providing the medicines needed for the Union war effort, a young cavalry commander named Colonel Eli Lilly was serving in their army"

Switzerland also rapidly developed a home-grown pharmaceutical industry in the second half of the 19th century. Previously a centre of the trade in textiles and dyes, Swiss manufacturers gradually began to realise their dyestuffs had antiseptic and other properties and began to market them as pharmaceuticals, in contrast to the origin in pharmacies of other enterprises. Switzerland's total lack of patent laws led to it being accused of being a "pirate state" in the German Reichstag. Sandoz, CIBA-Geigy, Roche and the Basel hub of the pharmaceutical industry all have their roots in this boom.
1900s - Aspirin arrives
It wasn't just Swiss companies that had their roots in the dye trade. Bayer was founded in 1863 as a dye maker in Wuppertal, the hometown of Karl Marx's collaborator Friedrich Engels. It later moved into medicines, commercialising aspirin around the turn of the 20th century, one of the most successful pharmaceuticals ever at that point.

The unregulated nature of the trade in medicines during this period ensured there was a far less strict delineation between 'pharmaceutical' and 'chemical' industries than we have nowadays. These companies focused as much on cod liver oil, toothpaste, citric acid for soft drinks, and hair gel as on prescription medicines, as well as selling products like heroin on the over-the-counter market.

The national rivalries and conflicts that characterised this period also had their impact on the developing industry.

[caption id="attachment_24716" align="alignnone" width="300"] An advert for Bayer's Aspirin from the early 20th century[/caption]

Bayer had the aspirin trademark and its US assets seized during World War One, whilst "American" Merck (now Merck & Co. in the US or Merck Sharp & Dohme (MSD) elsewhere) was compulsorily split off from its Germany parent company (Merck KGaA) at the same time. Bayer also had its Russian subsidiary seized during the Russian revolution. This disruption to Germany's position as the leader in pharmaceuticals in the early 20th century by the war meant that others, particularly in the US, could take relative advantage. The beginnings of the globalisation of the industry were seen both before and after the war - in the UK, import duties incentivised many foreign companies such as Wyeth, Sandoz, CIBA, Eli Lilly and MSD to set up subsidiaries in Britain in the post-war years.
The interwar years
The period between 1918 and 1939 was marked by two breakthroughs that presaged the arrival of the pharma industry as we know it today. The first was insulin - Frederick Banting and colleagues managed to isolate insulin that could treat diabetes, up until that point a fatal condition. But it was only in collaboration with the scientists at Eli Lilly that they were able to sufficiently purify the extract and industrially produce and distribute it as an effective medicine.

The second was penicillin, a discovery of an impact possibly unparalleled by any other in medicine. After Alexander Fleming's initial discovery of the penicillium mould's antibiotic properties in 1928, and Howard Florey and Ernst Chain's further experimentation, a government-supported international collaboration including Merck, Pfizer and Squibb worked on mass producing the drug during World War Two, saving thousands of soldiers' lives. The immense scale and sophistication of the penicillin development effort marked a new era for the way the pharmaceutical industry developed drugs. The war had also encouraged research into everything from new analgesics to drugs against typhus, with a great deal of collaboration between the companies and government.
Post-war period
After the war, the arrival of social healthcare systems such as the UK's National Health Service (NHS) in Europe created a much more structured system, both for prescription of drugs and their reimbursement. In 1957, the NHS brought in what was essentially a price fixing scheme to allow reasonable return on investment for drug manufacturers, solidifying the incentive to invest in new medicines.

The US pharmaceutical industry was booming, thanks to being part of the world's biggest and most dynamic economy. Its growth was also helped by generous funding from the government, with the National Institutes of Health seeing its federal funding rise to nearly $100 million by 1956. This investment fuelled the development of drugs to come over the coming decades.

Meanwhile, as the industry grew wealthy thanks to its growing portfolio of products, the potential ethical conflicts of making money from selling healthcare products became increasingly apparent.

George Merck addressed this question directly in 1950, proclaiming that: "We try never to forget that medicine is for the people. It is not for the profits. The profits follow, and if we have remembered that, they have never failed to appear. The better we remember it, the larger they have been."

This public-spirited industry still required greater oversight, however, and government regulations on medicines increased on both sides of the Atlantic.

[caption id="attachment_24729" align="alignnone" width="307"] George Merck on the cover of Time magazine[/caption]
Thalidomide and the development of drug safety regulation and monitoring
The Thalidomide scandal of 1961 prompted an increase in the regulation and testing of drugs before licensing, with a new amendment to US Food and Drug Administration (FDA) rules demanding proof of efficacy and accurate disclosure of side-effects for new medications (the Kefauver-Harris Amendment) being implemented in 1962. Likewise, the 1964 Declaration of Helsinki put greater ethical structures on clinical research, clearly cementing the difference between production of scientific prescription medicines and other chemicals.

[caption id="attachment_24715" align="alignnone" width="400"] The FDA's Frances O Kelsey: by blocking approval of Thalidomide in the US, Kelsey prevented thousands of children being born with life-changing deformities. Photo: FDA[/caption]

Fordian methods enabled more rational methods of mass production, and increasing understanding of biology and chemistry enabled drug candidates to be chosen systematically rather than discovered serendipitously. This 'golden age' of drug development took place in the broader landscape of the post-war boom, a general context of massive improvements in standards of living and technological optimism that characterised the 40s to the early 70s, as well as the science-boosting competition of the cold war. As the barriers to entry in drug production were raised, a great deal of consolidation occurred in the industry. Likewise, the processes of internationalisation begun before the war were continued - in 1951 alone Pfizer opened subsidiaries in nine new countries.

The list of novel drugs from the post-war era speaks for itself. The contraceptive pill, introduced in 1960, had an impact on society almost as massive as that of penicillin, enabling women to effectively control their fertility and enabling sexual equality for the first time. Valium (diazepam) was brought to the market by Roche in 1963, followed by the introduction of the monoamine oxidase inhibitor (MAOI) class of anti-depressants and antipsychotic haloperidol.

These drugs ushered in a new era of psychiatric treatment, adding pill-based treatments to the psychoanalytic ones that had previously characterised psychiatry in this era. The 1970s provided a wave of cancer drugs, as part of the US government's "war on cancer", a recent report from Cancer Research UK showed that survival rates have doubled since the early 70s - due in large part to the massive innovation in oncology medicines that has occurred since then. ACE inhibitors arrived in 1975, improving cardiac health, and even drugs as ubiquitous as paracetamol and ibuprofen were developed in 1956 and 1969 respectively.

As the 1970s drew to an end, a shift began in the way the pharma industry focused its energies. In 1977, Tagamet, an ulcer medication, became the first ever "blockbuster" drug, earning its manufacturers more than $1 billion a year and its creators the Nobel Prize. This marked a new departure as companies competed to be the developer of the next big blockbuster, and many achieved great success. Eli Lilly released the first selective serotonin reuptake inhibitor (SSRI), Prozac, in 1987, once again revolutionising mental health practice. The first statin was also approved in 1987, manufactured by Merck (MSD).
New challenges in an age of innovation
The 2010s have seen the development of innovative new classes of medicines, building on the greater understanding of the body since the genome was first sequenced at the end of the last century.

This knowledge of genetics and the underlying cause of many diseases, including cancer, has resulted in powerful new drugs.

In cancer, the pharma industry has begun producing immunotherapies, which do not act directly against the disease but instead enlist the immune system to fight against malignant tissues.

This was followed by Merck & Co's Keytruda (pembrolizumab) and a gang of rival PD-L/PD-L1 checkpoint inhibitors, which have set new standards in cancer care in many different forms of the disease.

The importance of cancer immunotherapy was underlined in 2018, when James Allison and Tasuku Honjo were granted the Nobel Prize for their early work on CTLA4 and PD-1 checkpoint inhibitors, respectively.

But there are challenges: the new generation of drugs are expensive and have pushed the limits of health care systems' finances as well as the boundaries of science.

With its hepatitis C drugs, Gilead faced huge amounts of controversy over the initial costs of its therapies, although these were reduced drastically over time as more competitors came to market.

And firms such as Vertex have added to the controversy with tough pricing demands for new therapies for cystic fibrosis, leading to stand-offs lasting several years with payers in countries such as the UK.

While the industry has made huge achievements in some areas, research into new antibiotics has stagnated as they do not create the revenues big pharma companies are looking for - and this comes at a time when the world is still coming to grips with the scale of the threat from antimicrobial resistance.

The future is bright for the pharma industry, but maintaining public trust and preventing millions of deaths from antibiotic resistant bacterial strains are two major challenges it must overcome as the century progresses.

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A history of the pharmaceutical industry

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The 21st century pharmaceutical and biotech sector has come a long way from its roots in 19th century pharmacy. pharmaphorum looks at its evolution over the centuries

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https://www.thecanadianencyclopedia.ca/en/article/pharmaceutical-industry

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Banting and Best's laboratory where insulin was discovered (courtesy University of Toronto Archives/A1965-0004).

The pharmaceutical industry involves companies that research, create, market and sell both generic and brand-name drugs. The first pharmaceutical company in Canada was established in Toronto in 1879 by E. B. Shuttleworth. Today, the vast majority of drug companies operating in Canada are foreign owned.

Structure of Pharmaceutical Companies

Companies engaged in the manufacture of pharmaceuticals fall into three types: subsidiaries of foreign multinational companies manufacturing brand-name drugs; generic companies manufacturing drugs that are ineligible for patents, drugs for which patents have expired and patented drugs for which they have obtained compulsory licences; and small biotechnology companies that generally focus on early-stage research and development and have few products on the market.

In Canada, the association now known as Canada's Research-Based Pharmaceutical Companies (Rx&D), founded in 1914, represents more than 50 brand-name companies, of which the large majority are subsidiaries of foreign multinationals. The Canadian Generic Pharmaceutical Association (CGPA) has 10 member companies, more than half of which are owned by non-Canadian corporations.

History

In 1879, the first pharmaceutical company in Canada was established in Toronto by E. B. Shuttleworth. Shortly thereafter, in 1887, the first foreign-owned subsidiary was started in Windsor by the American firm Parke, Davis and Company. Branch-plant operations such as this one were primarily set up to take advantage of Canadian tariff laws designed to protect domestic manufacturers from foreign competition. In order to undercut a competitor's price, a company would establish a manufacturing facility in Canada. These branch plants usually confined their activities to secondary manufacturing (i.e., combining the active and inactive ingredients into their final form) and sales.

In the 1940s, the Canadian industry underwent a dramatic transformation. As potent new drugs were rapidly developed and marketed, the location of pharmaceutical preparation shifted from the drugstore to the factory where sophisticated technological processes were employed. It became possible to produce large volumes of drugs at a reduced cost, and production was centralized in a few locations. Unable to compete on the scale demanded by the new technology, small domestic companies fell under foreign control.

The 1970s and 1980s saw the emergence of Canadian-controlled generic drug companies; however, many of these are now foreign owned.

Sales and employment

In 2011, the total Canadian pharmaceutical market was the world's eighth largest, representing about 2.6 per cent of global pharmaceutical sales.

The Canadian prescription pharmaceutical market was worth an estimated $29 billion in 2013. Also by 2013, generic drugs accounted for just over 66 per cent of the 574 million prescriptions filled in Canada, but represented slightly less than 24 per cent of medication spending, as they are typically less expensive than brand-name drugs. The largest company in Canada is American-owned Johnson & Johnson with 2011 sales of $1.75 billion. The only Canadian-owned company among the largest 10 pharmaceutical corporations in Canada is Apotex, ranking fifth with 2011 sales of $1.21 billion.

Total employment in the manufacturing portion of the pharmaceutical industry went down from about 30,080 in 2006 to 26,950 in 2013. Of these employees, about 16,000 worked for brand-name companies and the remainder for generic companies. Employment is concentrated around Toronto and Montréal.

Patents

Patents on pharmaceuticals are issued for both the product itself and the process used to make the product. Patent life is 20 years from the date on which the patent was filed. Nearly all Canadian pharmaceutical patents are owned by foreign companies. The company holding the patent on a drug generally has a monopoly on its sale for the life of the patent. The length of a patent is an international standard, established by the Agreement on Trade-Related Aspects of Intellectual Property Rights (known as TRIPS), one of the treaties administered by the World Trade Organization. Although patents last 20 years, an estimated eight years is usually taken up with the process of developing the drug and doing the clinical tests necessary to get it approved for marketing. Therefore, the effective patent life is about 12 years. In 2014, Canada and the European Union signed the Comprehensive Economic and Trade Agreement, adding up to two years to the effective patent life due to pressure from European countries that are home to a number of large multinational pharmaceutical companies.

In the 1960s, three federal reports identified patent protection as a key factor in inhibiting competition and leading to drug prices in Canada being among the highest in the world. Under patent protection, there is no competition from lower-priced generic drugs until the patent has expired. In order to counter the issue, the federal government passed Bill C-102, allowing compulsory licensing (i.e., the ability to import lower-priced drugs even if the original was still under patent). Firms receiving these licences are called generic companies and the products they market are referred to as generic drugs. Multinational companies strongly objected to the introduction of Bill C-102 and lobbied vigorously against it.

As part of the negotiations for the Free Trade Agreement with the United States and then the North American Free Trade Agreement with the United States and Mexico, the Conservative government under Brian Mulroney passed two pieces of legislation: Bill C-22 in 1987 and Bill C-91 in 1993 ( See Free Trade). Bill C-22 weakened compulsory licensing and Bill C-91 abolished it completely. In return for the increased patent protection, the member companies of Rx&D (then known as the Pharmaceutical Manufacturers Association of Canada) promised to invest 10 per cent of sales in research and development (R&D) by 1995 and to create directly 2,000 new R&D jobs. Both pieces of legislation were opposed by the CGPA (then called the Canadian Drug Manufacturers Association) and many consumer and senior citizen groups, including the Consumers' Association of Canada and the Canadian Health Coalition.

Drug Prices and Spending

In addition to weakening compulsory licensing, Bill C-22 created the Patented Medicine Prices Review Board (PMPRB) with a mandate to control the introductory price of new patented medications and to keep the rising price rate of patented drugs within the rate of inflation. Since 1988 (shortly after Bill C-22 was introduced), the rise in the price of patented drugs at the manufacturers' level has been consistently below the rate of inflation. Despite this, overall prescribed drug spending increased 137 per cent between 2000 and 2012, from $11.7 billion to $27.7 billion. In fact, drug spending is the second largest cost to the Canadian health care system after hospitals. Among the 34 countries in the Organization for Economic Co-operation and Development, Canada has the second-highest per capita spending on drugs after the United States, according to 2012 data. Besides prices, other factors affecting spending are population growth, population aging, inflation, the number and size of prescriptions filled and changes in the drugs doctors choose to treat various conditions.

Prices for generic drugs do not rise as quickly as those for brand-name drugs. Between 2003 and 2013 the price for a prescription for brand-name drugs went from $58.25 to $80.88, compared to a small decrease in the prescription price for generic drugs - from $22.44 to $22.11. Despite the lower prices for generic drugs, Canadian generic prices are still high by international standards. Generic drug prices are determined by provincial drug plans and not by the PMPRB.

Payment for Prescription Drugs

Only drugs prescribed to people who are in hospital are covered under medicare. Outpatient prescriptions are paid for in one of three ways: either through provincial drug plans, by private insurance or out-of-pocket. Each province has developed its own plan; some provide coverage based on age (people 65 and over) and whether people are receiving social assistance, and some use income status. The list of drugs that the provinces cover is called a formulary. On average, provinces pay for 38.5 per cent of the cost of prescription medications. Social security funds and the federal government pay an additional 6 per cent. Because of the difference in provincial plans, the amount that people have to pay on their own varies considerably. For example, in 2006 a 40-year-old social assistance recipient taking drugs for high blood pressure and high cholesterol would have received drugs for free in Alberta and British Columbia but would have paid $200 in Québec. Overall, low-income seniors would pay 35 per cent or less of their drug costs in British Columbia, Newfoundland, New Brunswick, Ontario and Prince Edward Island, but up to 100 per cent in Alberta and Nova Scotia. When both brand-name and generic drugs are listed on formularies, provincial plans will only pay for the cost of the generic product.

Before provinces make a decision about whether to cover a drug, the drug is evaluated by the Common Drug Review. The CDR provides advice about the clinical efficacy and cost effectiveness of a drug against other drug therapies so that public funds are optimally used. The CDR is funded by federal, provincial (except Québec) and territorial governments and is governed by a 13-member Board of Directors appointed by federal, provincial and territorial deputy ministers of health. Provinces are not bound by the recommendations from the CDR about whether or not to pay for the drug. As a result, there is variation among provinces in terms of what drugs are covered. Not all drugs approved by Health Canada are paid for by provincial drug plans.

On average, private insurance pays for 35.4 per cent of prescription drug costs in Canada. At least 68 per cent of the Canadian population had private drug coverage in 2010, usually as part of a benefit package through work. Estimates from a 2000 report indicated that 20 per cent of the Canadian population was either uninsured or underinsured for routine prescription drug costs, and people in the lowest income bracket had the highest rates of underinsurance. Whether or not people have drug insurance and their level of income has a large role in determining if they take medications that have been prescribed for them. Based on 2007 data, 3.6 per cent of those with a high income (annual household income of $80,000 or more) and insurance did not take their medications due to cost, while for those with a low income (annual household income less than $20,000) and no insurance it was 35.6 per cent, or in other words ten times greater.

Research

Drugs are often given credit for many of the significant positive changes in health that have been observed over the past century. It is undoubtedly true that insulin, discovered at the University of Toronto in 1921, revolutionized the treatment of diabetes. Other developments, such as the polio vaccine and antibiotics, have saved many lives and reduced the suffering of millions. However, the decline in mortality from infectious diseases such as rheumatic fever and tuberculosis started long before the era of modern drugs. Most of the increase in lifespan can be traced to a sharp decrease in the infant mortality rate, which largely resulted from improved living and nutritional standards.

Worldwide, the pharmaceutical industry spent an estimated USD 137 billion in 2012 on research. Drug companies do develop treatments for rare diseases, but since the companies operate on the profit motive most of their research expenditures go into developing products that serve large markets and have the potential for substantial sales. From 2000 to 2011, for example, only 1 per cent of the 336 new drugs approved were for neglected diseases (i.e., diseases that occur primarily in poor developing countries).

The pharmaceutical industry claims that it costs nearly USD 2.6 billion to research and develop a new drug; such figures have been challenged by critics who estimate that the figure is a fraction of that amount. Research and development (R & D) spending in Canada by the brand-name companies went from 6.5 per cent of sales in 1988 to 12.9 per cent in 1997, but has declined since. In 2013, it was 5.4 per cent. Employment in R & D has also been going down since 2006 and now about 3,300 people are employed in this field by brand-name and generic companies.

About 25 to 35 new active substances (i.e., drugs that have never been on the Canadian market before in any form) are approved annually in Canada. Based on data from the PMPRB, fewer than 10 per cent of these represent "breakthrough" medications or substantial improvements over existing therapies. Other drugs may provide minor advantages in terms of being taken less often or in being better tolerated by some groups of patients.

Drug Regulation

The federal government had no power to limit the sale of drugs until 1939, when amendments were made to the Food and Drugs Act. In 1951, it became mandatory for companies to submit safety data to Health and Welfare Canada (now Health Canada) prior to marketing a new drug. This change was provoked by the realization that Canada was being used as a proving ground for foreign manufacturers to test-market their new drugs.

The Canadian laws were changed again in 1963, following the experience with thalidomide. Pregnant women who took this drug gave birth to babies with congenital malformations of the limbs. About 115 such children were born in Canada. Besides strengthening safety standards, the 1963 amendments required manufacturers to submit information showing that their products were effective for the conditions recommended. Neither the 1951 nor the 1963 changes were made retroactive.

Once the basic research for a potential new drug has been completed, the company submits a Preclinical New Drug Submission containing all known data on the substance to Health Canada. If this submission is approved, the company proceeds to the clinical research stage, where the drug is determined to be safe and effective for humans. During this phase, a detailed description of the proposed tests needs to be approved by a Research Ethics Board before it can be carried out. Canada has a comparative advantage in clinical research over many other countries because of a highly skilled medical establishment and hospitals with excellent facilities.

At the conclusion of clinical testing, a New Drug Submission is sent to Health Canada with complete information on the new drug. Approval of this submission results in the company receiving a Notice of Compliance, allowing the drug to be sold in Canada. The notice is accompanied by a product monograph that summarizes all the information about the drug and is available to health professionals to guide them in its use. The monograph is also accessible to the public through the Drug Products Database.

Generic drugs are copies of the original product that contain the same amount of the active ingredient. In order to be able to sell a generic drug, the manufacturer has to submit data to Health Canada showing that its product is bioequivalent to the brand-name drug. Bioequivalence means that the generic drug enters into the bloodstream and is eliminated from the body at the same rate as the brand-name drug.

After a new drug is marketed, companies are required to notify Health Canada of any adverse reactions that they become aware of. In addition, Health Canada operates MedEffect Canada to monitor the safety of drugs. Warnings about safety problems are posted on the MedEffect website. In addition, health professionals and consumers can report adverse drug reactions to MedEffect. In 2012, the website received about 53,000 reports. Reporting is voluntary and it is believed that only 1 to 10 per cent of all adverse reactions are documented. All of the reports are publicly available in a searchable database. About 4 per cent of the drugs that are approved in a five-year period eventually need to be taken off the market because of safety problems.

Promotion

The Food and Drugs Act prohibits false advertising and companies can only promote their products for conditions that have been approved by Health Canada. However, Health Canada has no control over how doctors actually use drugs, and drugs are often prescribed off-label (i.e., for uses that Health Canada has not approved). Although Health Canada has the legal authority to regulate promotion, for the most part it has turned its authority over to the pharmaceutical industry and various private organizations, although it may still intervene in situations including serious threats to public safety.

Most promotion is for prescription drugs and is directed at doctors. There are no exact figures about the amount spent on promotion in Canada, but it has been estimated at upwards of $2.4 billion annually. Advertising in medical journals and promotion by other means is regulated by the Pharmaceutical Advertising Advisory Board (PAAB), established in 1976. The board includes an advisor from Health Canada, as well as representatives from the pharmaceutical industry and medical, pharmacist and consumer associations, as well as from advertising agencies. The PAAB examines all advertising before it is used to ensure that it conforms to its code. The effectiveness of the PAAB has been questioned, especially since the only sanction for violating the board's guidelines is either modifying or withdrawing the ad in question.

Other forms of promotion to doctors are governed by the ethics code developed by Rx&D, the organization representing brand-name companies. The code governs the activities of sales representatives and the samples of drugs that they leave with doctors. Sales representatives dealing with physicians are required to complete approximately 250 to 300 hours of study in two units: anatomy and physiology, and pathophysiology and pharmacology. About 90 per cent of all Canadian doctors see sales representatives to get information about drugs, according to a recent survey of physicians. Another recent study found that sales representatives did not provide Canadian general practitioners any information about harmful side effects in the drugs they were promoting in 66 per cent of visits. Rx&D polices its own code and if a violation is confirmed, the penalty ranges from $25,000 for the first to $100,000 for the fourth.

Although direct-to-consumer advertising of prescription drugs is not legal in Canada, companies are allowed to run advertisements naming drugs as long as they do not say what the drug is used for. They can also run what are termed "disease awareness ads." These advertisements mention a condition and suggest viewers "ask your doctor" about a treatment. Complaints about both types of ads are handled by Health Canada, which has been criticized for being slow in responding to complaints.

Canada has always permitted companies to promote over-the-counter products directly to consumers on the assumption that the products are relatively safe for the intended condition of use and that members of the public can readily identify the condition (e.g., a fever or a cough). Since 1997, private agencies have been responsible for regulating this type of promotion. Health Canada does not monitor the performance of these agencies but sets criteria for how they should operate and allows them to "self-attest" that they have met the criteria.

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Banting and Best's laboratory where insulin was discovered (courtesy University of Toronto Archives/A1965-0004). The pharmaceutical industry involves companies that research, create, market and sell both generic and brand-name drugs. The first pharmaceutical company in Canada was established in Toronto in 1879 by E. B. Shuttleworth.

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https://lithub.com/a-brief-history-of-american-pharma-from-snake-oil-to-big-money/

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A Brief History of American Pharma: From Snake Oil to Big Money

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For more than a century, the most common symbol for all things medical in the United States has been the caduceus, the familiar winged rod with two snakes twined around it. It was adopted by the US…

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https://www.arnoldventures.org/stories/congress-pharmas-price-gouging-is-purposeful

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For decades, pharmaceutical companies have gamed the U.S. patent system and engaged in anticompetitive behaviors to drive up prices, making it increasingly difficult for American families to afford life-saving drugs.

Those findings, released Friday, were the culmination of three years of Congressional investigation into pharma's price gouging and anticompetitive business practices.

The House Oversight Committee investigation, led by Democrats, relied upon hundreds of pages of internal documents and dozens of hours of Congressional testimony. The investigation found that pharma deploys an intentional strategy to extract profits off the backs of American patients, employers, and taxpayers - raising prices to meet revenue targets, incentivizing executives to hike prices, targeting the U.S. for higher prices while discounting the same exact drugs elsewhere, abusing the patent system to suppress competition and maintain monopoly pricing, and so on.

"While there are many actors that contribute to high drug prices, this investigation again reveals how pharmaceutical companies conduct business and reinforces the need for Congressional action to end anticompetitive behavior and price-gouging tactics that curtail access," said Mark Miller, executive vice president of health care at Arnold Ventures. ​"Research has long shown that pharmaceutical companies engage in behaviors that drive up drug prices, but the internal documents obtained by the Oversight Committee reveal that these behaviors are part of a concerted and coordinated attempt to maximize profits at the expense of access. Bottom line: Congress must enact reforms that protect patients - allowing them to afford drugs they desperately need - and drive down the costs that have burdened employers and taxpayers."

Separately on Friday, Republicans on the Oversight committee issued their own report, laying the blame on pharmacy benefit managers (PBMs) for the dramatic increases in prices and drug spending. Both pharmaceutical companies and PBMs engage in bad behaviors that contribute to rising drug prices - however, independent and nonpartisan research has long demonstrated that PBMs contribute to a much smaller fraction of the problem than large pharmaceutical companies.

The Build Back Better Act would empower Medicare to negotiate drug prices and require drugmakers to reimburse taxpayers when they hike drug prices higher than inflation. The package has been passed by the House and is now awaiting approval in the Senate. Comprehensive drug pricing reform is necessary - and should include measures that address the holistic failures inherent across the system - however, as Americans continue to struggle to afford their prescriptions, Congress has an opportunity now to take action to help lower drug prices while continuing to work in the future to ensure affordability and accessibility.

David Mitchell, president and founder of Patients for Affordable Drugs, whose experience with an incurable but treatable blood cancer galvanized his fight to make prescription drugs more accessible and affordable, urged lawmakers to take necessary steps to lower drug prices immediately.

"My experience has taught me an irrefutable fact, and that is, drugs don't work if people can't afford them," Mitchell said.

That resonates deeply at a time when one in three Americans reports not taking their medication as prescribed, simply because to costs too much.

Type 1 Diabetes patient Mindy Salango talked about the tradeoffs she has made when it comes to providing for her daughter and paying for her medication.

"In order to keep food on the table and a roof over our heads, sacrifices had to be made. And oftentimes, that was my insulin."

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Arnold Ventures | Congress: Pharma's Price Gouging is Purposeful

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For decades, pharmaceutical companies have gamed the U.S. patent system and engaged in anticompetitive behaviors to drive up prices, making it increasingly difficult for American families to afford life-saving drugs. Those findings, released Friday, were the culmination of three years of Congressional investigation into pharma's price gouging and anticompetitive business practices.

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German physicist Wilhelm Rӧntgen accidentally invents the x-ray, c. 1895

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In 1846, William Morton successfully uses the anaesthetic- ether during surgery. Following the discovery, humanity has frequently used anaesthesia for painless surgeries

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French microbiologist Louis Pasteur discovers that infectious diseases were caused by pathogens, revolutionizing how diseases were treated, controlled, and prevented c. 1861

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In 1928 following the invention of Penicillin by Alexander Flemming, other antibiotics were introduced, saving many lives

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The first successful organ transplant operation was carried out by Dr. Joseph Murray and David Hume in 1954

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In the 1960s, the research regarding antiviral drugs skyrocketed and improved significantly. This resulted in the blockage of the reproduction of viral diseases such as AIDS/ HIV and Ebola

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1977- Dr. Raymond Damadian successfully completed the first cross-sectional image of a human, leading to the invention of the MRI machine

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The Pharmaceutical industry generated over 1.3 trillion dollars in 2021 and six of the top 10 wealthiest companies have their headquarters stationed in the U.S. These include Johnson & Johnson, Pfizer, Merck, and AbbVie

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Big Pharma (A conglomerate of companies in the Pharmaceutical industry) is responsible for 2/3 of the Food and Drug Administration's budget

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The structure of the Pharmaceutical industry is similar to an iceberg. Research based companies such as AstraZenneca, Pfizer and Merck represents 40% of the industry. The "generic companies" represents >90% of the total companies and are responsible for the production of medication

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The industry has a terrible reputation and has been involved with many controversies, from fraud to bribery and lawsuits

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In 2017, 1378 lobbyists were hired and from 1998 to 2016, over 3.5 billion was spent on lobbying, more than the defence and corporate business industry combined

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A study done, found that for every $1 spent on research, $19 was spent on advertising

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Patents are valuable to companies as it gives them the exclusive rights to manufacture and sell a drug, however after the duration of the patent expires, others are eligible to also manufacture and sell the drug

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The succession rate for developing a drug that can be sold in the pharmacy is <1%. This rate is decreasing as regulations continue to increase

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After the expiration of the patent, the medication is deemed "generic", thus the term "generic pharmaceutical" companies is coined. "Generic pharmaceutical" companies are low cost, low risk, and tend to save money on advertising, since the drug has already been promoted

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The advancements of treatments for illnesses has significantly contributed to the increase in life expectancy. In 1900, the average life expectancy in the world was 32 years, while in 2019, it was 73 years

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Smallpox- Responsible for the deaths of Pharaohs and between 300-500 million during the 20th century was officially eradicated in 1979 following a global vaccination effort

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Pharmaceuticals such as painkillers have been used to relieve pain, symptoms, or side effects. This has improved quality of life significantly as a study done by the World Health Organization (WHO) discovered that individuals who live with pain are four times more likely to develop depression and anxiety

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In the Medieval and Renaissance Ages, there were no services for healthcare, and education regarding the topic as scarce- today we have universal healthcare, myriads of professionals in the medical field and many prestigious institutions offering medicinal knowledge and research

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The Church was very influential in the supposed curation of sicknesses as people practiced penance and prayed, hoping for a cure. In our modern society, people rely on the advice and prescription our doctors give

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In the 1900s, industries became industrialized and many work-related diseases were prevalent such as dermatitis and lung disease. Cities began to expand rapidly, resulting in diseases such as Typhus and Cholera becoming more prevalent. Doctors began experimenting with hygienics and antiseptics to treat and prevent infectious diseases

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Advancements in the field of medicine resulted in people demanding that health was a human right. It was finally recognized in the 1966 International Covenant on Economic, Social and Cultural Rights

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The implementation of clean water has saved billions of lives- from deadly water-borne diseases such as cholera and other infectious diseases that would target young infants. In the 1900s 25% of infants would die before the age of one, in 2020, the mortality rate dropped to approximately 0.03%

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X-rays have saved millions of lives by diagnosing problems within patients from lung and heart problems to bone fractures and cancer. Since Röntgen's discovery, investigators discovered that x-rays could be used to kill cancer cells or shrink inoperable tumors

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As pharmaceutical technology advance and the access to medicine is easier, the length of hospital stays decrease, reducing pressure on the healthcare system. In 1950 the average stay in the hospital was 8 days, in 2020, it is 4-5 days

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The pharmaceutical industry employs over 0.9% of the European Union's workforce and contributes to over 1.4% of its GDP

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Only 2 disease in the history of mankind has been declared fully eradicated- Smallpox and Rinderpest. 7 other disease are close to eradication, including: measles, rubella, polio, guinea worm and lymphatic filariasis

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With the advent of vaccines, healthcare spending has decreased and productivity has increased, impacting the economy. A study done by the WHO found that for every $1 spent on child vaccinations, $10 is saved from future treatments of diseases

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In the medieval ages, Christianity played a huge factor in the establishment of the hospital because they hosted indiscriminate personalized care to their patients and since, hospitals have maintained that integrity by caring for everyone

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Many medicinal plants used to treat ailments are still used across the world. The Indigenous people of Canada used Yarrow to cure coughing, sores, vomiting, nausea, cold and cramps

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The use of herbs in medicine has been documented since humanity's first civilization, the Sumerians, over 5000 years ago. Many modern medication are created using plants and supplements can come in the form of dried, chopped or powdered

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Traditional Chinese medicine such as acupuncture was believed to help improve the flow of Qi. Today, acupuncture has many practitioners within China and even around the lower mainland area

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Many ancient techniques remain in practice today and are proven to have benefits. These include leeching "bloodletting" (use of leeches to rid people of "humors", which supposedly made people sick), electroconvulsive therapy (controversial and was utilized by the Romans) and transsphenoidal surgery (common treatment for pituitary tumor, and a technique used by ancient Egyptians to mummify corpses)

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Some of my friends and loved ones would perish and my mental health would deteriorate along with many others. The productivity of society would plummet as many people would be stricken with illnesses or despondency

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Interactions with our friends would be seldom and different as we’d take more precautions (more severe than COVID-19) and avoid hotspots.

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People infected would be stigmatized and when they die, (as evidenced during the Black Plague) would not receive proper burials, a breach of their faith and their culture. The poorer echelons of society would suffer the most, because the rich could flee and the poor typically live in a more condensed area where the disease can spread more easily

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As more people die, people because more desensitized to death and society will adjust by giving responsibilities to members in their community such as burying/cremating the dead

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The many pioneers in the field of medicine had good intentions and intended to help treat patients using different medical techniques and medicine, however many pharmaceutical companies no longer follow the same principles and many have become increasingly greedy

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Following the outbreak of COVID-19, many pharmaceutical companies such as BioNTech, Moderna, Pfizer and AstraZeneca were tasked with developing vaccines, which was funded by $100 billion in public funding. Their intentions were to maximize profits and use public investments in exchange to develop a life saving drug to sell for an exorbitant of money and pay little tax

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Pfizer/BioNTech and Moderna have sold their vaccines up to 24 times the cost of production with some sources stating that the cost of producing one dose is as little as $1.20

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These huge companies have created monopolies and many people in poorer countries have not yet been vaccinated. The vaccine helped lower the number of infections, however there still are many cases of COVID

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Pharmaceutical products enter the environment sometime during their life-cycle, and by discharging antibiotics to the environment, this can inadvertently develop antibiotic-resistant pathogens, making diseases harder to treat

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The factories that produce pharmaceutical ingredients often don’t clean up its production, which can significantly harm the environment by promoting the development of drug resistance and the animals living around that area, particularly fish

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A study by the UK government found that 86% of fish are intersex due to pollution from ethinylestradiol, an ingredient used in the contraceptive pill

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Medicine has truly benefitted society beyond reasonable doubt. Life expectancy has increased, our quality of life increased and countless lives are saved every year due to medicine and other technologies such as MRI’s, X-rays and vaccines

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Although there are some risks and defects as evidenced in the Thalidomide scandal, as long as there is strict regulation on which drugs can be sold on the market, this calamity will not repeat again

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The work that pharmaceutical companies have done such as researching and manufacturing countless medical technologies benefitted society in the past century in aiding to the prosperity of mankind, however the impact of their presence has been detrimental as they prioritize profit over doing what’s right, and in doing so, hurt the financial state of the average consumer and their governments and the environment

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Every group in society from across the globe benefitted from medicine sometime in the previous thousand years, whether it is in the form of crushed herbs or vaccines

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People living in poorer countries, especially those in the continent of Africa, lack proper medicine and have very minimal access to it

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Every year, 1.6 million Africans succumb to malaria, tuberculosis and other H.I.V related diseases. These diseases are easily preventable/treated, however since only 2% of the drugs consumed are domestic, most drugs are imported internationally and are very expensive