Laureates of the Japan Prize

The 1988 (4th) Japan Prize

Preventative Medicine
The eradication of smallpox (Joint Award)

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Dr. Donald A. Henderson (USA)

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Dr. Isao Arita (Japan)

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Dr. Frank Fenner (Australia)

Dean, Johns Hopkins University, School of Hygiene and Public Health.
Born in 1928
Director, Kumamoto National Hospital.
Born in 1926
Professor Emeritus, Visiting Fellow, The John Curtin School of Medical Research, The Australian National University.
(1914-2010)
Award Citation

The theme of research, as subject to this year's Japan Prize, is the eradication of smallpox. The history of smallpox goes back thousands of years. For example, the mummified remains of Ramses V (died 1157BC) of Egypt, now in the collection of the Cairo Museum, and other mummies of the same era contain the cicatrice characteristics of smallpox which suggest that the epidemic was already rampant about three thousand years ago.

The discovery of the vaccination against smallpox by Edward Jenner in the early 18th century was an epochal discovery but with the spread of smallpox worldwide, it was almost impossible to control the disease on any great scale.

Smallpox has tormented human beings for at least three thousand years, and until twenty years ago, it was a prevalent disease in 31 countries among 1,200 million people in the world, affecting 15 to 20 million and causing 2 million deaths every year. It was been completely eradicated since the last case in Somalia in October 1977. Its eradication was a memorable achievement in the history of mankind and the three doctors who made this success possible were Dr. Henderson, Dr. Arita and Dr. Fenner.

The smallpox eradication program was proposed and approved by the World Health Assembly in 1957 but its implementation was very difficult.

The intensified smallpox eradication program was again implemented in 1966 with the aim to distribute the vaccine as widely as possible, but this task was also extremely difficult to carry out. There were several reasons: for example, it was necessary for the vaccine to be not only highly effective but also heat-resistant because the areas where the virus was most prevalent were mostly tropical. When the project was started in 1967, however, only about 30 percent of the vaccine available was both effective and heat-resistant.

Also, in order to carry out the eradication project, it was imperative that they be able to monitor and pinpoint the regions where the disease was most prevalent and then immediately transfer this information to the field personnel. However, this was also not a very easy task to accomplish.

These problems were overcome in one area by Dr. Aria who endeavored to establish the basic knowledge necessary for thoroughly carrying out smallpox eradication measures. He performed epidemiological analysis as well as surveys and research of natural hosts of the disease and completed quality improvement and control for the vaccine.

Dr. Henderson dedicated his efforts to the development of group vaccinations for countries where smallpox was in evidence and also organized the education and training of personnel taking part in this work. Since 1970, the two doctors frequently travelled in turn to areas throughout South America, Asia and Africa to give guidance to the field workers who were engaged in the smallpox eradication program as well as to help solve technical, social and political problems often arising in those countries where the program was implemented.

Dr. Fanner is originally a virologist whose research achievements are internationally known through theses and books. He constantly evaluated the progress of the smallpox eradication program as part of his research and guided the thorough implementation of the program.

Thus the smallpox eradication program made rapid progress and with the last patient in Asia recorded with the disease in 1975, came the fruitful results of Dr. Henderson's first objective. Dr. Aria directed and managed the last world eradication program in the North East region of Africa. During this time, he thought that the traditional method of vaccinating the entire population was not as effective as vaccinating inhabitants in limited affected areas. By implementing the latter method, he succeeded in the "containment" of the spread of smallpox. As a result, on October 26, 1977, the history of the natural spread of smallpox came to an end with the patient in Somalia being the last on record.

Dr. Arita continued to direct a worldwide smallpox surveillance program with the focus on confirmation of the disease's eradication in 79 danger areas. The contribution of Dr. Fenner in this surveillance and the eradication confirmation project also is great. Since such a task of preventative medicine has a great influence socially, a further deliberate ten-year observation period continued and in 1987 the eradication of smallpox was finally confirmed.

This achievement is a grand world-scale experiment that has proved for the first time that it is possible to eradicate one of mankind's most dreaded parasitic diseases. The exercise has been epochal in the annals of virology.

Also this achievement not only accomplished the eradication of smallpox but has established a basis for designing world-scale plans to eradicate or prevent the spread of other virological diseases and new epidemics. Also it made a breakthrough for future preventative medicine to create vaccines which recombine genes of protective antigens from other pathogenic bacteria to control an epidemic for which man previously had no methods of treatment.

The above is an abridged text of the report outlining the basis for awarding the Japan Prize.

Preventative Medicine
Discovery of the AIDS causing virus and development of diagnostic methods (Joint Award)

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Dr. Luc Montagnier (France)

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Dr. Robert C. Gallo (USA)

Chief, Department of Virus Tumours, Pasteur Institute
Born in 1932
Chief, Laboratory of Tumour Cell Biology, National Institute of Health
Born in 1937
Award Citation

The theme of research, as subject to this year's Japan Prize, is the discovery of HIV, the pathogen behind AIDS (acquired immune deficiency syndrome) and the development of its diagnostic methods.

AIDS was classified as an independent disease in 1981-82 in the United States. The disease causes a severe breakdown of the body's immune system leaving it defenseless against infections by even ordinary bacillus or weak pathogens and the mortality rate of its victims is high.

Both Dr. Montagnier and Dr. Gallo discovered HIV and respectively clarified its virological nature and course of infection. In addition, practical blood serum diagnostic methods were developed for the establishment of basic preventive counter-measures by the easy recognition of virus carriers and infected blood and plasma.

Dr. Montagnier conducted several creative research studies mainly in the fields of virology and cancer before this research. Especially noted is his discovery made in 1964 in joint research with Dr. McPherson. It is the original study on the soft agar colony which is still used as the most important index in the examination of cancer-bearing cells.

Dr. Montagnier was the first to isolate the HIV-1 or the AIDS virus in 1983, while leading the joint researchers of the Pasteur Institute. The virus was first called LAV (Lymphoadenopathy Associated Virus) because it was discovered in a Lymphoadenopathy patient, but it actually was the prototype of HIV-1. Later Dr. Montagnier showed that the Helper-T cell was the target. While researching AIDS in Africa, Dr. Montagnier made several discoveries such as the development of the ELISA method for diagnosing the mother-child infection of HIV and its antibody, the discovery of T4 antigen-the receptor of HIV, followed by the discovery of HIV-2 and associated viruses of a different antigen type, the gene cloning, etc.

Dr. Gallo, on the other hand, had made two great achievements related to AIDS research. One was the discovery of TCGF or IL-2. With information on the TCGF, the culture of the T lymph globe was pinpointed leading to progress in the study of HIV. His second great achievement was the separation of the HIV-1 from the T lymph cell growth which is recognized as the first retrovirus separation in man. This served as a great influence on later research in human retroviruses.

The first of the achievements which was highly evaluated for the Japan Prize was the analysis of the relation on HIV with AIDS. His achievements further include the presentation of many useful T cell roots, the detection of viruses in saliva and semen, the explanation of the course of infection, the analysis of the virological nature of HIV, the cloning and analysis of provirus DNA, etc. In addition, the production and supply of the single clone antigen against HIV, and the research and development of AZT which is currently recognized as the most effective remedy against AIDS are also achievements of Dr. Gallo's group.

As described above, the two doctors, leading their own groups, discovered HIV and respectively clarified its virological nature and course of infection. In addition, practical methods to diagnose the virus in blood serum were developed for the establishment of basic preventative countermeasures to ease recognition of healthy carriers and blood infected with the AIDS virus.

Further they paved the way for the development of a vaccine through the gene cloning of provirus DNA. They are also gaining remarkable results in their efforts to develop antivirus medicine. Further, it has become possible to almost completely prevent infection by transfusion or blood serum by examination of blood donors and serum.

However, the remaining problems may be the establishment of actual preventative methods and the containment of the disease in society at large. As to the latter, the development of a vaccine is thought to be possible through the achievements made in gene cloning experiments and the verification of neutralizing reaction made by the two doctor's groups. Efforts in development are the only key, it is believed.

We believe both Dr. Montagnier and Dr. Gallo both deserve to be awarded the Japan Prize for 1988.

 

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