“If Nicaragua embraces science, I see a magnificent future for it”

Nobel Laureate in Medicine Richard Roberts gave the inaugural speech for the academic year of Managua’s Central American University (UCA) this year. He left this simple, direct and accessible message with the university community that afternoon.

Richard J. Roberts

I’ve come to Nicaragua several times and I always see areas in which the country could do important things, embracing science and involving scientists in the educational process.

Science has changed our lives

Everybody who lives in this society is absolutely clear that science is an integral part of our daily lives. I’m sure many of you are already looking at your smart phones because you’re bored with what I’m saying. This is just one example of how science has changed the way people live. Smart phones are particularly interesting because it turns out that Africa has the greatest invasion of cellular phones; more than any other part of the world. In Soweto, one of South Africa’s poorest ghettoes, 99% of the population has a cell phone and it has made a huge difference to their lives.

Computers, tablets, cell phones and so many other technological inventions are based on science. These devices are everywhere, and they are the product of some very good physics research.

Something else that everyone today is familiar with is what has happened in the world of medicine. When I was a boy I used to suffer very badly from infections. Every time I cut my leg it would become infected. And in those days there was no treatment for it, so they would put a hot poultice on it to kill the bacteria. But believe me, that’s not the best way to kill the bacteria infecting your leg. Then all of a sudden, any infection could be treated with antibiotics, and that has made an enormous difference in many people’s life.
But of course being humans, the first thing we do when we discover something really good is to abuse it. So now, with so many people using so many antibiotics and doing so incorrectly, what we have is relatively fewer antibiotics left that are really effective. I’ll return to this later because I think in the end there are some opportunities for scientists here to do something effective.

Other improvements in our lives thanks to science have occurred in food, in agriculture. Agriculture or farming as we understand it got going in Mesopotamia some five or six thousand years ago, when human beings discovered that they could take the best grains they were growing, cross them and get new strains. So over the years we’ve produced better and better crops using techniques we all know as breeding. In the past fifty years this has become a tremendous science, with advances that are quite dramatic. Without science in this and many other fields, our lives wouldn’t be anything like they are today.

Why have we moved away from science?

One of the problems that has come with science is that a lot of scientists haven’t felt it necessary to tell the rest of the citizenry what they’re doing, to explain to the general public just how science works, the basis for it and how it can be helpful to people. This has opened the door to a number of people or groups of people who have decided that they don’t like some aspects of science. They find it very easy to criticize science, taking advantage of the fact that most people, and I do mean most people, do not have a good grounding in science.

It’s taught in schools, but usually as a memorization task: remember the name of this chemical or of this flower, without really teaching the underlying principle of how science works. It isn’t taught in primary and secondary schools in a way that gets people to think. It’s a major problem, and not only in the developing countries but in the developed world too. We also find this in the United States and in Europe. We haven’t taught science as well as we should. It’s very sad to think how it could be, because we know very well that when children are three or four years old they’re very curious, they want to know, they are constantly asking why this and why that…

All children are by nature little scientists, but when we send them to school we make it as difficult as possible for them to want to be scientists. They end up thinking science is boring and they hate it. The result is a population, a citizenry, with no interest in science, one that has lost interest in and enthusiasm for it.

The media should also teach science. When there’s news of a new discovery the science that’s behind that finding should be taught. Instead “scientific” information is often very superficial, presented as data that this is what you must do: one day we’re told you shouldn’t eat eggs because they produce too much cholesterol then a few months later you discover eggs are okay. With that same superficiality they talk about milk, salt, everything… That isn’t science.

A majority of media don’t know what they’re talking about when they talk about science. Every time they mention global warming, for example, they think they have to interview people who say it isn’t happening. They think they’re presenting a balanced argument, even though today 95% of the scientific community knows global warming is real. Nobody in the scientific community is debating it and barely 5% deny it only to be contrary.

There still is that debate among politicians, however. They love debate and if they see that science supports their arguments, they’re all for it, but if it doesn’t support them, they go nuts and don’t want to admit what they’re hearing. Many politicians don’t know anything about science, but they express their opinion. This is a big problem, not just in this country and the rest of the developing world, but in the US and Europe. Most politicians went to law school and know little about science; they only want to hear from it if it supports their political positions. And this is wrong. They need to listen to what science has to say then make policy decisions on the basis of what it said.

Scientific investigation
and the scientific method

Universities obviously play an enormously important part when it comes to education. But unfortunately universities tend to interact with only a very small segment of society: with those who manage to get through high school and after that all the exams and tests that follow. It’s a relatively small population.

Many things have to be taught in university, but one of them is a continuation of what is taught in high school. Science has to be taught in the university, but the university has to be sure that what is taught is very, very current. And that’s very tricky. It’s very hard to keep up with all the advances that are taking place; there are always new discoveries so it’s hard for a university professor to stay up to date. Essentially we have to teach the modern stuff and not what we thought was true twenty or thirty years ago, or learned in outdated textbooks.

Another challenge for the universities is to encourage research. Research is really very important. One of the key elements of good research in the sciences is to teach the students how to ask interesting questions and then how to find the answers. The so-called scientific method, which is something that’s been used very widely for the last two or three hundred years—in which you generate hypotheses and test them with experiments—is a great way to try to teach people to do science.

In fact, what we’re seeing at the moment is a little dangerous for science: to think that research consists only of collecting vast amounts of data: for example, people who sequence the DNA of any organism and say that with that they know how that organism works. As you know, studying micro-organisms is my work, and DNA only gives a kind of blueprint that indicates to us how that organism might work; after that you have to do a lot of investigative and experimental work to get to the next level, to understand how it really works.

I can give you a blueprint for an automobile, and I can say this is the distributor but if you don’t know how a distributor works and what it does, this is going to tell you nothing. You might as well not study it in the first place.

So at the moment in many countries, we’re seeing the danger of putting together data and more data, thinking that data equal knowledge, but they don’t. It’s the same as when kids are taught to memorize and they have to regurgitate it in an exam. Memorizing data and being able to repeat them doesn’t mean they understand anything. We have to understand the fundamentals of science in the schools and particularly in the universities in order to take it to a higher level.

Science is Singapore’s
motor force of development

I’d like to give you three examples of how research has helped developing countries. Let’s begin in Singapore, a wonderful example of a country that basically has no natural resources whatsoever, with the exception of its people, who are very intelligent, educated by governments that made the strategic decision to educate their people well, that at one moment decided that if they were going to prosper economically it was no use depending on natural resources they don’t have so they decided to rely on brain power.

Today Singapore has one of the world’s finest educational systems and some incredibly well educated people… but the problem is that they don’t permit creativity as much as they should. They don’t like students saying no to their teachers. One of the things you have to do if you want people to achieve well in school, at the university and in society, is to allow them to be creative, to rebel. Rebellion is an excellent creative attitude. It’s very positive when a young person listens to his or her professor, father or mother, then sometimes says: No! That’s not right; I don’t believe that!

I’ve always done that. Any time I hear people tell me they’ve done the same thing their whole life because doing it that way is best, I decide to do the opposite. Especially if someone tells me ‘You definitely shouldn’t do this!’ I always feel it’s something really good so I want to try it. Yes, you have to have this contrariness, to react against authorities when they put forward some conventional wisdom. There’s still fear of creativity and rebellion in the East, but that’s changing. Singapore has invested a lot of money in science and has a very developed economy, lots of it driven on the basis of science. They haven’t yet made the great discoveries they’re capable of doing, but I think that with time they probably will.

Cuba also took science seriously

Let’s look at the Cuban case because it’s a very interesting country that in some ways parallels Nicaragua. When Fidel Castro came to power he decided that science was going to become a strategic too for development and he initiated the biotechnology industry. He used a lot of resources, built laboratories and encouraged people to get haveily involved in biotechnology. That happened many years ago and despite everything that has happened in Cuba, including the US embargo, Cuba now exports vaccines and other reagents to the United States that the US doesn’t know how to make for itself. Cuba has been incredibly successful in this field because it embraced science, got involved with science.

And China gambled
its future on science

Now let’s talk about China. China has a very interesting government, because today almost everybody associated with higher levels of power in China is either a scientist or an engineer. Some time ago the Chinese governments decided that science and engineering would pave the way to the country’s future. And they began to invest very heavily in all kinds of scientific and engineering projects… not necessarily the best ones in the world, but they’re heading in the right direction.

They believe in the importance of educating people and assign enormous amounts of resources to education. But unfortunately they don’t foster creativity there either; they don’t like students to say NO to their teachers, but I think this will come because they have a very large society and it’s going to be increasingly more difficult for them to stop the students and scientists from doing what they need to do to become really creative.

China’s leaders desperately want a Chinese winner of the Nobel Prize in some field of science. This is their driving ambition. I think that to be able to it they will have to allow these young kids to rebel, to be creative and do the science they want and not what the universities or their professor or their government wants them to do. If the Chinese government wants to have a scientific community that makes really important discoveries, if it wants to win prizes, if it wants science to be the motor force of society, than it has to let the students be free. If not, they’ll still do many things, but not in the vanguard.

What could science do in Nicaragua?

Now I want to say something specific about research and how it should be done in developing countries. Probably one of the most important messages has to do with finding specialized niches. What you don’t want to do in a country like Nicaragua is to try to understand how Higgs boson works or invest in astrophysics projects… Let’s leave those massive projects to the Brits, the Japanese or US scientists. Nicaragua needs to find areas in which very meaningful things can be done and in which there’s not a lot of competition from other countries.

It takes some creativity, some thought to discover the areas where a country like Nicaragua can actually make a difference. The first thing is to identify the local resources. And what Nicaragua has in abundance is biodiversity. The range of biological life in Nicaragua is enormous. There are many, many species, some of which you can see and others that you can’t. There’s a lot of life in the oceans; there are viruses, bacteria, funguses in Nicaragua that are unique. But do you know about them? Probably not, because you never go out and document that wealth and don’t know what you have.

You have to be very careful not to do what we did in the West: destroy our environment without even learning about it. That’s why the interoceanic canal project needs to be thought through more intensely. You need to do a good environmental impact study to see exactly what impact the canal will have on the environment. If that isn’t done, if it isn’t known what the impact will be, there is a great risk of destroying species that could be very valuable in the future. You have to be extremely careful not to destroy the wonderful environment you have, which is unique and could be used in a sustainable way. But if you destroy it, as was done in so many countries of Europe and in parts of the United States you will lose that opportunity.

You also have to embrace new technologies. That doesn’t mean going out and buying the most expensive instruments. It means taking a good look at what new things there are, all the new things that are going on. One of the things I mentioned earlier, for example, is that everyone’s involved in sequencing DNA. It used to be that those investigations were very expensive. The first sequencing of the human genome cost something like US$1 billion, and now it only costs somewhere between US$1,000 and US$3,000. The price keeps coming down. The cost of sequencing a simple bacterium is only US$100 or so and can be done in a day. It’s so easy to document what you have that I think the sequencing of DNA is a technology that has to be brought to Nicaragua because it can be done locally and it’s cheap. It also means providing a supportive environment, in which young people who want to do some of these odd things feel it’s okay, that it’s useful. It just means bringing in some money and resources so they can go out and buy some equipment and pay technicians, pay for expeditions to go out and learn something…

One of the things you can do is to make sure that the young people coming up through the universities feel loved and encouraged. They want to feel that you will do your very best to make sure they have the best possible future.

Sometimes this means old people stepping aside. I love young people, and for several reasons. One is that they have no fear. They don’t believe anything can stop them. And this is great. By the time you get to my age, you’re a lot more cautious. There’s no way I’m going anywhere near a mine field. I don’t like the idea that I could be killed! But young people don’t have this fear of the unknown. So it’s really important to encourage them, to nurture young people, to give them the very best education and support they can.

Transgenics: Science for Nicaragua

I want to talk a little bit about some research opportunities I see here in Nicaragua. And the first one I want to talk about is in agriculture.

In the last five thousand years humanity has dedicated a huge amount of time and effort doing what we call traditional breeding, whether with pigs or sheep… almost everything we see on a farm today is not natural; it exists because thousands of years ago someone discovered that they could blend two closely related species and make something that would work better.

Many anti-genome people today are all up in arms about genetically modified species. But the traditional way human beings crossed two closely related species was that if you didn’t get what you want, you typically treated it with X-rays or added mutagens to the plants or animals to eventually get to what you wanted. This isn’t terribly natural. More importantly, with two kinds of crosses, with typical planned breeding, you take a hundred genes from one organism and cross it with another organism without knowing what’s going to happen because you don’t know exactly what those genes are or do, so you just look at what comes out of them and try to decide if the result will be useful. This is a very imprecise way of doing things and one at first sight we could even think is dangerous.

Unfortunately hundreds of years ago when breeders did the wrong kind of crossing, they probably did things that killed them, so you don’t see those. But in fact the kind of breeders these days are working much more carefully and the results are telling us that they are healthy, nutritious and have the qualities we’re looking for… And it’s important to know that those results come from scientific testing.

Somehow genetically modified organisms, GMOs, have become anathema to many, many people. Yet GMOs are incredibly important because they allow us to do things we cannot do by the more traditional methods. One of the things we’re already seeing is a shortage of water. If you wanted to pick a topic on which the next war may be fought, that’s it. In California water for agriculture is running out and there’s even a shortage of drinking water in some places. And this isn’t uncommon. There are many regions of the world where they are suffering a severe drought.

You know what consumes the most water? Agriculture. Almost 80% of the water used in the world isn’t for human consumption; it’s used to grow the crops that feed us. Today we know that there are many crops that can resist drought and live on much less water. In many cases we know exactly what genes are involved in providing this resistance to plants. It just makes sense to try to move some of these traits into crops that are necessary to eat. They use half as much water. This is fine. How you do it doesn’t matter as long as you test the product that comes out of it to find out whether it’s okay or not.

Politics trumped science in
the fight against transgenics

Now you have to realize that the way we reached this point where people began to get suspicious about GMOs is statements that had to do with politics. What happened was that Monsanto, DuPont and several other big agricultural seed companies from the US wanted to control this technology to then control the food supply because this is the way they make money. And when they first introduced GMO crops, instead of producing good food for consumers, foods that tasted better or didn’t cost so much, they only produced products that would make the most money for them and a little more money for the farmers who grew them.

When they introduced those products to Europe there was a strong opposition because people didn’t want US seed companies controlling the food supply of on the European continent. In practice, Monsanto and DuPont and the others already controlled the food supply because they had been selling seeds in Europe for decades, but people saw the GMOs as the last straw.

Although it would have been logical to just stop buying from Monsanto, it turned out to be hard to boycott a company that supplies almost all the seeds for almost all the food we eat in the world. So the way very influential politicians and activists—who really called the shots—dealt with this was to say we can’t fight with Monsanto, so we’ll fight with GMOs. We’ll claim that they’re dangerous because they aren’t natural since in this process you bypass what are considered to be Nature’s normal barriers.

But there’s nothing inherently dangerous in this. As it turns out, bacterial genes, most notably those of agro-bacteria, move into plants and modify them all the time. In fact, GMOs use agro-bacteria to make these modifications, or at least that’s how it all got started.

But it was very easy to scare people. Politicians love to scare people so they can then say: I will protect you. I will stop that dangerous thing and then you will vote for me. And this was the philosophy behind Greenpeace’s movement to stop GMOs in Europe. And it worked really well. They managed to get their members elected into European parliaments and gain quite a lot of power in Europe. But they didn’t think it through properly, scientifically.

Monsanto is responsible

The problem with this approach was that Europe didn’t need GMOs. When did you last see a starving European? But in other parts of the world there are indeed people who don’t have enough to eat, and they do need that GMO technology. But the Europeans couldn’t go and tell the rest of the world that GMOs are very bad for them but good for others. So they just spread the idea that GMOs are bad for everyone. And that’s not true. GMOs are not bad for you.

Of course you could make something harmful deliberately using GMO technology if you wanted to, but who wants to? It’s very easy to test the things that are made. In the past 12 years every scientific society has been looking at the results of GMO testing and every single one of them has concluded that they are safe. In fact if I were to produce a list of all the national academies of science that support GMO foods the list would be enormous. If on the other hand I showed you the list of scientists or academies that are against GMOs, there would be no contenders. It’s an empty list.

Not a single scientific community opposes GMOs, but that hasn’t stopped the activists. And it should be the citizens of the poor countries, the ones suffering hunger, who should be doing the advocacy. There are many very promising technologies coming out of science, but governments don’t always know about those discoveries. This means that the people who want access to these technologies have to advocate for it. I’ll tell you about an example in the health care industry in a moment.

So who’s the real villain in the GMO story? It wasn’t the GMOs; it was corporate America, which doesn’t have a very good reputation for many reasons. In that particular story Monsanto really should be taken to task because GMOs are good, but the way Monsanto promoted them sparked rejection.

Science discovered “golden rice”

I want to mention briefly one of the consequences of being against GMOs. You may or may not know that in the wider world Vitamin A deficiency is a huge problem, particularly for the many people for whom rice is the daily staple, because rice doesn’t produce beta-carotene, the precursor to vitamin A, needed to have healthy eyes among other things. Observing this, two scientists, one in Germany and the other in Switzerland, decided to move the genes that produce beta-carotene into rice so you could actually make rice that produces beta-carotene. They began working on it 15 years ago and within 2 years had their first samples of what is called golden rice, because beta-carotene gives a yellow coloration to the rice.

Had it been produced by traditional plant breeding, this rice would be growing in every rice paddy around the world by now. But it wasn’t. Because it was produced in Europe and because of the European ban on GMOs, it was not allowed to be sold or exported. There was a specific license associated with golden rice such that any smallholder or farmer who wanted to grow it had to pay a special license fee. Golden rice is not sterile, so it could be used by others to go on and grow their own crops instead of relying on seed companies… But the Europeans thought it was a bad idea. As a result of this, several million kids die every year due to vitamin A deficiency. Nonetheless, right up to today the activists are still fighting against that rice because it’s genetically modified. How many children will have to die before that rice is allowed to be commercialized?

GMOs really help with nutrition, they can help the world and in particular can help developing countries. Now that there is so much antagonism to GMOs in the developed world, why don’t the developing countries step in? You know you can make crops here in Nicaragua that are specific for certain land, specific to Latin America, specific to Central America…

Genetically modified products can make a major difference in the food supply for the populations of the poorest countries. It’s no longer a difficult technology; it’s already described and could generate a profitable business, since food could be produced not only for the Nicaraguan population suffering malnutrition, but also to make profitable exports. It would take a while to do, but there’s no need to rush. It has to be done properly; it has to be tested and proven. Just find crops that the US wouldn’t be interested in, that most Americans might even turn their nose up at, but that interest neighboring countries; it’s an open road, an opportunity. But you could develop seed in the very best way you possibly can.

So the lesson that came out of this is that when big developed countries are making policy, when they’re contemplating bans, or thinking about promoting something, it’s no good just to think about the consequences for the local people. Nowadays we live in a world in which everything is interrelated and everything that happens in one country quickly affects others, so we have to think about how policies are going to affect the rest of the world, but that was not done in Europe. The European politicians did a terrible job. They didn’t think about and decide on policies that affected others. They only thought about themselves and thus benefited no one. Simply because they had no need of genetically modified products they prevented others from being able to use them, which would have saved lives. This is just one example of how we need to oblige politicians to listen to science and design policies with a scientific basis.

A crucial field of research

Now let’s talk about health. There is something incredibly impressive about our bodies, about what a typical human body has in it. It has a great many cells, but there’s a lot of other stuff there too. And that “other stuff” is bacteria. We’re absolutely full of them: hair, skin, nose, eyes, mouth, all our organs… Everywhere you look there are bacteria.

When we think about bacteria we think about diseases, illness, because we were taught that bacteria are bad and cause disease. But in fact, the bacteria that live in us are our friends; they are the ones that stop pathogens from growing inside us. If I could see your stomach I would see the amount of pathogens that want to make you sick and can’t. If I were to put those pathogens into a laboratory they would grow very nicely, but they don’t grow inside you. Why? Because the other bacteria are stopping them from growing.

We call this collection of bacteria the “microbiome.” It is the other side of human life. If we were to invent a super-antibiotic capable of killing all the bacteria in our bodies we’d die. We can’t live without bacteria. They are as important as the human genome. There is a lot of talk about what a panacea it is to know about the human genome, because now we’ll be able to cure all human illnesses. Not true. Bacteria are every bit as important.

Only now are we beginning to understand that there are small viruses that we call bacteriophages that can grow on these bacteria and kill them. We know almost nothing about those viruses that kill bacteria and yet they are crucial because the bacteria that live with us have to be able to combat them.

There’s thus a very interesting biological play going on here about which we still know very little. Almost everything we know we’ve learned by sequencing the DNA of some bacteria en masse, but typically some million, maybe ten million genes are killing bacteria that are crucial for our health and we only know anything about a handful of them. And I will guarantee that the bacteria that live in you, here in Nicaragua, are different than the bacteria that live in me, in the US. That’s because our diet is different; we eat different kinds of fruit and other things, and the bacteria will vary depending on how well we metabolize that food.

This is an area that is going to become unbelievably important, having to do with human health, and I’ll give you an example of why it is going to be so important. One of the nice things about bacteria from a research standpoint is that they’re so small; you can easily grow them in the lab… Almost 50% of all life on this planet is bacteria. We, all trees, all animals, all plants, everything alive is full of bacteria. You need a microscope to see them, but there they are. The majority of the life on the planet is microscopic.

They’re in every aspect of life. Soils are fundamentally an enormous melting pot of bacteria. If I go from one field to another I’ll find different bacteria and the bacteria in the soil will be different in different places on Earth. Nonetheless, we don’t know very much about them. This is a wide open area for research, and research that isn’t expensive. Some excellent investigative work could be done in this field without spending much money.

Why we should love bacteria

I have a talk I titled “Why I love bacteria,” that now I call why should you love bacteria? The answer is what’s not to love? They are our defense against the pathogens that otherwise would be trying to take us over. They are wonderful organisms, essential for life. They are the ones that educate and train our immunological system. Sometimes we want our children not to get dirty playing, to always be clean. But the healthiest people on this planet are the kids who go out and play in the dirt and pick up bacteria and develop very effective defense systems. They may develop diseases later on, but as kids they are healthier than the children in Europe and the Unites States, who are always clean but not as healthy as those kids who live in constant contact with Nature. Being a little dirty is good. Most bacteria are our friends.

I’d like to draw an analogy to help you understand about bacteria in a nice way. Imagine what happens when you buy your first house: what do you do? You protect it. You put a nice fence around it or you can put an alarm system in and you set it up in such a way that you feel safe. Okay; we are bacteria’s home so they want to protect us. They don’t want us getting ill, because their home would be destroyed. So they plan all sorts of ways to protect us. Good bacteria are anti-bacterial agents that kill pathogenic bacteria. They make many agents that will kill many of the harmful bacteria. They also don’t want us to get cancer so they produce anti-cancer compounds. There are probably a lot of other things they do that we don’t even know about yet. This is untouched territory. Even in the US only recently have scientists discovered how valuable all this is, so now they’re starting to put some resources into it to study it. And the nice thing is that your bacteria are different than mine, so you’ll be able to do research here and in other countries. I can guarantee that India, just like Nicaragua, will have some very interesting bacteria, and studying it will be very useful therapeutically.

A hundred and fifty years ago, when we discovered the bacteria that cause disease, we focused on all those organisms. And this is why bacteria acquired a bad name. And it’s why in the popular press people got it in their mind that all bacteria are bad. But bacteria aren’t bad. Bacteria are really good. You should take care of them, love them and nurture them.

Many of you know about something about probiotics, these compounds you take that make you feel better. A lot of them contain live bacteria, and one of the very best is yogurt. Many, many people love yogurt, which has Lactobacillus bacteria. This is a really good source of organisms that can do wonders for your stomach and is very, very good.

In fact, even some of the bacteria considered a little dangerous have some useful property. Helicobacter pylori, which is associated with stomach ulcers, also protects from asthma… So even some of these bacteria that have properties considered a little bit dicey may be good for us.

The downside of C-sections

I just want to mention something here because of how prevalent it is in Nicaragua. Caesarian births are only a good option if it’s to save the mother’s life. In many countries women prefer to give birth by Caesarean rather than a natural birth for the main reason that with a Caesarean they can program the day and hour of the birth, which they can’t know if the birth is natural. But it turns out that children born by caesarean section typically have some health problems that children born by a normal vaginal birth do not have. And we think we know the answer, which is that when a baby passes through its mother’s birth canal it picks up all her bacteria and this starts the microbiome process. Upon being born, its skin is covered with the mother’s vaginal juices and those good bacteria are like seeding a good farm. Today many obstetricians and gynecologists defend natural birth because it’s healthier. And when it’s necessary to do a caesarean section they a swab of the mother’s vagina and coat the baby in order to try to get that microbiome going.

So I think that having a C-section is only a good option if you cannot give birth normally. But not if it’s only done for the mother’s convenience. I think it’s probably much better to just wait.

Clostridum difficile, a dicey bacterium

And speaking of dicey bacteria, I want to present one to you. It’s clostridum difficile, an interesting bacterium that causes colitis and serious intestinal symptoms. If you go to the hospital and spend any amount of time there, chances are that you’ll come away with a clostridum difficile infection. It causes unexpected diarrhea and other very nasty symptoms that can dramatically change people’s life. The illness lasts for months sometimes. This happens because many of the bacterial strains found in hospitals have been made resistant to all antibiotics. Even the two most top-line antibiotics, vancomycin and fidaxomicin can only a kill a few strains of it, but they don’t kill all of them.

There’s not a single antibiotic that assures us of being able to kill it. That’s why it’s called difficile. If you have a clostridum difficile infection, it doesn’t necessarily kill you, at least not at first, but it makes your life so miserable that you just want to stay home because the diarrhea can attack violently at any time…. This is just one of many diseases that we biologists still know virtually nothing about.

The good news is that there is a treatment for the infections this bacteria causes, and it’s called fecal transplant. Bacteria are taken from the gut of a healthy individual and passed to the individual infected with clostridum difficile and 91% of the time it kills the infection. There is something in the duodenal microbiome of healthy individuals that can kill this highly resistant infection. Fecal transplants aren’t the nicest thing you could contemplate, so a friend of mine is studying a better way to do it. What she did was to isolate the bacterial slurry and find a way to put it into a capsule the way you might take any capsule of medicine. Unfortunately the capsule she came up with is translucent, which is probably not the best.

It’s something very admirable: there is a bacterium that resists everything yet there are bacteria inside of that can beat it. How does it work? Right now this study is still a black box, but discovering how it works will be very useful. It would be a very interesting area to do research on here in Nicaragua. And there must be many other examples that would show up when we start laboratory studies.

Fecal transplant is a very inexpensive way to treat such a bothersome illness that’s resistant to antibiotics. The majority of medicines we buy from the pharmaceutical companies have prices agreed upon according to the laws of the market. In the case of clostridum difficile, the typical treatment with antibiotics that treat some of the infections caused by that bacterium cost US$3,000 and really don’t work. Yet the medical companies won’t pay for the fecal transplant but will pay for the antibiotic. They prefer to pay US$3,000 for a treatment that doesn’t work than pay US$500 for one that does. Why is that? Because it’s about feces and they consider it will be harmful for the patients so the hospitals refuse to do those transplants, even when the patients sign that they accept them. And why do they refuse? Because they fear a lawsuit and are scared to death of lawyers.

Bacteria are science
within Nicaragua’s reach

The study of bacteria is virgin territory. In the United States only very recently have scientists discovered the importance and the value of this research. And now it’s spending resources on it.

This is a field of scientific research within your reach in Nicaragua. I assure you, I guarantee you, that the bacteria living with you here in Nicaragua are different than the bacteria that live with me in the United States, because we have different diets. The bacteria that live in a person’s body basically eat what that person eats. The study of bacteria is a very important area for human health. And they are relatively easy to study. They are small; we have them in the laboratory; and sequencing them allows us to know about them…

If we already know that Nicaraguans’ bacteria aren’t the same as mine, it’s with those bacteria from here that you can do research in Nicaragua. And surely the bacteria of Mayangnas and Miskitus are also different from those of the population from the Pacific. By studying them you can use them therapeutically.

Let’s all study science!

Certainly medicine will be increasingly personalized, but this means that it will also be increasingly expensive. And the political authorities don’t know how to deal with that. They have fears; they are bureaucratic authorities and are afraid of lawyers. What’s the solution in my opinion? Close the Harvard Law School and send all the law students to the School of Medicine to turn all those lawyers, who will later become politicians, into scientists, gettting rid of two problems at once.
What’s my conclusion? If the people of Nicaragua, the educators, politicians, media and society itself embrace science, I see a magnificent future here for researchers who will benefit the universities, the economy, society and over the long haul the world. I’m sure that, from science’s hand, things can be discovered in Nicaragua that will be beneficial for the entire planet.

Richard J. Roberts is a biochemist, 1993 winner of the Nobel Prize in Physiology and Medicine, which he shared with Phillip A. Sharp. Experimenting with genetic adenovirus material, they concluded that ribonucleic acid (RNA) preceded deoxyribonucleic acid (DNA) in evolution.

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