Funding original ideas

The Nobel Prize in medicine and physiology was given to Barry Marshall and Robin Warren in 2005 (Sweet, M., “Smug as a bug.” Sydney Morning Herald, August 2 1997). They had discovered that a germ, helicobacter pylori, was the cause of gastritis and ulcers, when this went against conventional thinking. They had benefited humans with their discovery and rightly deserved the prize and the recognition.

Professor Marshall has been made a Fellow of the Royal Society and a Fellow of the Academy of Science in Australia, both very appropriate awards for any Nobel laureate.

But they were ridiculed by establishment scientists and doctors, certainly early on because their theories did not “fit” with mainstream thinking.

They applied for, and did not win, a project grant from the National Health and Medical Research Council (NHMRC) in 1983 for a project which embodied their views. They were funded the following year when the grant application went through their hospital.

The consensus view then (and I was one researcher in their field) was that acid was an essential component of ulcers and, since their infection theory did not mention acid, it was assumed that it must be mistaken. It was only when all of Koch’s postulates were satisfied that people came to accept the radical ideas which Marshall and Warren were promoting. The then current view correctly talked about the balance between acid and protection but did not realise that an infectious agent was the cause of diminished protection.

Had Marshall and Warren been totally dependent on peer review grants from the NHMRC, they would not have been able to do their work. A commentator has written: “There is no way that program funding would have been made available to a gastroenterology registrar and a hospital pathologist.” One wonders: why not? It is the idea and not the person who matters.

To be fair to the NHMRC they didn’t do nothing. In 2003, 20 years after the first rejection and just before Marshall and Warren got the Nobel Prize, the NHMRC again declined to fund Warren and Marshall. In 2006 Professor Marshall spoke to the new CEO of NHMRC soon after his appointment and consequently the NHMRC decided to establish special scholarships for those scientists awarded the Nobel Prize.

And so they should!

It seems that the system, careful as it is, failed in this instance. By the way, this treatment is in contrast to the treatment by the University of Western Australia and the Government of Western Australia which have been generous and quick with their support.

The error seems to have been one that statisticians call “confounders”. One can say that all rapists have eaten mashed potatoes, but one cannot then say that mashed potatoes cause rape. Similarly, one can observe that most people with duodenal ulcers have high levels of acid, but it does not follow logically that those acid levels cause duodenal ulcer. Yet that is the line of thinking that conventional research was pursuing.

It is not as if what happened in this instance was unique and was an accident. History is littered with examples that show similar failures to support ground breaking different ideas when those ideas have been heterodox.

First, we might consider the Great Plague in London in the 1600s. The consensus view at that time was that the fatal illness may have been caused by birds or miasmas and that long bird shaped facial masks with bunches of flowers or strong smelling herbs in the end were a protection against the birds and bad smells, and therefore against the plague. After all, those who wore the masks were not being attacked by birds, and were breathing the sweet smell of the flowers, not the bad smells of the environment. If someone at a consensus meeting then had stood and suggested that little bacteria, invisible to the naked eye, were the cause of bubonic plague, that person would have been laughed out of the meeting. The people responsible devised a logical - albeit an incorrect and ineffective - means of addressing the disease.