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Prevention Gets Its Day

A girl is getting a vaccin against cerviA girl is getting a vaccin against cervi
A girl receives an HPV vaccine.Photograph by AFP/Getty Images

One of American’s premier science prizes is celebrating research into the prevention of cancer. I have three words for that: It’s. About. Time.

The Albert and Mary Lasker Foundation announced yesterday that it was presenting its prestigious 2017 Lasker-DeBakey Clinical Medical Research Award to a pair of National Cancer Institute researchers, Douglas Lowy and John Schiller, who created a vaccine to prevent human papilloma virus, or HPV, from taking hold in the body. Certain strains of the virus, which is sexually transmitted, are known to lead to the development of cervical cancer, as well as to cancers of the genitals, anus, and oropharynx (the part of the throat that lies just behind the mouth). Together, these brutal malignancies kill an estimated 250,000 people each year—many of them in the poorest countries on the planet.

Overall, HPV is the most common sexually transmitted infection in the United States, with one 2007 JAMA study detecting the virus in 27% of the nearly 2,000 women tested between the ages of 14 and 59. While the human body is able to clear most infections within a couple of years, those that linger can cause problems. Certain low-risk strains—there are, in fact, more than 100 types of HPV in all—can cause genital warts or benign or low-grade changes in the cells of the uterine cervix. The much rarer HPV 16 and 18 strains, however, can turn deadly. It’s believed that these two strains of the virus cause 70% of cervical cancers worldwide. (There are good write-ups about this in the journals Science and Cell, and in Paul Goldberg’s authoritative The Cancer Letter.)

Lowy, who is the NCI’s acting director, and Schiller, who is deputy chief of the Institute’s Laboratory of Cellular Oncology, have collaborated for three decades in the NCI’s famed intramural research program. In a seminal 1992 paper published in the journal PNAS, Lowy, Schiller, and colleagues showed that certain proteins in HPV’s capsid, or shell, could trigger an immune response, even in the absence of the infectious virions (the dangerous part of the virus).

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The finding, along with a huge amount of follow-up work, suggested that these capsid proteins could serve as the basis for a safe and effective vaccine against a virus that causes enormous suffering in the world. But when they broached the idea of developing such a vaccine with drug companies, nearly all of them said, “No, thank you very much, but we’re not interested,” recalls Schiller in a Lasker Foundation interview. “They’re probably kicking themselves now because it’s a multibillion-dollar drug,” he adds.

There are actually a few of those drugs now: Cervarix, made by GSK, which targets strains 16 and 18; Gardasil, made by Merck, which preempts those two killers, plus strains 6 and 11; and Merck’s Gardasil 9, which primes the body’s immune system to create protective antibodies against—you guessed it—nine types of HPV.

We’ve had real-world data about the vaccines’ effectiveness since 2006, when the FDA approved the first. And, yes—they’re safe and very (though not wholly) protective. Quite astoundingly—and unfortunately—their adoption has been far too modest and spotty in the U.S.—but that’s an issue for a different essay.

Nonetheless, the work celebrated by the 2017 Lasker-DeBakey award—is truly world changing. “In the next 50 or 60 years,” said Schiller, “the vaccine has the potential of preventing like 19 million cervical cancer cases and 10 million cervical cancer deaths. That’s huge.”

It sure is.

Which brings me to the release today of Fortune’s annual celebrated “Change the World” list, where we highlight companies that are tackling key societal problems with the same ambition—and, importantly, sustaining profit motive—that they’re pursuing their core business operations. I think it’s a great—and surprising—list. Please take a moment and give it a read. And as always, please write and let me know what you agree and disagree with, or think we missed.