An imaginary yet perfectly plausible scenario: a ICREA researcher is receiving a Nobel Prize in Stockholm, and in her acceptance speech she reviews the institution’s history and the challenges it still faces. The names mentioned are real people who work here in Barcelona and are currently playing key roles in the history of biomedicine that is unfolding.
© Òscar Julve
The presenter had summarised her scientific career very elegantly, leaving the atmosphere crisp with expectation. She made her way toward the lectern, sensing the weight of all eyes on her. The lighting was adjusted and the polite applause faded away. The first seconds of any talk are always the most important. She had thought she would make an institutional-type speech, but had changed her plans at the last minute. Suddenly it didn’t seem like such a good idea.
“The work that has led us to this Nobel Prize has greatly affected my life and, thankfully, those of many others too. Now it’s easy to take centre stage, here in the spotlight, in front of this distinguished audience.”
She picked up her glass to stop her hand from shaking.
“It is the outcome of a sequence of inspired decisions by a number of people, all of them committed to Barcelona, Catalonia and its biomedical research.”
“Twenty years ago”, she continued, “people began to see research as a way of bringing change to Catalonia’s economy. At the start of the century, we were victims of the belief that ‘construction equals profit’. We missed out on a great opportunity to build the economy on a stronger foundation.
Fortunately, a small group of influential figures began a new era, without fear and with the idea that they could change the model. Now their vision is a reality. The fact is that a social transformation of this scale had not been seen in Europe since Finland in the final third of the 20th century. Research institutes were created that were small, agile and determined, and there were many of them, like never before. It was surely the most significant change in research we will ever see. These institutes sprouted up both in and around Barcelona, certainly making the most of the tremendous pull the city already had, even then.
The ICREA (Catalan Institution for Research and Advanced Studies) was thus founded at the turn of the century, as were most of the research centres that have been key players in this history. The other main ingredient was connections. As well as being simply functional, to reap full rewards institutions need to work within society. Thanks to the fact that our researchers can move throughout the system without any restrictions, the ICREA again proved itself to be a key part of the network.
The revolution that took place in hospitals during the first decade of the 21st century, but which had already begun in Catalonia long before that, was another factor.
We now know that far from negatively affecting healthcare as was previously thought, clinical research actually strengthens and improves it. Key factors include the fact that Catalonia is now the world leader in the number of clinical trials per million inhabitants – a position it already holds in the number of transplants. Without this, our research into cancer would never have been so far-reaching or so closely linked to treatments.
Neither would we be here today were it not for the brave policy of recognising that the private sector is essential for the success of the public sector, and were it not for a firm public procurement policy designed to use the considerable purchasing power of government health spending to drive research, putting in place appropriate incentives for the companies that innovate within our system. In a nutshell, if Barcelona has now become the principal biomedical hub in Europe, it is thanks to many factors: the healthcare system, the research system and the public sector’s will for innovation through cooperation with the private sector. There are many cities that have one of these elements, but none that combines all of them. It is thanks to this that we have a medical devices industry that competes with German companies, something undreamed of at the start of the century when we were lagging far behind in Europe.
When we started out, we already knew that inflammation was linked to cancerous processes, and we had also come to the conclusion that it is not a good idea to spoil the work of the immune system with chemotherapy that shoots everything that moves. You could say that we were on the right track, but with a long way still to go and still a lot to be done.
Then Manel Esteller brought our attention to the fact that healthy cells sleep, whereas cells in tumours are insomniacs. Xavier Salvatella pointed out that proteins can be pliant or rigid, like the parts of medieval armour made of solid plate and chain mail. And Eduard Batlle deciphered the spider web of relationships that dictate the progression of colon cancer and the sequence of orders that can slow its advance.
Furthermore, Ben Lehner provided his insight that tumours are not balls of cells, but in fact complex ecosystems, highly differentiated and with specialist cells to carry out each of the functions that make cancer possible: mobility, invasion, regulation, growth, administration, logistics, etc. Each of these functions can be hereditary in the cells, and can be desperately needed.
You see, the fight against cancer has been going on since before humans. It really began 550 million years ago, and was the first problem solved by the first multicellular organisms. However paradoxical it may seem, theoretical biology has enabled us to discover the mechanisms that made this first victory possible and gave us the knowledge to repeat the technique, to prevent tumour stem cells from building resistance to drugs.
These are all things that only make a real difference when they are brought together in the right place.
When patients from the whole country can be used as a platform to develop new therapies, the speed at which ideas turn into results rockets; the fact that our therapy has been protected, developed, registered and used in less than five years is a milestone that has changed the way biomedical research is conducted on a global scale.
These inputs have all contributed to the complex mosaic that we now control. First you must understand the problem, then you need the right technology to deliver your solutions to the precise spot where they are to take effect.
Thanks must be given to the authorities for their generosity and courage in continuing to spur the sector on throughout this time, without any guarantee other than scientific excellence. We must also publicly thank our investors who have helped to make all this possible and have trusted our ability to bring this major breakthrough to market, and above all the people who have made Barcelona the community with the finest integration between the health care, academic and industrial sectors in the world. Thank you so much.”
The room burst into applause. The speech had worked, that was obvious. Nevertheless, as she cast her eyes across the crowd, she could not help but wonder: “Fantastic. So what next?”
This is of course an imaginary scenario, but one that is perfectly plausible; the names she mentions are real people who work here in Barcelona and are currently playing key roles in the history of biomedicine that is unfolding.