A Miracle Drug for the world’s poor
Part of the “miracle impact” of ivermectin is its ability to reach and benefit the most remote rural parts of Africa and elsewhere, including communities where there are no health workers or resources. The drug combats diseases cause by parasitic helminth worms, such as onchocerciasis, and lymphatic filariasis, as well as reduces the socioeconomic impact of the diseases by allowing people to work and be more productive. Yet getting people to take the drug required extreme efforts and creativity to surmount language barriers, lack of equipment to measure the proper dose, and lack of trained health personnel. Overcoming these obstacles led to the creation of the world’s largest, longest running and most successful drug donation program.
Ivermectin has overcome all of these obstacles. As Omura himself puts it, “It is an extremely safe drug. Anyone can administer it, even if they’re not a doctor. Most medicines need to be taken multiple times to be effective, but this only needs to be taken once, annually.” A person’s height is roughly proportional to weight, so village representatives can allot the number of pills to individuals based on height, making it possible for anyone to administer the appropriate dosage. Today the drug is freely available through a worldwide drug donation program for the treatment of onchocerciasis and lymphatic filariasis, thanks to the combined efforts of “a large collaborative international partnership, including the World Health Organization, the American pharmaceutical corporation Merck & Co., the World Bank, foundations, and individual countries and NGOs.”
Born “By Chance” from the Soil of Japan
The small plastic bag from his wallet
This incredible drug came from a chemical produced by a microorganism unearthed from soil in the Izu Peninsula in Shizuoka Prefecture near a golf course. Omura gathered some soil, separated it out, and analyzed the microbes it contained to discover which ones were novel and unique. After initial screening for novel chemicals produced by the microbes and to identify any bioactivity, the most promising organisms were sent to Merck & Co. in the U.S., where a completely new substance, avermectin, produced by one of them, was found to be effective in killing parasites in Merck’s specialized screening system. Avermectin was further developed by a multidisciplinary team into a drug called ivermectin—effective not only against parasites in livestock, but also later found to be dramatically effective against onchocerciasis in humans.
Omura says that this miracle drug came from Shizuoka “by chance.” “I gather 2,500 samples all across the country each year. I cultivate and assess the bacteria, which usually aren’t useful for anything. I just repeat that process over and over. It’s a lot of work.” Omura takes out his wallet. “I don’t have much money in here,” he jokes, pulling out a plastic bag. “But I always carry this with me, and even now gather things (soil and so forth) and send them to the lab. I sometimes find things that are worthwhile because I do this all the time, whether awake or asleep.” His hunger for research is insatiable.
Pivoting from Teaching High School to Organic Chemistry Research and Working in the United States
Omura during his time as a high school teacher
Omura’s work history is unusual. He is originally from Yamanashi Prefecture. In high school and university he focused his attention on sports and was so talented at cross-country skiing that he was “without peer in the prefecture.” He went on trips to Niigata Prefecture, which is famous for its ski slopes, and practiced with Olympic athletes. “I learned that it’s valuable to put yourself in a high-level environment. And that it’s important to work really hard without copying other people.”
After graduating from Yamanashi University, he took a part-time teaching position in science and physical education at a high school. However, he struggled with teaching students of his own generation. He realized that he “needed to go back to school,” and so became a trainee at the Tokyo University of Education (now the University of Tsukuba) and then a Master’s candidate at Tokyo University of Science. In 1965, he joined the Kitasato Institute as a researcher.
The Kitasato Institute, established by Shibasaburō Kitasato, is a research institute that has made significant contributions to the development of medical science in Japan and internationally. However, Omura’s specialization in organic chemistry was not considered “mainstream,” and he realized that the breadth and depth of his research would be limited if he remained in Japan. In 1971, he went to Wesleyan University in the United States to work with Professor Max Tishler, who would later serve as president of the American Chemical Society. Tishler, who once led the laboratories of Merck & Co., introduced Omura to this global corporation and thus helped expand his network in the industrial–academic community in the US.
Why was Omura so highly respected by one of the most prominent professors in the United States? Omura says that it was because “in addition to having made scholarly achievements,” he was “also good at teaching.” There are few people who can write high-quality papers and also inspire and motivate students. Years later, after the creation of ivermectin and when Merck & Co. was in the process of determining royalties that should be paid to Omura for his crucial contribution in the discovery and development of what became the world’s most profitable animal health drug, Tishler reached out to his personal high-ranking friends in the company, asking them to “make Satoshi happy.”
“If you don’t have the money, be smarter. If you are not smart enough, work harder and don’t stop.”
After returning to Japan, Omura took over the ongoing research program at the Kitasato Institute. “It was a tiny lab. There were two people with graduate degrees, two with undergraduate degrees, and one person who’d only completed high school,” he recalls. As an environment for research, it did not compare with well-resourced labs in the United States. But he encouraged his staff, telling them “become an expert in the field” and supporting them through praise and positive reinforcement.
Fortunately, thanks to his insight and tireless work, his lab had a generous budget. He had initiated negotiations with Merck & Co. before leaving the United States and arranged to receive an extraordinary US80,000 dollars per year in research funds, which made him a pioneer in industrial–academic collaboration. He continued to grow this cross-sector network through his lab in Japan. As a part of his effort to create a positive work environment, Omura hosted regular seminars with compelling guest speakers from both inside and outside Japan—an impressive lineup that included many Nobel Prize winners. He says, “I wanted to create a seminar to which it would be an honor to be invited.”
He showed distinctive “Omura style” in his approach to staff education, as well. He once distributed copies of a respected paper to his team and said, “don’t imitate what is written here.” He always told his young researchers, “If you don’t have the money, be smarter. If you are not smart enough, work harder and don’t stop.”
He has also had an outstanding history of receiving awards, of which the Nobel Prize was a crowning achievement. Despite these accolades, he says he carries a sense of unfinished obligation as a researcher. “During university, all I did was ski, so my research was always behind. I feel like I have to work really hard to make up for that now.”
A Passion for the Arts
Omura’s achievements are not limited to the field of chemistry. The Kitasato Laboratory Medical Center Hospital, which was built using the royalties from ivermectin, is a “hospital filled with art.” Omura has a deep knowledge of art, and its influence on him is powerful: “When I get stuck on something, I look at art.” He was an early proponent of the positive relationship between art and healing. In addition to being a chemist, he is also the board chairman of Joshibi University of Art and Design.
He has contributed a great deal to local communities. To support scientific research in Yamanashi Prefecture, he proposed the establishment of the Yamanashi Academy of Sciences, which celebrated its 20th anniversary in 2015. This prefectural science academy is exceptional in Japan and reflects his strong feelings about his home prefecture. “I’ve been doing ‘regional revitalization’ for the past 20 years. The most important part of regional revitalization is education.”
“Dramatically Effective” against Tropical Diseases in Africa
Ivermectin bottles distributed in Africa
The compound “avermectin,” which proved to be effective against livestock parasites, was detected in a microbe gathered from soil near a golf course in Shizuoka Prefecture. Ivermectin, used to treat internal and external parasites in livestock and pets worldwide, was one of the most successful compounds developed from the original avermectin. It was the top seller among animal drugs for more than 20 years worldwide and contributed to increased food production as well as high-quality leather. Until the release of this drug, both onchocherciasis and lymphatic filariasis plagued hundreds of millions of mostly poverty-stricken people around the world but there was no universally useful therapeutic drug to treat them. Thanks to ivermectin, both diseases are now expected to be eradicated globally within 10 years. As a human health product developed in collaboration with a multidisciplinary international partnership, ivermectin is unique, unmatched and highly successful. It serves as the paramount example of how global health can be greatly improved through research and development work, especially that involving industrial–public–academic cooperation.
Discoverer of Ivermectin
Born in Nirasaki, Yamanashi Prefecture, Omura became a teacher at a public high school after graduating from Yamanashi University. He then switched careers and became an organic chemistry researcher. After serving as an visiting research professor at Wesleyan University in the United States, among other scientific leadership positions, he spent a long time as the head of Tokyo’s Kitasato Institute. His research on naturally occurring organic compounds has been highly praised worldwide and he has been widely recognized as a world leader in this field, especially with respect to macrolide antibiotics. In 1995, he founded a science academy in Japan that is now a public interest corporation. He has a deep knowledge of the arts and serves as the board chairman of Joshibi University of Art and Design. He also built the Nirasaki Omura Art Museum, which he has donated to his ancestral home city.