Sir Mark Walport - Director, Wellcome Trust HARDtalk

That's it from me. It is now time for HARDtalk.

Welcome to a special edition of HARDtalk, recorded in front of an

audience in the village of Portmeirion. My guest today is Sir

Mark Walport, the director of the Wellcome Trust, one of the biggest

most influential funders of medical research in the world. Must of the

trust money is being ploughed into cutting-edge genetic science. It

promises to transform healthcare around the world. Our knowledge is

ever expending. But what about owl was done?

Beached as, bro!, welcome to HARDtalk. It seems to me you are a

doctor who works on the most extraordinarily wide canvas. You

are responsible for the disbursement of hundreds of

millions of pounds a year it to find the best cutting edge medical

research. It is -- it sounds quite daunting. Yes, but it is also very

good fun. I started my life as a medical researcher working on a

narrow focus problem. I was interested in understanding how a

deficiency in the immune system would cause a small number of

people to develop and serious auto- immune disease. I have always been

interested in the broad canvas of science. I started as a boy by

collecting Beatles and butterflies. I have always been interested in

brought things. I used to be faced with I whole range of different

facts and puzzles. The EU believe we are a long way down the journey

to understanding human biology? How much did we yet know? We don't know

each future mark. The Wellcome Trust has set out five big

challenges for the community. One of the questions is understanding

the brain. Do we think we will in the next ten years? Not a chance.

There are big questions. You are suggesting war is on known Denise

unknown? It is difficult to quantify that. But there is a huge

amount we don't know. You have talked about a revolution in

bioscience. You have targeted what is happening in genetics. I want

you to explain to me why you believe work with genetics, the

human genome, is so revolutionary? It gives us a more complete picture

of our biology in a way we never had before. Two examples. Cancer.

For the first time it is possible to sequence the care of the genome

from a skin cancer and compare it with the cells and tissues from

which it came. You can identify all the mutations. There is a good

example. In 2003, one of my colleagues sequenced malignant

melanoma. When it developed secondaries, it is one of the

nastiest, most difficult cancers to treat. He found the mutation in a

specific gene which happens to be expressive protein in a growth past

way. It activates it. Immediately you see something that activates

something. That is a candidate for a cancer-causing gene. Decided to

find that mean that if a test was run on me and we had that

particular genetic trait, we could be without doubt predicted as

getting all being prone to getting a melanoma? No, because that is in

a quiet mutation. It has one of the ones that causes it. But that was

in 2003. Lastly, we have a licensed drug that actually starts to treat

that cancer. That is an extraordinary journey. But another

example which is that in some families where there is frequent

occurrence of breast and ovarian cancer, that isn't I had -- that

isn't an inherited trait. You can identify women and men. That brings

me to the big plate. To what extent is it going to lead us to a new

form of determinism within medicine? If all newborns across

the world at some point up mapped, their genetic code was fully mapped,

would be then be able to say, this childbed this child and this child

are going to leave for so may use and diet of a particular disease?

The answer is it all depends. But we are in a wonderful mixture of

jeans, our environment, and chance. At one end, there is a disease like

cystic fibrosis. If you had the genetic mutations, the disease will

happen. There are a number of those. For most of us, the genes that are

being discovered just cause a tiny increase in the contribution to the

likelihood of getting the disease. Most of the genes that have been

discovered contribute to susceptibility to type 2 diabetes,

for example, there is a huge environmental factor in that. He's

just come for her are a tiny increase in risk. Why is that worth

finding out? Because it tells you the pathways that you might

manipulate with drugs to actually treat or prevent it. Or try to win

Ginny? To what extent we now looking as the ability to we and

Ginny? Going into the embryo, further than a newborn babies. --

we engineers. If we see problems when we screened their genetic

make-up, trying to repair the problem? There are two examples.

Firstly, gene therapy. It doesn't affect the germline. It treats me

as a patient but it is not something I would pass on to my

children. That is beginning to happen for young children who are

born with extreme indifference -- inefficiencies. Theremin systems

did work. They can't survive outside a bubble. Gene therapy is

starting to give their Amin systems back. It sounds very soothing.

is. Is it really? I have read in the past a whole stream of

newspaper stories suggesting that the ability to reach Engineer our

DNA and material is actually extraordinarily worrying. It gives

scientists a power that reminds us of so many frightening things about

the ambitions of humans to perfect the human form. But you have to

take specific examples. I don't think many people would argue that

using gene therapy to keep someone alive, a child alive he would have

a miserable time with rejections and then die, most people would

think it is entirely acceptable. Gene therapy to change the colour

of your eyes, most people would think that's ridiculous. I take

your point. But it is complicated in the benign case you mentioned

before. There is an issue right now. Newcastle University scientists are

trying to change the mitochondrial DNA. Because that essentially, if a

child is born with an opponent of their mitochondrial material, they

will die. It needs to be fixed in the embryo. But to fix it, you have

to take demands -- genetic material from a donor egg. The trialled is

their unborn with Material not just from its parents, but from another

person as well. There are all sorts of ethical questions. The Iraq yes.

We have an ethical framework for discussing that in the UK. It is

not a decision that will be made by a single doctor. Bought a

healthcare team working with patients. It is debated by society.

There has been legislation that enables it to happen. Regulations

would need to be late. Human Fertilisation Authority is... We

set up this structure in the UK which is taken from IVF to the

position we are in now. It is an interesting test case. What you're

doing is taking youngsters who are born with diseases in the

mitochondria. Mitochondria is the batteries of the cell. The vast

majority of the DNA which we inherit from her parents, more than

99.9 %, is in the nucleus. But mitochondrial, which are the

batteries, have their own small amount of the Naze. A handful of

genes. By swapping the Nuclear's from the parents who would

otherwise transmit the disease into an egg which has had its nucleus

taken out, you can potentially fix that for that trialled and for that

child of spring. You don't think it is a problem that the trialled then,

biologically, is formed of more than its own parents? You don't

judge a camera by the make of its batteries. I don't think the

mitochondria gives you much in the wake of personality. I think in

this particular case, it is OK. But there is, if you like, a slippery

slope. There are always two ways. You can approach it in two ways.

With creme pawns or with skis. Which are you wearing right now?

Creme Poms. This is a very small change. It is going to be well

debated by society. You say it has been well debated and that the

public is on board. But I wonder. But if one takes a step back and

looks at the big picture. It is fair to say that faith and trust in

science and scientist has taken a knock in recent years. Look at all

different sort of controversies from the measles, mumps, rubella

argument. A leading scientist was discredited with his argument. You

could look at the Climate Gate, the way in which information about the

warming of the planet was interpreted. Look at opinion polls.

They suggest the public is sceptical about science. You can

apply it to medical science. Is the public ready to put as much faith

in it? You say that but when you look at the balls of trust in the

sense, scientists come up very high. That was below the belt but I do

accept that. Trust is a specific. You trust

someone in a particular context. I just made a below-the-belt comment

about journalists. Trust is specific and a thing that is one.

When you talk about gene therapy, what gene for what purpose, the

genetically modified food debate was couched in the wrong terms. It

was thought that as a generic thing but it isn't. What a gene for what

purpose? At the end of the day, the consumer did not think that much

about a tomato that took longer to rot because they do not rot very

much in the fridge anyway. But what about rice with more vitamin There

protect blind us? That needs to be the discourse about science and

society. It is not up to the side is to tell everyone what to do. It

is the sort of discussion. Indeed and that leads me to another

element of the trust debate. Not so much about the principle it fits

behind some of the work that has been done that more about how safe

the information is that is now being gathered. We talked earlier

on in the conversation about the mapping of the genome and it is

quite likely every saying that every individual and the

industrialised society would have the most amazingly detailed

statistical data upon themselves within some sort of computerised

system. If they want to have that?

Here it is an interesting point. How can you be so sure?

This is about trust again, isn't I have spent my entire life as a

doctor and the first thing I learned and medical school is the

only do a test if you can do something useful with the result.

But I have already read papers where researchers have said that

there's so much incredibly useful information out there - if only it

is anonymous. Ie, it is Orchid the monomers and we cannot link it to a

particular individual. -- war kept anonymous.

The first thing I would say is that our health records are an

enormously powerful source of personal information and public

health information and so the question is, is it proper that

medical records should be sheared in and an ominous form - and we can

debate the meaning of anonymity - in such a way that if I was

diagnosed something that my treatment could be used to inform

others. One of the things the or realise is that when the new drugs

get into the market place when a general, they are being used in

different people and that means new side-effects and the rich. And

don't we all want - information? I would be scandalised if I had a

side effect and the information was not shared. I am concerned that my

own personal confidentiality is contained and that means you do not

without information it could eventually identify me on the

internet but you put it out into a safe haven, where, if you like, a

member of the health team could look at what the side-effects are

associated with a particular treatment and I think that could

happen. How many patients do you want...

So I take it that you are in favour of as much information and data

sharing as possible? Yes but within boundaries.

By a aside from the privacy issues, other also commercial issues here?

Not so long ago I wish -- I interviewed one of the leading

lights behind the Matthew of the human genome. His motivation has

been commercial from the very beginning. He wants to make sure it

loads of money from his brilliant research. How do you feel about

those who want to make money out of their brilliant research and keep

copyright and patent over what they are discovering? You have a problem

with that? I will answer that in two parts. In

terms of the genome, our frost was part of a public effort. We funded

the decoding of a third of the human genome and we wanted to

maximise the value of that and the way to maximise the value of that

was to put it on the Internet and that was what happened and had

prevailed. Patents are about inventions and the secrets of the

human genome or any other is not an invention of humans - it is an

invention of nature. On the general question as to, should people be

able to make money out of biomedical research? Well, who

makes for its? It is the brick industry.

Do you think the huge pharmaceutical giants of the world

put their money into the sort of research that is most useful, most

beneficial, for the most human beings on this planet...

The answer is for some diseases, yes. For example, the reduction of

cardiovascular disease by the discovery of certain compounds has

been hugely beneficial. There is a market Fabia for some other

diseases we have markets that cannot afford to pay for treatment,

such as in the developing world. That is why new mechanisms are

being developed. Is that will you come in? You see

your role as a way of filling in the cracks where, you call it a

market failure, with the commercial pharmaceuticals will not put money

in for research because they do not a profit -- see profit in it? Is

that the UK and in? -- is that we do you come in?

For us it is about the brightest minds. The scientists who have the

best ideas and we believe in supporting the smartest people. But

in terms of... Picking winners, some would call it

- you are a bit like a venture capitalist or medicine?

There are since it -- some similarities in principle but the

vision of our frost has to improve human help and that will only

happen if the discoveries in the laboratory bench and it may take a

very long time - and one of the positive aspects of our crosses

that we have a long-term time horizon. We do not have elections

every four is a week and have a long vision. Industry must play its

part as well. With it and an age of all austerity.

Not just in the United Kingdom but across the industrialised world

which presumably means there is a squeeze on medical research budget

along with many other publicly funded budgets. Before you open

your mouth, let me ask you this - do you think in the current climate

that PC in the West that there is a real danger that the best most

important medical research and Scientific Investment will move to

other parts of the world? I am thinking particularly of China. Is

that we're we need to look for the next generation of breakthroughs

was back China and India -- the next generation of breakthroughs?

China and India are funding more medical research. We also fund

projects in India. A so you are globalised. You do not

see a UK-based you? The majority of our funding is

spent in the UK because it is a good environment for research and

we will continue to fund research in the UK as long as that remains

the case. But we do have a global view. Our mission is not to support

the UK economy. It is to achieve extraordinary improvements in human

and animal health. We take a global view and fund in order to have an

impact. But there is a broader question which has about the case

of science and technology in economic growth. You only have to

look around this room and see how much our lives are influenced by

science and technology. What is happening in China and India is

that those governments are seeing the value of science and technology

and fortunately I think the governments here have understood an

argument about science leading to economic growth and so it has

remained relatively well-funded through the economic turmoil that

we are going through at the moment. We have to end at the moment so I

want the end by coming back to something we discussed at the

beginning. I asked you about the extent to which we still do not

know that you do much about human biology. So here is the most basic

question of all - when they come up. In the future, given the sort of

medical research and brilliant thinking that you up funding, we're

Yemen beings can expect to live to an AIDS where frankly they'd die of

old age - but that is not too stupid a way to put it? That we can

expect barring an accident to live a full lifespan because all of the

diseases and problems that we are familiar with have been taken out

of the equation? I think that is a very long time

away if we ever get there but you are touching on one of the major

Democratic challenges for societies around the world which is, as we

live longer, the challenge is, how can we live longer and remain

healthy? So we had this huge burden of neurodegenerative disease such

as dementia and one of the challenges of preventing dementia

is that, you have to understand that the normal brain -- you have

to understand a normal brain before you can understand what happens

when things go wrong. Understanding the brain and understanding

cognition is one of the toughest challenges of all. Since he breezed

earlier determines this question. That is not an interesting question.

The complexity of the nervous system and the fact that the

connections are not all hard-wired - the genes probably get a set of

rules about the way the brain has constructed but that will lead to

different rants at every one of a soap I do not fear that we are

suddenly going to turn into a world where everything is determined. The