:00:13. > :00:18.That's it from me. It is now time for HARDtalk.
:00:18. > :00:22.Welcome to a special edition of HARDtalk, recorded in front of an
:00:22. > :00:26.audience in the village of Portmeirion. My guest today is Sir
:00:26. > :00:32.Mark Walport, the director of the Wellcome Trust, one of the biggest
:00:32. > :00:36.most influential funders of medical research in the world. Must of the
:00:36. > :00:42.trust money is being ploughed into cutting-edge genetic science. It
:00:42. > :00:49.promises to transform healthcare around the world. Our knowledge is
:00:49. > :00:59.ever expending. But what about owl was done?
:00:59. > :01:18.
:01:18. > :01:22.Beached as, bro!, welcome to HARDtalk. It seems to me you are a
:01:22. > :01:26.doctor who works on the most extraordinarily wide canvas. You
:01:26. > :01:31.are responsible for the disbursement of hundreds of
:01:31. > :01:38.millions of pounds a year it to find the best cutting edge medical
:01:38. > :01:42.research. It is -- it sounds quite daunting. Yes, but it is also very
:01:42. > :01:49.good fun. I started my life as a medical researcher working on a
:01:49. > :01:52.narrow focus problem. I was interested in understanding how a
:01:52. > :01:57.deficiency in the immune system would cause a small number of
:01:57. > :02:02.people to develop and serious auto- immune disease. I have always been
:02:02. > :02:06.interested in the broad canvas of science. I started as a boy by
:02:06. > :02:12.collecting Beatles and butterflies. I have always been interested in
:02:12. > :02:19.brought things. I used to be faced with I whole range of different
:02:19. > :02:25.facts and puzzles. The EU believe we are a long way down the journey
:02:25. > :02:30.to understanding human biology? How much did we yet know? We don't know
:02:30. > :02:34.each future mark. The Wellcome Trust has set out five big
:02:34. > :02:40.challenges for the community. One of the questions is understanding
:02:40. > :02:44.the brain. Do we think we will in the next ten years? Not a chance.
:02:44. > :02:49.There are big questions. You are suggesting war is on known Denise
:02:49. > :02:54.unknown? It is difficult to quantify that. But there is a huge
:02:54. > :02:59.amount we don't know. You have talked about a revolution in
:02:59. > :03:04.bioscience. You have targeted what is happening in genetics. I want
:03:04. > :03:10.you to explain to me why you believe work with genetics, the
:03:10. > :03:16.human genome, is so revolutionary? It gives us a more complete picture
:03:16. > :03:20.of our biology in a way we never had before. Two examples. Cancer.
:03:20. > :03:25.For the first time it is possible to sequence the care of the genome
:03:25. > :03:30.from a skin cancer and compare it with the cells and tissues from
:03:30. > :03:36.which it came. You can identify all the mutations. There is a good
:03:36. > :03:41.example. In 2003, one of my colleagues sequenced malignant
:03:41. > :03:47.melanoma. When it developed secondaries, it is one of the
:03:47. > :03:51.nastiest, most difficult cancers to treat. He found the mutation in a
:03:51. > :03:56.specific gene which happens to be expressive protein in a growth past
:03:56. > :04:03.way. It activates it. Immediately you see something that activates
:04:03. > :04:07.something. That is a candidate for a cancer-causing gene. Decided to
:04:07. > :04:13.find that mean that if a test was run on me and we had that
:04:13. > :04:19.particular genetic trait, we could be without doubt predicted as
:04:19. > :04:23.getting all being prone to getting a melanoma? No, because that is in
:04:23. > :04:31.a quiet mutation. It has one of the ones that causes it. But that was
:04:31. > :04:36.in 2003. Lastly, we have a licensed drug that actually starts to treat
:04:36. > :04:40.that cancer. That is an extraordinary journey. But another
:04:40. > :04:46.example which is that in some families where there is frequent
:04:46. > :04:56.occurrence of breast and ovarian cancer, that isn't I had -- that
:04:56. > :04:56.
:04:57. > :05:02.isn't an inherited trait. You can identify women and men. That brings
:05:02. > :05:07.me to the big plate. To what extent is it going to lead us to a new
:05:07. > :05:12.form of determinism within medicine? If all newborns across
:05:12. > :05:18.the world at some point up mapped, their genetic code was fully mapped,
:05:18. > :05:24.would be then be able to say, this childbed this child and this child
:05:24. > :05:31.are going to leave for so may use and diet of a particular disease?
:05:31. > :05:37.The answer is it all depends. But we are in a wonderful mixture of
:05:37. > :05:40.jeans, our environment, and chance. At one end, there is a disease like
:05:40. > :05:46.cystic fibrosis. If you had the genetic mutations, the disease will
:05:46. > :05:50.happen. There are a number of those. For most of us, the genes that are
:05:50. > :05:56.being discovered just cause a tiny increase in the contribution to the
:05:56. > :05:58.likelihood of getting the disease. Most of the genes that have been
:05:58. > :06:05.discovered contribute to susceptibility to type 2 diabetes,
:06:05. > :06:09.for example, there is a huge environmental factor in that. He's
:06:09. > :06:13.just come for her are a tiny increase in risk. Why is that worth
:06:13. > :06:21.finding out? Because it tells you the pathways that you might
:06:21. > :06:26.manipulate with drugs to actually treat or prevent it. Or try to win
:06:26. > :06:32.Ginny? To what extent we now looking as the ability to we and
:06:32. > :06:39.Ginny? Going into the embryo, further than a newborn babies. --
:06:39. > :06:45.we engineers. If we see problems when we screened their genetic
:06:45. > :06:51.make-up, trying to repair the problem? There are two examples.
:06:51. > :06:55.Firstly, gene therapy. It doesn't affect the germline. It treats me
:06:55. > :07:00.as a patient but it is not something I would pass on to my
:07:00. > :07:04.children. That is beginning to happen for young children who are
:07:04. > :07:09.born with extreme indifference -- inefficiencies. Theremin systems
:07:09. > :07:17.did work. They can't survive outside a bubble. Gene therapy is
:07:17. > :07:25.starting to give their Amin systems back. It sounds very soothing.
:07:25. > :07:29.is. Is it really? I have read in the past a whole stream of
:07:29. > :07:35.newspaper stories suggesting that the ability to reach Engineer our
:07:35. > :07:41.DNA and material is actually extraordinarily worrying. It gives
:07:41. > :07:49.scientists a power that reminds us of so many frightening things about
:07:49. > :07:53.the ambitions of humans to perfect the human form. But you have to
:07:53. > :07:58.take specific examples. I don't think many people would argue that
:07:58. > :08:02.using gene therapy to keep someone alive, a child alive he would have
:08:02. > :08:06.a miserable time with rejections and then die, most people would
:08:06. > :08:12.think it is entirely acceptable. Gene therapy to change the colour
:08:12. > :08:16.of your eyes, most people would think that's ridiculous. I take
:08:16. > :08:23.your point. But it is complicated in the benign case you mentioned
:08:23. > :08:28.before. There is an issue right now. Newcastle University scientists are
:08:28. > :08:32.trying to change the mitochondrial DNA. Because that essentially, if a
:08:32. > :08:41.child is born with an opponent of their mitochondrial material, they
:08:41. > :08:45.will die. It needs to be fixed in the embryo. But to fix it, you have
:08:45. > :08:51.to take demands -- genetic material from a donor egg. The trialled is
:08:51. > :08:58.their unborn with Material not just from its parents, but from another
:08:58. > :09:03.person as well. There are all sorts of ethical questions. The Iraq yes.
:09:03. > :09:09.We have an ethical framework for discussing that in the UK. It is
:09:09. > :09:13.not a decision that will be made by a single doctor. Bought a
:09:13. > :09:18.healthcare team working with patients. It is debated by society.
:09:18. > :09:23.There has been legislation that enables it to happen. Regulations
:09:23. > :09:28.would need to be late. Human Fertilisation Authority is... We
:09:28. > :09:33.set up this structure in the UK which is taken from IVF to the
:09:33. > :09:39.position we are in now. It is an interesting test case. What you're
:09:39. > :09:43.doing is taking youngsters who are born with diseases in the
:09:43. > :09:48.mitochondria. Mitochondria is the batteries of the cell. The vast
:09:48. > :09:54.majority of the DNA which we inherit from her parents, more than
:09:54. > :09:58.99.9 %, is in the nucleus. But mitochondrial, which are the
:09:59. > :10:08.batteries, have their own small amount of the Naze. A handful of
:10:08. > :10:13.genes. By swapping the Nuclear's from the parents who would
:10:13. > :10:18.otherwise transmit the disease into an egg which has had its nucleus
:10:18. > :10:26.taken out, you can potentially fix that for that trialled and for that
:10:26. > :10:32.child of spring. You don't think it is a problem that the trialled then,
:10:32. > :10:38.biologically, is formed of more than its own parents? You don't
:10:38. > :10:44.judge a camera by the make of its batteries. I don't think the
:10:44. > :10:49.mitochondria gives you much in the wake of personality. I think in
:10:49. > :10:56.this particular case, it is OK. But there is, if you like, a slippery
:10:56. > :11:02.slope. There are always two ways. You can approach it in two ways.
:11:02. > :11:07.With creme pawns or with skis. Which are you wearing right now?
:11:07. > :11:14.Creme Poms. This is a very small change. It is going to be well
:11:14. > :11:19.debated by society. You say it has been well debated and that the
:11:19. > :11:24.public is on board. But I wonder. But if one takes a step back and
:11:24. > :11:28.looks at the big picture. It is fair to say that faith and trust in
:11:28. > :11:32.science and scientist has taken a knock in recent years. Look at all
:11:32. > :11:39.different sort of controversies from the measles, mumps, rubella
:11:39. > :11:44.argument. A leading scientist was discredited with his argument. You
:11:44. > :11:48.could look at the Climate Gate, the way in which information about the
:11:48. > :11:52.warming of the planet was interpreted. Look at opinion polls.
:11:52. > :11:57.They suggest the public is sceptical about science. You can
:11:57. > :12:06.apply it to medical science. Is the public ready to put as much faith
:12:06. > :12:16.in it? You say that but when you look at the balls of trust in the
:12:16. > :12:20.
:12:20. > :12:30.sense, scientists come up very high. That was below the belt but I do
:12:30. > :12:30.
:12:30. > :12:33.accept that. Trust is a specific. You trust
:12:33. > :12:43.someone in a particular context. I just made a below-the-belt comment
:12:43. > :12:44.
:12:44. > :12:50.about journalists. Trust is specific and a thing that is one.
:12:50. > :12:55.When you talk about gene therapy, what gene for what purpose, the
:12:55. > :13:00.genetically modified food debate was couched in the wrong terms. It
:13:00. > :13:07.was thought that as a generic thing but it isn't. What a gene for what
:13:07. > :13:12.purpose? At the end of the day, the consumer did not think that much
:13:12. > :13:16.about a tomato that took longer to rot because they do not rot very
:13:16. > :13:20.much in the fridge anyway. But what about rice with more vitamin There
:13:21. > :13:24.protect blind us? That needs to be the discourse about science and
:13:24. > :13:30.society. It is not up to the side is to tell everyone what to do. It
:13:30. > :13:34.is the sort of discussion. Indeed and that leads me to another
:13:34. > :13:39.element of the trust debate. Not so much about the principle it fits
:13:39. > :13:44.behind some of the work that has been done that more about how safe
:13:44. > :13:49.the information is that is now being gathered. We talked earlier
:13:49. > :13:53.on in the conversation about the mapping of the genome and it is
:13:53. > :13:56.quite likely every saying that every individual and the
:13:56. > :14:00.industrialised society would have the most amazingly detailed
:14:00. > :14:04.statistical data upon themselves within some sort of computerised
:14:04. > :14:11.system. If they want to have that?
:14:11. > :14:18.Here it is an interesting point. How can you be so sure?
:14:18. > :14:22.This is about trust again, isn't I have spent my entire life as a
:14:22. > :14:26.doctor and the first thing I learned and medical school is the
:14:26. > :14:30.only do a test if you can do something useful with the result.
:14:30. > :14:34.But I have already read papers where researchers have said that
:14:34. > :14:43.there's so much incredibly useful information out there - if only it
:14:43. > :14:48.is anonymous. Ie, it is Orchid the monomers and we cannot link it to a
:14:48. > :14:54.particular individual. -- war kept anonymous.
:14:54. > :14:58.The first thing I would say is that our health records are an
:14:58. > :15:03.enormously powerful source of personal information and public
:15:03. > :15:09.health information and so the question is, is it proper that
:15:10. > :15:18.medical records should be sheared in and an ominous form - and we can
:15:18. > :15:21.debate the meaning of anonymity - in such a way that if I was
:15:21. > :15:27.diagnosed something that my treatment could be used to inform
:15:27. > :15:32.others. One of the things the or realise is that when the new drugs
:15:32. > :15:36.get into the market place when a general, they are being used in
:15:36. > :15:44.different people and that means new side-effects and the rich. And
:15:44. > :15:47.don't we all want - information? I would be scandalised if I had a
:15:47. > :15:51.side effect and the information was not shared. I am concerned that my
:15:51. > :15:55.own personal confidentiality is contained and that means you do not
:15:55. > :16:01.without information it could eventually identify me on the
:16:01. > :16:04.internet but you put it out into a safe haven, where, if you like, a
:16:04. > :16:08.member of the health team could look at what the side-effects are
:16:08. > :16:17.associated with a particular treatment and I think that could
:16:17. > :16:21.happen. How many patients do you want...
:16:21. > :16:25.So I take it that you are in favour of as much information and data
:16:25. > :16:30.sharing as possible? Yes but within boundaries.
:16:30. > :16:34.By a aside from the privacy issues, other also commercial issues here?
:16:35. > :16:39.Not so long ago I wish -- I interviewed one of the leading
:16:39. > :16:43.lights behind the Matthew of the human genome. His motivation has
:16:43. > :16:47.been commercial from the very beginning. He wants to make sure it
:16:47. > :16:53.loads of money from his brilliant research. How do you feel about
:16:53. > :16:56.those who want to make money out of their brilliant research and keep
:16:56. > :17:01.copyright and patent over what they are discovering? You have a problem
:17:01. > :17:08.with that? I will answer that in two parts. In
:17:08. > :17:13.terms of the genome, our frost was part of a public effort. We funded
:17:13. > :17:17.the decoding of a third of the human genome and we wanted to
:17:17. > :17:20.maximise the value of that and the way to maximise the value of that
:17:20. > :17:28.was to put it on the Internet and that was what happened and had
:17:28. > :17:32.prevailed. Patents are about inventions and the secrets of the
:17:32. > :17:38.human genome or any other is not an invention of humans - it is an
:17:39. > :17:45.invention of nature. On the general question as to, should people be
:17:45. > :17:49.able to make money out of biomedical research? Well, who
:17:49. > :17:52.makes for its? It is the brick industry.
:17:52. > :17:57.Do you think the huge pharmaceutical giants of the world
:17:57. > :18:01.put their money into the sort of research that is most useful, most
:18:01. > :18:08.beneficial, for the most human beings on this planet...
:18:08. > :18:12.The answer is for some diseases, yes. For example, the reduction of
:18:12. > :18:17.cardiovascular disease by the discovery of certain compounds has
:18:17. > :18:21.been hugely beneficial. There is a market Fabia for some other
:18:21. > :18:25.diseases we have markets that cannot afford to pay for treatment,
:18:25. > :18:29.such as in the developing world. That is why new mechanisms are
:18:29. > :18:34.being developed. Is that will you come in? You see
:18:34. > :18:37.your role as a way of filling in the cracks where, you call it a
:18:37. > :18:42.market failure, with the commercial pharmaceuticals will not put money
:18:42. > :18:49.in for research because they do not a profit -- see profit in it? Is
:18:49. > :18:54.that the UK and in? -- is that we do you come in?
:18:54. > :18:58.For us it is about the brightest minds. The scientists who have the
:18:58. > :19:03.best ideas and we believe in supporting the smartest people. But
:19:03. > :19:08.in terms of... Picking winners, some would call it
:19:08. > :19:10.- you are a bit like a venture capitalist or medicine?
:19:10. > :19:16.There are since it -- some similarities in principle but the
:19:16. > :19:19.vision of our frost has to improve human help and that will only
:19:19. > :19:28.happen if the discoveries in the laboratory bench and it may take a
:19:28. > :19:33.very long time - and one of the positive aspects of our crosses
:19:33. > :19:37.that we have a long-term time horizon. We do not have elections
:19:37. > :19:41.every four is a week and have a long vision. Industry must play its
:19:41. > :19:45.part as well. With it and an age of all austerity.
:19:45. > :19:49.Not just in the United Kingdom but across the industrialised world
:19:49. > :19:54.which presumably means there is a squeeze on medical research budget
:19:54. > :19:58.along with many other publicly funded budgets. Before you open
:19:58. > :20:04.your mouth, let me ask you this - do you think in the current climate
:20:04. > :20:09.that PC in the West that there is a real danger that the best most
:20:09. > :20:13.important medical research and Scientific Investment will move to
:20:13. > :20:20.other parts of the world? I am thinking particularly of China. Is
:20:20. > :20:29.that we're we need to look for the next generation of breakthroughs
:20:29. > :20:35.was back China and India -- the next generation of breakthroughs?
:20:35. > :20:39.China and India are funding more medical research. We also fund
:20:39. > :20:44.projects in India. A so you are globalised. You do not
:20:44. > :20:47.see a UK-based you? The majority of our funding is
:20:47. > :20:51.spent in the UK because it is a good environment for research and
:20:51. > :20:56.we will continue to fund research in the UK as long as that remains
:20:56. > :21:01.the case. But we do have a global view. Our mission is not to support
:21:01. > :21:05.the UK economy. It is to achieve extraordinary improvements in human
:21:05. > :21:09.and animal health. We take a global view and fund in order to have an
:21:09. > :21:12.impact. But there is a broader question which has about the case
:21:12. > :21:17.of science and technology in economic growth. You only have to
:21:17. > :21:21.look around this room and see how much our lives are influenced by
:21:21. > :21:25.science and technology. What is happening in China and India is
:21:25. > :21:32.that those governments are seeing the value of science and technology
:21:32. > :21:36.and fortunately I think the governments here have understood an
:21:36. > :21:39.argument about science leading to economic growth and so it has
:21:39. > :21:43.remained relatively well-funded through the economic turmoil that
:21:43. > :21:46.we are going through at the moment. We have to end at the moment so I
:21:46. > :21:51.want the end by coming back to something we discussed at the
:21:51. > :21:56.beginning. I asked you about the extent to which we still do not
:21:56. > :22:01.know that you do much about human biology. So here is the most basic
:22:01. > :22:06.question of all - when they come up. In the future, given the sort of
:22:06. > :22:13.medical research and brilliant thinking that you up funding, we're
:22:13. > :22:20.Yemen beings can expect to live to an AIDS where frankly they'd die of
:22:20. > :22:24.old age - but that is not too stupid a way to put it? That we can
:22:24. > :22:28.expect barring an accident to live a full lifespan because all of the
:22:28. > :22:34.diseases and problems that we are familiar with have been taken out
:22:34. > :22:38.of the equation? I think that is a very long time
:22:38. > :22:41.away if we ever get there but you are touching on one of the major
:22:41. > :22:46.Democratic challenges for societies around the world which is, as we
:22:46. > :22:51.live longer, the challenge is, how can we live longer and remain
:22:51. > :22:54.healthy? So we had this huge burden of neurodegenerative disease such
:22:54. > :23:00.as dementia and one of the challenges of preventing dementia
:23:00. > :23:04.is that, you have to understand that the normal brain -- you have
:23:04. > :23:09.to understand a normal brain before you can understand what happens
:23:09. > :23:14.when things go wrong. Understanding the brain and understanding
:23:14. > :23:18.cognition is one of the toughest challenges of all. Since he breezed
:23:18. > :23:23.earlier determines this question. That is not an interesting question.
:23:23. > :23:28.The complexity of the nervous system and the fact that the
:23:28. > :23:32.connections are not all hard-wired - the genes probably get a set of
:23:32. > :23:36.rules about the way the brain has constructed but that will lead to
:23:36. > :23:43.different rants at every one of a soap I do not fear that we are
:23:43. > :23:47.suddenly going to turn into a world where everything is determined. The