Epidemiology's contributions to a Nobel Prize recognition.

The Nobel Prize Committee awarded last year's Physiology and Medicine prize to 3 sci ntists wh identified the causes of 2 diseases that kill millions of people world wide: HIV/AIDS and cancer of the cervix. Harald zur Hausen received half of the prize "for his discovery of human papilloma viruses causing cervical cancer" and Franchise Barre-Sinoussi and Luc Montagnier shared the other half of the award "for their discovery of human immunodeficiency virus. "1 The knowledge that stemmed directly or indirectly from the vigorous research by these 3 outstanding scientists will prevent the countless premature deaths caused by these diseases. As epidemiologists working in public health on the global scene, we applaud the Nobel Committee's decision. We hasten to add, however, that in this era in which advances in medical knowledge can come only from strong multidisciplinary approaches, the laurels of recognition to those who initiate or sustain the basic science discoveries are grounded on a foundation of public health science. Our arguments, summarized later, are self serving. The 4 of us are card-carrying epidemiologists who have witnessed how the monumental work of the 3 Nobel laureates was validated and brought to the attention of the public and the pharmaceutical and biotechnology sector by a massive public health research undertaking championed by epidemiologists. That the Nobel Committee has chosen not to add the names of such champions is more or less understandable. The Committee has a track record of rewarding primarily the forebears of the scientific domains that led to the medical advances. There are many candidates competing for science's highest accolade, and there is only one Nobel Prize given each year in Medicine. Packaging 2 diseases into the 2008 award may have helped the Nobel Committee deal with the backlog of eminent scientists who must be recognized with as little delay as possible (the rules of the award state that the prize cannot be given posthumously). Without questioning the Nobel's modus operandi (the very glamour of the prize rests in the organization's aura of tradition and independence in reaching its decisions), we feel that the readers of Epidemiology will find comfort in being reminded of the contribution of their discipline in the accomplishments that led to a Nobel recognition in 2008, and that ultimately enabled the Nobel-Prize-winners' work to have impact. Over history, epidemiologic studies have made many of the observations that were necessary for getting the right hypotheses to bear fruit in terms of health interventions. Robert Koch was given the Nobel Prize in 1905 for his work in tuberculosis, but he could also have received the prize for his isolation of the Vibrio cholerae. Had the Nobel Committee awarded the prize for cholera, according to their current practice they would have left out John Snow who elegantly demonstrated where the infectious agent came from, how it spread and how it could be prevented. One of the lines of inquiry of the last century with most influence on public health intervention was the demonstration of the carcinogenic role of tobacco smoking. The list of pioneer epidemiologists who cham