Biography

 

Professor Dr. M. Abdul Mannan

(BAAS Vice-President: 1984-1985)

Professor Dr. M. Abdul Mannan was born in 1932 at Monohordy, Narshingdi, Bangladesh. He obtained B.Sc. (Hons.) in Chemistry and M.Sc. in Bio-Chemistry in 1954 and 1955 respectively from Dhaka University. He received Ph.D. from University of Alberta, Canada in 1973.

Professor Mannan started his career as an Assistant Technologist, Government of the then East Pakistan. In 1961, he joined as a Lecturer in the Department of Biochemistry of Dhaka University and became Professor of the Department of Pharmacy in 1980. He was the Vice- Chancellor of Dhaka University from 12th January 1986 to 23rd March 1990.   He   was   also   the   founder   Vice   Chancellor   of   the   People‟s University of Bangladesh (PUB), Dhaka. His fileds of specialization were biomedical, pharmacological and endocrinological aspects of uraemia, blood pressure, hormonal derangement and diabetes.

Professor Mannan was the President of Bangladesh Microbiologist Society. He was the recipient of Gold Medal by Ghent University, Belgium, “Samsad Professor” by Viswa Unyan Samsad (India), Hanneyman Gold Medal and Ibrahim Memorial Gold Medal.

Professor A. Mannan expired in 1996.

 

 

Presidential Address

23 March 1985

Science for Health

 

 

Mr. President, Your Excellencies; Chairman, Organizing Committee;

Members of the Bangladesh Association for the Advancement of Science;

Distinguished Guests; Ladies and Gentlemen,

 

 

I am deeply moved by the highest honour the members of BAAS bestowed on me by electing me to preside in absence of the President of BAAS and present presidential address this morning at the 10th Annual Bangladesh Science Conference of Bangladesh Association for the Advancement of Science. I express my deepest sense of gratitude and thanks to them. The confidence reposed on me by the colleague scientists of the country carries with it an onerous responsibility which I accept with all humility and with full awareness of my shortcomings and limitations. May Allah be with as well.

Mr. President, Sir, we are tremendously honoured and encouraged by your graceful presence amidst us this morning. Inspite of numerous pressing state businesses you could come and give us some of your valuable times to be with the scientists of this country and to listen to them. It only shows how dearest the issues of science and technology and particularly the health of nation are to your heart. Since your assumption of highest office as a President of the People‟s Republic of Bangladesh you have kindly accepted our offer to be the Patron-In-Chief of BAAS, a national society and have extended your helping hands to BAAS in many

 

ways. This political will of yours has tremendously inspired us in our scientific pursuit. We hope under your patronage and dynamic leadership the scientists of Bangladesh will get their rightful respective place in the society so they can continue to give their best for the country. We thank you, Sir.

The focal theme of this year‟s 10th Annual Conference of BAAS is “Science for Health” and it is most appropriate that this conference is being held at and organized by the 12 institutions of the Mohakhali Medical Complex under the able chairmanship of Professor M.A. Matin.

The serene and tranquil atmosphere of this campus humming with health activities will, I am sure, have a soberly mode on the focal theme of which I wish to address now.

Apparently, the theme was criticized by a colleague in basic science to be too much medical bias but a deep probe would prove otherwise. Health does not exist in isolation. It is the cumulative effect and nurturing product of the fundamental approaches of basic physical and biological sciences. The theme will be focused covering aspects relating to its relevance, role, areas of thrust and support.

It dismays me like many of you when I see that concept of excellence is being lost, that centres of excellence find difficult to survive due to lack of appreciation concerning issues of administrative and financial nature and the attitude of the industries. Our brilliant students are unemployed, or inappropriately employed and in shabby position for training and advance research at our educational institutions. These institutions which have the responsibility for generating scientific manpower do not receive sufficient fund for running practical classes and research programmes with requisite requirements of reagents, chemicals, diagnostic kits, instrument and other paraphernalia. Scientists are least equated with top officials in the administration and judiciaries, their emoluments, pay scales, professional and social status and dignity are far from ideal. These are the

components which need political will and Government support for creating an excellent climate for science teaching and research.

It is our firm belief that freedom is incomplete without economic independence and economic independence can not be achieved without scientific self reliance. To the scientists the expression of “science for health” has specific connotations. It is not in a narrow sense of medical science alone. Most inventors in the last century were not scientists by profession but their inventions help in founding or discovering science. We have a firm foundation of science in all possible disciplines but have not succeeded in providing facilities of general climate which gives full encouragement to intellectual enquiry. “Modern science demands wandering” as said one scientist i.e. scientists must have some freedom to pursue fresh trial.

Sir Francis Bacon in the Noum Organum in 1620 taught that the real and legitimate goal of science is the endowment of human life with new innovations and after 365 years this remains the same principal justification for the many to be devoted to scientific research.

The importance of scientists and physicians in the society was realized in the beginning of 18th century. The Arab physician, Al- Tabari wrote in his Paradise of Wisdom (compendium for the doctor of the body as of the soul) as “No one should live in a country which does not have four things: a just Government, useful medicament, flowing water and educated physicians”. –Stress on medicament and educated physician amply illustrate the necessity for a healthy life and his central position in the community. To give importance to science no matter who possesses it our prophet (peace be on him) set an example. “Mohammed (peace be on him) had allowed himself to be advised by a physician who was an unbeliever and, therefore, his followers in their choice of a physician had to be not more Mohammedan than Mohammed” (peace be on him).

 

Ladies and Gentlemen,

Relevance of the Theme:

The constitution of Bangladesh recognizes health care as fundamental right of all citizens.

For full realization of this constitutional obligation it would be relevent if the Government formulates a National Health Policy embodying the societal ideology, its culture, needs, historical, political and economic roots of disease, restructured curriculum for medical and science education commensurate with the societal situation, provision for incentives to scientific pursuits, integration of traditional and folkloric medicine with modern medicine and creation of the awareness of health and medical right of the deprived, exploited and landless millions.

UNESCO definition of science education as “Learning to be, learning to live to enable to absorb new knowledge all through life, learning to love the world and to make it more humane, learning to develop through creative work” will be critically appraised in analyses of the theme.

Medicine and health care system play vital role in determining national health status. Health policy written or unwritten of a nation is the reflection of its social ideology and philosophy, social condition and Govt‟s societal policy. In terms of resources for economic development nothing can be considered of higher importance than the health of the people which is the measure of their energy, capacity, and potential man hours for productive work in relation to the total numbers of persons maintained by the nation. For building sound and healthy nation and worthy citizens the protection of the mother and child is of utmost importance. Mother is responsible for promotion of health within the family and through the family in the community but unfortunately traditionally females get worst deal in the family in matter of food and nutrition in our society.

Medicine acting at the interface between biology and society through history reflected and reinforced our traditional culture, belief and ideology.

The present characteristics of medicine is to seek care of sickness in the individual body is termed clinical paradigm and defines health and disease. This attribute thus obscures the historical, political and economic role of disease. For instance, lathyrism and the epidemic of fatal liver disease that are responsible in endemic region of northern Bangladesh are caused by the kind of food people, because of their oppressive and exploited status, are forced to eat. For prevention of such episode health policy must make provision for economic capacity of these people, not medicine alone, will solve the problem. Delinking medicine from social cause would affect health care system. It should be the aim of the policy to ensure generation of large numbers of students from socially disadvantaged, non-elite and unprivileged classes with only one criteria that they have been exposed to the hazardous social condition, poverty, injustice and inequality in matter  of food, health and diseases. The policy can only get for analysis of disease in their historical, political, and local socio-economic perspective, For instance malaria or leprosy is not just vector or bacteria borne disease but also consequences of socio economic exploitation and misery. This is a new frontier of science called medical sociology. This pro-people medical sociology should be taught in medical education. The problem of T.B. inspite of specific miracle drugs is not receding in our society because the victim must have the purchasing capacity to use medicine in full courses and proper nutrition. Because of poverty the victims have to die.

Similar is the case with cholera and diarrhoea also. Fundamental cause of diarrhoea and dysentery in our children is poverty, lack of proper water supply, food, and health education. It is encouraging to note that the Government has taken a new strategy in diarrhoeal disease by its inclusion in medical education curricula. Similar steps in other diseases are also desirable.

 

Health and illness being fundamentally a product of socio- economic relation, technological measure can have an important but subordinate role. Secondly mercantile interest in medical care and drug production when reign supreme, the importance of technology on mass welfare becomes minimal. There is still a well marked relationship between life expectancy and social means. In this part of the globe, despite eradication of small pox infectious diseases remained great killer. The six most serious diseases took lives of five million children each year. One of the disturbing trends in 1970 onward was the increasing resistance of insect vectors of malaria to pesticides and mounting parasites resistance to drugs, viral diseases remained wide spread, and malnutrition continued to be an underlying factor in such death and illness. The most common diseases, TB, diarrhoea, scabies, dysentery, and infectious diseases began to recede in the west because of public health measures namely sewage disposal, preventive treatment, provision of pure water and sanitation (latrine). Therefore, in health planning public health should attain highest consideration.

Population explosion and illiteracy have denied 85% of our population access to modern medicine. Forty eight percent of our population being children is victim of malnutrition, anemia, diarrhea, dysentery and other six preventable diseases. 1985 is the year of International Youths and theme of WHO on 7th April 1985 World Health Day is “Healthy youths our best resources”. Unless top priority in pediatric health care with production of more preventive than curative medicine becomes our strategy many of our children will not see the day of youth. 5.7% of our total population (of which 63% have no land) are senior citizens. With increase of life expectancy by the over-sixty population has increased by 27% by now. Gradual disintegration of traditional joint family system due to economic crisis, inflation, fragmentation of agricultural holdings and increased population the traditional social security and dependence of senior citizens on their sons and daughters are disappearing. These growing elderly citizens need social security, support and geriatric health care. Under these conditions country‟s health system is operated with qualified

physicians to population ratio of 1:27,000 with 3000 qualified physicians in rural areas and 1:7,500 with 1200 qualified physicians in urban areas and one hospital bed for 45,000 people. Practitioners in traditional systems of medicine viz. Ayurvedi, Unani, and Homeopath (of which only 36% are qualified) are the first contact men and only hope for 85% population. These systems need scientific appraisals and Government recognition by integration with modern medicine or each side by side. National health insurance in GroupWise (e.g. pediatric) or disease wise or in totality may be a good answer to the relevances of disease and health.

The third world countries spent more money in producing curative medicines than preventive medicines while developed or western countries saved money by producing preventive drugs for them and earn money by exporting through subsidiaries curative drugs to the third world countries. For us producing more preventive drugs in generic names can render more good to our people.

 

Role of the Theme

Scenario of Science for Health: Communicable and infectious diseases and veterinary sciences are interrelated. Over 150 diseases are recorded all over the world which are communicable from animals and men. The field of zoonosis is of major importance in biomedical research periphery. Animal and human health are also interrelated. The importance of zoonosis–the diseases and infections transmitted in nature between men and vertebrate animals are well recognized and new disease problems are solved. In most developed countries there has been an improvement in rural medical services so that many zoonosis are recognized at an earlier stages e.g. TB, salmonelloses, brucellosis etc. Animal management on scientific way can lead to changes in both the epidemiological and clinical picture of disease by multidisciplinary approach to human and animal health. In bio-medical sciences public health thus occupies a position as ecology has in biological sciences.

 

Bangladesh with an over population density of 1,500 persons per sq. mile is the most densely populated country of the world and are at the risk of getting infectious disease living symbiotically with animals.

“Science for Health” has come after many sacrifices. Doctors in search of answers to many questions carried out experiments on themselves. The whole of homeopathy rests finally on Hanneman‟s self experiments. More than all other branches of medicine bacteriology has moved doctors to experiment on themselves. One of the famous of these self-experiments was that by max Van Pollenkoff (1818-1901), Professor of hygiene at Munich who at the age of 74 drank a pure culture of live cholera organisms to prove that for cholera to break out not only the specific organism but also a susceptible population and influences associated with time and place are necessary. Following him over 40 doctors and scientists experimented on them with cholera organisms, plague, typhus, yellow fever, and many gave their lives as victims of self experiment. So the science which come to the rescue of ill health was the combination of many sacrifices and dedication. Of them, German Surgeon, Werner Forssman shared the noble prize in 1956 for becoming successful for passing a thin rubber tube into right side of his heart through one of the veins of his arm.

It is only since the World War II that medicine began to turn into some thing like a science. Between now and the turn of this century if the basic research efforts can be contained we ought to be able to understand the mechanism of any of the diseases that are now in front of us.

Through the progress in seemingly remote field of science such as cryogenics, electronic engineering, physics, chemistry, metallurgy the most impressive medical advances in recent decades has been in anesthesia. Historically discovery of salicylate (aspirin) was brought about by observation that willow trees flourish in damp conditions. It was noticed that patient suffering from rheumatoid arthritis complained pain under the same damp condition. It seems

logical to take extract from willow trees and gives it to rheumatic sufferers and this lead to discovery of aspirin.

The latest contribution of physics and physical sciences is the NMR at Princess Margaret Hospital, Toronto which operates on principle of physics never used in medicine before and the information received by NMR may be terribly important in answering medical questions.

Health care-preventive, diagnostic, curative or rehabilitative is increasingly depending on laboratory findings and to health care activities.

External quality assessment schemes in clinical chemistry, biochemistry and pharmacy, hematology, micro-biology, histopathology or cytology are in operation over 65,000 clinical laboratories in European countries. These diagnostic laboratories are very much needed in Bangladesh and to have reliable results of the laboratories need good cadre of technicians with diploma or B.Sc in clinical pharmacy or medical technology. Such a course and diploma should be introduced in the University of Dhaka under an Institute of Clinical Technology. This will serve dual purposes-by giving admission to many brilliant students who could not get admission in university and many diseases can be diagnosed by proper tests.

 

Illustrative Areas of Thrust:

A wave of technology is crashing upon as that will have no business, no family, no home, no industry, no institute untouched, Artificial intelligence (new era of robots just begins), micro- electronics, genetic engineering, computer net work (artificial brain) all these will change our society beyond imagination during life time of many of you.

Revolution in life sciences has primarily been brought about through an increased understanding of biological system at the cellular and molecular levels. Spectacular changes have come in our understanding and capabilities. These capabilities relate to the

 

biotechnology in the field of tissue culture, recombinant DNA technology, genetic engineering, plasmid and gene transfer, development of hybridomas, aspect relating to enzyme engineering, immunology, neurotransmitter, photo-synthesis etc.

Genetic has been responsible for two way traffics between the physical sciences on the one hand and life sciences on the other hand. The tremendous development of life sciences owe to a great extent to the refinements in physical and biochemical methodology and simultaneously the sciences of biochemistry, a rejuvenescence due to the entrance in the field of genetics.

Art in biotechnology: Biotechnology is based on the understanding of the interactions of fundamental principles of basic sciences viz. Zoology, Botany, Chemistry, Bio-chemistry and Pharmacy. Gene cloning is no more an ivory tower esoteric research work. An impossible feat of isolating rat pancreas gene responsible for insulin synthesis is made and inserted it into E. Coli to produce successfully human insulin in Sept. 1978. Bacteria made human insulin after a rigorous clinical trial was first released on commercial scales in Sept. 1982. Starting with E. Coli many gram negative bacteria was transformed to produce different products of health importance. The transformation of yeast (gram positive bacteria) with the aid of bacterial as well as yeast plasmid has been made.

Following the trial of protoplast fusion a great technique of sematic cell fusion and hybridization, the use of liposome (artificial phospholipid essiceles) for pushing macromolecular medicine susceptible to stomach digestion into the body cell has been produced. Engineering of gene encoding seed proteins for a higher content of limiting amino acids, lysine and tryptophan can now be produced. Gene therapy has increased hope for correction of hereditary gene defect leading to mental retardation, thalasemia etc.

 

Health care bio-technology concerned with

⦁         Production of insulin, rabies  virus glycoprotein analogues, by

E.  Coli.   and   human   interferous   (also   bovine  & porcine),

growth hormone, calcitonin, albumin (using yeast), vaccine for animal and man diseases (e.g. foot mouth disease, tetanous, TB) and leucocyte which are ready for commercial production.

 

⦁         Monoclonal antibodies (homogenous immonological reagents of defined specificity, avidity and selected isotype) are now prepared in-vitro by chemical medicated fusion lymphocytes from immunized mice and mouse tumor cell line. The hybrid cells have antibody producing capability from the lymphocytes and ability to grow permanently in culture from the myeloma. Cloned hybrid cells produce continually individually monoclonal antibodies in endless supply.

 

⦁         Single cell protein (SCP) is the dried cell of photosynthetic or nonphotosynthetic microorganisms such as algae, fungi, or bacteria grown in large scale culture systems for use as protein sources in human food and animal feed. Imperial Chemical Co., UK using SCP process and methanol as substrate to produce pruteen (a new protein) at a rate of 70,000 metric tons per year for animal diet.

 

⦁         Plant cells and tissues are cultured in appropriate pabulum for production of a range of chemicals from opium to food colourings. A number of alkaloids like berberine, palmatine, nicotine, hyascyamine, rawalfin, camptothecine, various saponins, proteinase inhibitors, plant virus inhibitors, antiulcer substances, coccidiostats are under commercial production: A number of enzymes, food additives like betanin, anthocyanins, are under commercial production also. Stevioside, a saponin like glycosides tastes 300 times sweeter than sucrose has also been produced from callus culture from stevia rebaudiana:

 

⦁         Bio conversion: Cloning cellulase gene ( an enzyme digesting straw or biomass) as known to exist in Tricaderma reesae, clostridium thermo cellum pseudomonas fluorescens etc perform the dual functions of converting `cellulose to sugar

 

and sugar to ethanol. Using lactobacella for fermentation of straw to protein food through genetic engineering is now possible. Microorganisms would be used for biomethanation, biodegradation of Xenobiotic industrial waste. Also fast growing trees like pines, popular, eucalyptus and fast growing , shrubs like leucena, agro forestry waste and - municipal refuse could be used as the cheap renewable raw materials for fermenters:

 

⦁                     Biocatalysts: By immobilizing enzymes on certain support prolong their life time. The covalent attachment to or absorption on solid support, crosslinking and encapsulation of the enzymes can be applied in pharmaceutical, chemical and food industries and in analysis of medicines and chemicals.

 

⦁         Bio-electronic and bio-sensors: Electronics and biology soon will join hands to bring about revolution in the beginning of twenty first century. Fixing of a sensitive protein membrane on to a silicon chip biosensors have already been developed. These biosensors are used by the fermentation industry to control their complex brew of living cells. Certain novel biomedical biosensors can be used in early warning systems for cardiac disorders, diabetes, nephritis/uremia etc. Direct electron transfer principle of biotechnology is applied in sensor and fuel cells. The electron devices in the coming generation will be based on the exploitation of electron transfer reactions of protein, Enzyme transistors are already in the offing.

 

These illustrations are cited to visualize the impact of revolution ushered in by research on basic sciences and applied biology. Natural interferons, a remedy for certain type of cancer cost to-day

$150-200 per day. By gene cloning bio-technology this cost will come to $1 per day. About 100,000 lambs are meaded to extract one milligram of brain bormone, somatostatin which now can be produced after gene cloning in a laboratory fermenter. Capitalizing DNA   technology  as   many  as   200   new   companies  including

Genetech, Cetus, Genex, Biogen etc are now on commercial production using biotechnology techniques discovered by the scientists.

 

It is, therefore, a crying need for Bangladesh to set up a National Committee on Bio-technology under the direct chairmanship of the President himself to go into set up of biotechnology research centres with priority areas of production of preventive medicine. It is our firm belief that this recommendation will receive the highest consideration of the President.

 

Medical Education:

Medical college education is managed by faculty of medicine. In paper medicine is one of the university faculties with Dean's office and various medical colleges are constituent colleges of the respective university but in reality there is little relationship between the two. University has nothing to do with the selection of students, teachers and planning of courses and curriculum. The University merely conducts yearly examinations through faculty approved committees and provides graduate certificates. The entire affairs of appointments, promotion & transfer of Professors, their pay (which is less than those in University) are managed by the concerned Ministry and planning of syllabus and curriculum by Dental and Medical Council. These create many problems in imparting quality education and conducting examinations. As a member of the faculty of medicine I have seen it. Moreover practicing teachers remain preoccupied and over worked. It is, therefore, would be appropriate for the Government to take fresh look into it and to seek option from the medical teachers who wish to take up education as career and giving them highest pay scale with compensation for giving up practices. This has been done in a few neighboring countries and in all over west. The medical colleges being a constituent college of the respective university, it is logical that the colleges and teachers enjoy the same service conditions and the autonomous status as has been given to the university. If so done this will definitely improve the present

 

situation with improvement of quality education. Our strong hope and belief are that the President will kindly consider it. Another component of quality education and service of scientists, physicians, teachers, practitioners and all members of the health team who are at the job is to undergo compulsory continuing education of short courses every three years to update themselves with latest developments in their respective field.

We need “bio” component of all technology by producing finest micro-biologists, molecular biologists, & geneticist capable to be inducted to industry in their future career. I can say that our own biologists, zoologists and life` scientists have been ignored too long by our society to its own detriment.  For   development   of bio technology these are the people if received specialized expo- sure in bio technology can do miracle.

The future of science of Bangladesh will depend on attracting talents and finest minds of the country to scientific research. Importance of nurturing the potential young scientists of our country needs no emphasis. Total quantum and spectrum of S & T on viable basis both by human resources and finance cannot be covered and, therefore, we have to be selective in the thrust area we choose to concentrate.

Support: It is very commendable that the President and his Government have taken daring steps in materializing the country's commitment to UNO & WHO resolutions as one of the signatories of the charter by adopting a few measures in health care. These include (1) promulgation of 1982 National Drug Policy formulated by expert committee; (2) Launching of EPI (Expanded Programme on Immunization) against six diseases and (3) Action Programmes on “Health for all by 2000 A.D.” to ensure essential medicines production and supply and other health care measures to masses.

National Drug Policy: Drug policy came into ordinance in June 1982. Never in the history a benevolent pro-people welfare policy such as Drug Policy has been adopted by a Martial Law or any Civil Government Bangladesh is the first country to adopt WHO

recommendation and to limit to essential and life saving drugs. The policy has been enviously lauded all over the world. This policy is a challenge against poverty, socio-economic disparity and nationally and internationally powerful lobby of exploiters who lives on the miseries and sufferings of millions of unfortunate and deprived masses. Myself being one of the associates of both Expert Committees on modern & traditional medicines proudly share this great contributions.

The President and his minister of health deserve salutary appreciation by the: deprived masses of the nation. This policy limited modern drugs to 250 (band c-a 2500) from 300 drugs (band c-a 4000) with 150 essential drugs (12 for village levels, 33 for upazilla levels and 105 at tertiary levels) and 100 at specialist levels.

 

Ayurvedi medicines to 55 (disease-wise) out of presently 8000 formulations, unani medicines to 126 (48 for village levels, 39 at upazilla levels, 31 at tertiary levels and 8 at specialist levels) out of presently 2000 formulations and homeopathy to 130 including 12 biomedic medicines with the aims to

⦁         Give incentives and logistic supports to the national manufacturers (i) to boost production of low to medium technology drugs until time they are ready to high technology and foreign firms to go to production of high technology and sophisticated drugs and vaccines, (ii) to relieve users off the drug dependence and addiction by banning unnecessary, harmful and alcoholic drugs. The policy has already started fruitation with raw materials price decrease in the international markets and cost of the medicine at home. Other components of the drug policy needs to be implemented namely creation of a National Research Foundation by voluntary subscription of 1% of gross income of the manufacturer s to be utilized for improvement of quality control and good manufacturing practice (GMP) and for advancement of pharmacy and pharmaceutical education, research and technology.

 

⦁         EPI: EPI aimed at vaccination against six diseases namely diphtheria, pertussis, poliomyelitis, TB, tetanus and measles will go long way to protect the health of our children, and mothers and increasing the quality of life. The `cold chain' which maintains vaccines potency and standard specifications at all stages from manufacturers to users in remote villages at high temperature conditions is the life line of EPI. The people who vaccinate, handle at the early stages of transfer, transport and stock keeping must be trained about `cold chain' and method of handling.

 

⦁         Health for all by 2000 A.D.: It is a humanitarian but towering job in the population, poverty and pattern of diseases perspective. It will be rhetoric unless massive production of essential drugs and other paraphernalia at low cost are made and supplied along with supply of essential drugs i.e. proven remedies of TSM viz. Ayurvedi, Unani and Homeopathy medicines. This noble beginning definitely is a good approach.

 

Conclusion: With all available facilities in the delivery of health care we need to (i) ensure good doctors ready to make themselves more useful in the condition they have to work, (ii) scientific programmes aiming at health care research, (iii) restructured health education, and above all love for the people and science.

 

Mr. President, Ladies and Gentlemen,

 

I thank you all for hearing me so long with apt attention. Once again I thank you all.