Here's a scenario that I keep on questioning:
I fall ill, I make a doctor's appointment
and I have the appointment the next day.
The day of the visit, the doctor diagnoses me by observation,
since he doesn't have access to bodily fluids,
and he considers two or three possible infections.
Then, he either prescribes me a broad-spectrum treatment
to cover all eventualities,
or, he tries an illness-specific treatment
and if that does not work, it's changed at the next appointment.
Next, he calls for blood tests.
So, I have the blood tests on the morning of the third day,
and I get the results on the fourth day.
I call the doctor,
and I have my second appointment with the results on the fifth day.
Do you know how long it takes an organism to react to an infection?
A few hours.
The information we need to tell us what is wrong with us
is available in our blood within a few hours.
But the doctor does not have access to this information until five days later.
It's too long, inefficient, and it costs a lot of money.
During my PhD thesis, which I wrote at the University of Lille, France,
I always thought
that big analysis laboratories were a bit like phone boxes of the 80s -
it's a comparison which will speak more to those over 30 -
I thought that medical tests would go the same way
and that we would end up having our own self-testing kits at home.
What I didn't understand,
while home pregnancy tests have been on the market since 1970,
in 2013 we have still not been able to apply this concept
to infectious diseases.
After my PhD thesis, and a period spent at the University of California,
I joined the University of Washington,
where I started to work specifically on self-testing.
It was then that I understood that there were two major obstacles
which prevent this technology from being scaled up.
First of all, the issue of sensitivity.
In the majority of infections,
the molecules we want to detect are found in very small concentrations,
which means that the tests have to be very sensitive.
Because of this problem, it wasn't until 2012
that the first home testing kit was authorised in the USA.
That was the HIV test.
France has only just issued a favourable report
on their commercialisation a few weeks ago.
The problem with these tests
is that they are based on a rectangular, paper test strip.
Which is the cause of a certain limitation on sensitivity.
What is more, HIV tests
can only be used three months after infection,
since the virus needs time to multiply and reach sufficient concentrations,
and in the meantime, it wreaks havoc.
So, to avoid losing time,
and to be able to detect very weak concentrations,
we have developed a different approach over the course of the last year.
As usual, the true challenge of technology
is not in finding a solution to the problem,
but in finding a simple solution.
So, instead of cutting the paper into a rectangle,
we have cut it into a many-pointed star.
With this principle, you just have to put your sample in the centre of the star,
and the sample will separate itself into several components.
For example, with blood, red blood cells will go to one side,
and viruses, if the patient is infected, will go to the other side.
After separation, viruses will move from the centre towards the points.
Once at the points,
the water quickly evaporates, leaving the viruses behind to accumulate.
This accumulation will greatly increase the concentration of the viruses,
which allows us to achieve sensitivities
a billion times higher than the traditional test.
Once the viruses are at the points, we have to detect them,
and to do that, we have to use antibodies.
And it is there where we find the second obstacle in self-testing,
which is the delicateness and high cost of natural antibodies.
So an alternative had to be found.
To understand our work,
you must first of all understand how an antibody works.
When someone is infected by a virus,
the organism reacts by producing antibodies.
These antibodies are capable of recognising and catching the virus,
thanks to three properties:
Firstly, the antibody has to have spatial conformation;
a complementary shape to the virus.
It is somewhat similar to a key in a lock, the key being the virus.
Secondly, the surface of the antibody
must have positive and negative charges which, to put it simply,
are the opposite of what is present on the surface of the virus.
So it is a very exacting phenomenon.
And finally, the virus must be flexible enough
to adapt to the small variations in shape.
The principal is very simple, but what is complicated,
is carrying it out on a nanometric scale.
What you see here is a nanoparticle of gold,
which is 1,000 times finer than a hair.
If you want to make a synthetic antibody which replaces natural antibodies,
you have to reproduce these three properties.
So what we have done is this:
to make an antibody which can recognise a virus,
we first of all attach the virus to this particle.
The technique I'm describing is called "molecular imprinting."
So, before going onto the next step, I'll explain in a few words.
Think of a virus as something which you can hold in your hand.
If you put this virus in modelling clay and then take it out again,
you will leave behind an imprint whose shape complements the virus.
This imprint is now capable of recognising the same type of virus,
it's a synthetic antibody.
So, to make a synthetic antibody which can recognise a virus,
firstly we attach the virus, we then expand this polymer,
which is a sort of modelling clay, in order to surround the virus.
We take the virus out, and we get this magic imprint,
which is able to recognise the same type of virus.
Why do we use gold nanoparticles for this?
Because when the synthetic antibody recognises the virus,
the nanoparticles start to collect.
And when these particles collect, they change colour.
This change of colour can show up as a coloured strip on your test.
What I have just described
is an example of what we can call: preventive medical technologies.
These technologies will help you to understand your health risks,
and to follow their progression personally and in real-time.
I have talked to you about two technical problems
which we have resolved in the laboratory.
But, in fact, the true problem, the main obstacle, is not even scientific.
It is an obstacle which is common to all preventive medical technologies.
I'll quickly tell you about two more preventive medical technologies,
and explain where the main obstacle lies,
and why all of that is so important for the medicine of the future.
The second technology is portable devices or implants.
To give another example,
these days, diabetics control their blood sugar through self-testing.
In the future, they will have devices implanted under their skin,
which both measure and regulate the physiological parameters,
including blood sugar levels,
and which transmit this information to the patient's phone,
as well as to the doctor.
What is new and important here
is not the fact of having a device implanted.
The first pacemaker was implanted in 1958,
and that's what you see here in the heart.
So, what is new and important, is this capacity to collect information
directly from this device and send it to the doctor,
and the fact that the doctor can control the devices from a distance.
It's the convergence of technologies.
So, this technology has the potential to completely remove patients
from the centralised systems of hospitals,
whilst still maintaining a link with the doctor.
The third and last technology is even more impressive.
If someone offers you a box and tells you that inside,
there are three illnesses that you risk getting in your life
if you do nothing.
How many of you would open the box?
Remember, this box doesn't contain three illnesses that you're going to have,
but the illnesses that you are at risk of, if you do nothing.
In order to do something, I, personally, would open the box.
You've all received this box, it's your genetic inheritance.
We're all predisposed to certain illnesses,
and you have to know the risks to prevent the consequences.
Ten years ago, you needed 10 million dollars and several months
to sequence a human genome.
Today, you can do it for 100 dollars, or 72 pounds,
and receive a list of your genetic predispositions in a few weeks.
I know there are some issues with ethics and regulation,
but faced with the technology, the only viable response
is not banning it, but regulating it.
These technologies need to be regulated,
and I'm sure you've all seen, like me,
that in recent years, all the governments around the world
are complaining about incontrollable costs of health and social security systems.
But with every new reform,
we revert to the same health model, and look for a new way of financing it.
My belief is as follows: it's not a budgeting problem.
The only way for us to construct a sustainable health model
is to shift our focus from curative care towards preventive technologies.
From centralised, reactive medicine, to personalised, preventive medicine.
The patient must become the key player in the monitoring of their own health.
It's more than just an alternative, it's a necessity.
Thank you for listening.
(Applause)