The unprecedented pace of innovation today leaves many people wondering about our future. Whether robots will take our jobs; whether AI-based decisions about our security, finances, and health are obscure or biased; and whether our increasing energy demands will drive the Earth’s climate to the edge of catastrophe – these questions occupy the forefront of contemporary discourse.

Lord Browne of Madingley, Chairman of the Queen Elizabeth Prize for Engineering, argues in ‘Make, Think, Imagine’that we need not and must not put the brakes on technological advance. Civilisation is founded on engineering innovation; all progress stems from the human urge to make things and to shape the world around us, resulting in greater freedom, health and wealth for all. Below is an excerpt from the book.

‘Make, Think, Imagine’ by John Browne

Every inch of wall space in Robert Langer’s large office is covered by framed certificates, commemorating his many awards. Described as ‘the Edison of Medicine’, he has over one thousand patents, both granted and pending, and has published over a thousand scientific papers. The thirty companies that he has helped to launch have a combined market value of $25 billion, and only one of these ventures has failed. Langer is probably one of the world’s most influential engineers, but he is refreshingly down-to-earth and humble about his achievements. The focus of his work is deceptively simple. ‘[Drug] delivery is probably the number one thing,’ he says. The most potent medicines in the world can be effective only if they are able to reach the parts of the body where they are needed, in the correct state and at the right time – this is what he is trying to achieve.

Langer’s large laboratory is populated by chemical, mechanical and electrical engineers, materials scientists, molecular biologists, physicians, veterinary scientists, physicists, chemists and computer scientists. Among the many innovations that Langer’s diverse team have made are nanoparticles, just a few billionths of a metre across, that specifically seek out cancer cells and deliver drugs to them; polymers that release drugs in a slow, controlled fashion over months; microchip-based devices that release their payload by remote control and, recently, a form of modified table salt that could treat the vitamin and mineral deficiencies that afflict many of the world’s poorest people.

I was particularly struck by one of Langer’s inventions that demonstrates how the best engineering can slice through complexity and inefficiency to deliver an imaginative solution to a serious problem. Finding the best chemotherapy agents for a cancer is often a drawn-out and painful experience. Usually physicians have to apply them sequentially, over weeks, using indirect tests to help them decide if the drugs are working. What is more, most chemotherapy agents are poisons, and their side effects can be atrocious.

A new device from Langer’s lab could soon eliminate much of the guesswork and agony from this process. It seems surprisingly simple. There are no moving parts, no complex electronics, nor advanced nano-machines at work here – it is little more than a tiny rod, slightly smaller than a grain of rice, made from a robust resin. Micro-machined into it are dozens of tiny reservoirs, each preloaded with a different chemotherapy drug. The device is sent down a needle into a tumour, where the anti-cancer drugs then seep out into the cancerous tissue.  The next day, a slightly larger needle recovers the device and a halo of tumour cells surrounding it. Technicians then scrutinise the patches of drugged cancer cells, and are able to see immediately which drug cripples or kills the tumour cells best.

If ongoing clinical trials work out, his device could radically change cancer care. The latest version of the device can take up to a hundred different drugs. As well as transforming drug selection and dosage calculation, Langer believes his tool will also speed up the development of new cancer drugs, by allowing low-risk testing, in patients.

Does it take the incisive mind of a leading engineer like Langer to innovate in this way? ‘A lot of scientists have done some wonderful, wonderful work when they focus in on a single bit of genetics or a microorganism their whole life,’ he says, ‘but I think engineers are broader. We see a problem and just say, “Well, maybe we can attack it differently.”’ ‘I think most really good engineering technologies have many applications,’ he adds. The drug delivery vehicles that he has designed and built carry many different pharmaceutical cargoes into the body. In doing so, they have saved hundreds of millions of lives and improved the quality of billions more.

Langer’s ideas have not always been warmly received by the medical community. Back in the 1970s, his first nine research grant applications were turned down. This setback would have derailed many careers, but Langer was used to fighting his corner; he had applied for forty different assistant professor jobs before finally finding, at Boston Children’s Hospital, the only professor open-minded enough to welcome an engineer into a medical school. Since then, Langer has repeatedly cracked problems previously deemed unsolvable by the medical establishment.

While it is often said that engineers save more lives than doctors, Langer’s work shows just how far beyond the provision of clean water and sanitation the engineer’s impact can go. Every pill and every device has also been engineered. Engineers, therefore, play some hand in every single medical success story, without exception. Nothing expresses better the correct mission of medicine than Bob Langer’s parting words to me: ‘I just want to see us relieve suffering. I think that would be a good thing.’

John Browne is Chair of the Queen Elizabeth Prize for Engineering Foundation, former CEO of BP and former President of the Royal Academy of Engineering. This is a modified excerpt from his new book ‘Make, Think, Imagine: Engineering the Future of Civilisation.’

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