Only a handful of people have a job like that of Dr. Jeremy Levin, a South African-born physician based in the US who made the leap from clinical research to biotechnology and on to the business world. Since 2003, he has been "global head of strategic alliances" at Novartis Institutes for Biomedical Research, a division of one of the largest pharmaceutical companies in the world. A graduate of Oxford and Cambridge who did research on the structure of DNA, Levin was one of nine people to receive the 2005 Albert Einstein Award in Jerusalem's Old City from Mayor Uri Lupolianski last June. Cited for his "outstanding achievement in the life sciences," Levin has formed partnerships with more than 200 academic centers and 100 biotechnology companies in 25 countries - including Israel - to find new ways to understand disease and create new medicines. While conceding that he was deeply honored by receiving the award, he insisted that it recognized the work of many Novartis associates involved in collaborations. The soft-spoken physician, who saw Israel for the first time in 1967 and lived on Kibbutz Alonim in 1973, was here for another visit at the beginning of this month. "I come from a family of refugees," Levin told The Jerusalem Post. His father, the late Archie Levin, was a journalist who upset the regime by writing about the excesses of the apartheid government. Archie and his wife Leah moved with their three children to Rhodesia (now Zimbabwe), and Jeremy went to Oxford and Cambridge to earn his medical degree. He worked as a physician in internal medicine and cardiology, and then planned to spend a year in the US. But there he met his wife Margery, who works in investments, and stayed. They now have two daughters, 15 and 13, both of whom have been to Israel. In America, he was introduced to biotech. "I always enjoyed medicine, but I really fell in love with biotechnology," he recalls. "Very few things are more satisfying than knowing your patient is getting better. It's a privilege. While I don't treat patients anymore, developing and leading collaborations with partners in academia, biotech and pharmaceuticals often brings about medical technologies that make many patients better." Among the biotech companies where he learned the ropes were Focus Technologies in Washington; Cadus Pharmaceutical, of which he was CEO; Genzyme, where he was involved in Ceredase (the "orphan drug" prescribed for Gaucher's disease); and New Jersey-based Physiome Sciences, where he was named president. At that company he signed a major deal with a firm called 3rd Millennium for the sale of biological modeling technology for visualizing and simulating pathways related to Huntington's disease, a horrendous and incurable hereditary neurological disorder that usually strikes in mid-life. Then Levin was hired by Novartis Pharmaceuticals, the Swiss-based giant established in 1996 in a merger of Ciba-Geigy (a leading producer of patented prescription medications) and Sandoz, a well-known developer and marketer of generic drugs. Novartis has annual sales of $30 billion, and almost a fifth of its annual turnover is spent on research and development. On the day of the interview, it was announced that Novartis bought for some $5 billion the remaining available shares (that it did not previously own) in the California-based Chiron Corporation, the world's fifth-largest producer of vaccines. His current position, in which he is in charge of a core team of 30 who investigate over 400 research projects a year, is a combination of talent scout and matchmaker. Novartis has over 320 ongoing collaborations, including 200 programs with academic institutions, and he and his team are responsible for all early-stage technology partnering through first dosing in clinical studies. The global vaccine market is expected to double to more than $20 billion in the next five years. Forging strategic alliances in pharmaceuticals doesn't always end up in a commercial drug, Levin notes. "Even if it fails, you learn from the experience." IT TAKES a pharmaceutical company about 14 years and $800 million to turn a concept in a researcher's mind into a drug that can be applied for licensing. Many ideas never reach the development stage, and for every 10 drugs put though first trials, only one will proceed to the next stage. The high risks help explain the high prices of patented drugs, whose legal protection continues for only two decades. It's difficult to know what diseases will still need a solution a decade or two ahead, says Levin. "I couldn't predict 15 years ago what the market would be like today." Novartis focuses on medications in cardiology, metabolism, neuroscience, lungs, dermatology, rheumatology, gastroenterology, infectious diseases, hematology, oncology, ophthalmology, transplantation, immunology, bones and hormone replacement therapies, and its consumer health division is involved in nutritional supplements, infant care and veterinary drugs. Novartis has launched 13 new medicines in the US alone since 2000. Among the better-known are Gleevec, Exelon, Lamisil, Elidel, Trileptal, Foradil, Zelnorm/Zelmac, Neoral, Simulect, Femara and Zometa. Levin notes that it is worthwhile for pharmaceuticals to pursue treatment for little-known and uncommon diseases, because researchers can uncover mechanisms relevant to more common ones. For example, Von Buchem's disease, which is inherited, causes skull bones to thicken and the victim to die. "The same pathway causes pulmonary hypertension [high blood pressure in the lungs], which is much more common. So one could try a drug on a small group of Von Buchem's patients and see if it works for pulmonary hypertension as well." Novartis, he adds, is not one to ignore "orphan diseases," which affect only a few thousand people in his country. "You can learn from them," and the US Orphan Drug Law offers various legal and financial benefits to companies that devote their energies to treating or curing uncommon but often fatal disorders. Asked about lobbying in Israel for a similar Orphan Drug Law, Levin strongly endorses that it be passed. Generic drugs like those made by Novartis's Sandoz are a very important part of the healthcare system, says Levin. Companies that develop patent-protected products take it as a matter of course that down the road, they will lose this protection, he continues, and that generic companies will rush in to make their own versions of the drug. Pharmaceutical companies that develop their own drugs "have to prepare for that moment." Generic drugs, which range from aspirin to statins to alendronate, are much cheaper and serve a very important function in day-to-day medicine. "Generics free up resources in pharmaceutical companies to go on and develop novel drugs," Levin says. A frequent traveler, Levin says he spends half his time with his core team and the other half looking into potential investment projects and collaborations. "I do more of my work by videoconferencing, but since Novartis has dealings in 25 countries, I often have to be there. Israel, he concludes, has reached a very high level of basic and applied scientific research. "It is a powerhouse in this field. For example, we have just reached a new relationship with Prof. Irit Saguy, a leading structural biologist at the Weizmann Institute, and we have also created relationships with computational algorithm researchers here. Israel is different from the US, as it still doesn't have a large risk-venture capital market in the life sciences. Most of the companies focus on computers and electronics and are very successful. More Israeli venture capital firms will get into life sciences, and if they are very good ideas, we at Novartis will be willing to take the risk and help develop them."