As soon as human civilizations invented some form of written language and began documenting their

activities, early examples of applied medicine began to materialize. The first known civilization emerged
in what is now Iraq. These were the Sumerians who developed urban civilization around 4000 BC in
ancient Mesopotamia. Their documents show that they studied astronomy, metallurgy, geology,
mathematics, and also pharmacy. That typical pharmacy Compendia around 2000 BC involved plant
appointments, infusions, and concoctions from poppies, peppermint, Mandra Gora, thyme and many
other herbs. The Sumerians were already aware of the medicinal properties of cannabis and
morphine. They also used animal organs for their alleged medical properties, and even animal
excrements to repel evil spirits. A similar sort of traditional medicine emerged in practically every other
organized civilization, and a common thread linked them all. They were all based on the systematic trial
and error of all possible natural sources of chemicals available, mostly from the world of plants. The
Egyptians left copious logs of their discoveries by way of a Pharmacopoeia, which refers to books and
other documents containing lists of medicinal drugs, along with their effects and instructions for their
usage. For example, the famous papyrus Ebers dates from 1500 BC and contains over 700 treatments
described in 100 pages of hieroglyphics. This body of knowledge was probably acquired over many
centuries. The physicians in ancient Egypt belonged to the middle class, much like modern Western
societies and they were highly respected. They embraced magic and sorcery, but they incorporated
pharmacy more and more as time passed. The ancient Egyptian deity Thoth was credited with the
foundation of all scientific knowledge, including the act of giving Egyptian physicians their knowledge
of medicine and drugs.

In essentially every culture, the knowledge of medicine is represented as a gift from the gods. One
might wonder if these gods were a creation of collective fantasy, or if they described real historical
figures, endowed with advanced knowledge and were therefore deified. Western medicine, like most of
Western culture, draws its origins from Greek thought. In ancient Greece, the God who gave mankind
the gift of medicine is Asclepius, he is usually represented with a serpent entwined rod which may
look familiar. Its meaning is the object of speculation, but it is still used to represent the disciplines of
medicine and pharmacy today. The symbol is unfortunately often confused with the Caduceus, a
symbol of the god Hermes, and therefore not a symbol of medicine. And healthcare, but rather of
commerce and trade. However, because of the similarity, the two images are often used
interchangeably. A temple in Asclepius honor was founded in Epidaurus, which could be considered
the first hospital in history. Patients traveled from all over Greece to be treated their patients would
receive what was called pharmacology, which in Greek means both poison and drug.

This lack of distinction alludes to one of the most important underlying principles of modern
pharmacology, which is that the dose makes the poison, this means that a drug can save your life or
kill you, depending on the dose of fact, which can be applied to any other type of substance, even
those that we depend on for life, such as water and oxygen. One of the most famous doctors of all
time, the legendary Hippocrates of Coase practice there. Hippocrates lived from 460 to 370 BC, during
the Golden Age of Athens. This was an enlightened era. Characterized by democracy and freedom of
expression. Hippocrates has been seen over the ages as the founder of modern medicine,
distinguishing it as a discipline finally free of theology and philosophy. Some of his precepts are used
even today, among his professional principles, PRIMUM NON NOCERE which means first do not harm
the patient is still recognized as a pillar of experimental medicine. Hippocrates was probably the first
medical practitioner who believed that diseases are of natural origin and not caused by astrological
connections or evil spirits. He supported humanism, which was the theory of the four humors those
being blood, phlegm, yellow bile and black bile.

At the time, disease was thought to be due to an imbalance of these four humors. Although the theory
had no true scientific basis, it must be credited as the first attempt to create a foundation upon which to
build fact based medicinal practices. His theory and his practice of medicine are collected in an
impressive body of work called the corpus Hippocratic, which remained an important reference through
the Middle Ages. It was a collection of about 70 medical treatises, originally written in ionic Greek,
probably by his disciples and followers, and later translated into Latin, the official language of science
in Europe until the 18th century. In particular, the section called Hippocratic Oath, documents the
ethics of medical practice and constitutes the most influential section of the corpus, Hippocratic Oath.
In fact, the current laws and guidelines defining good medical practice are derived from the original
work of Hippocrates. After his death, the practice of medicine suffered a serious setback, mainly due
to political strife in ancient Greece, Hippocrates, his work was eventually taken up by the Romans,
who adopted the Greek mythological origin of medicine and renamed the god asleep. iOS as
Aesculapius. During the Roman imperial age. The most famous physician was Galen, also of Greek
origin, who lived during the second century AD. Born in Pergamon, a Greek colony which is in present
day Turkey, he spent most of his life in Rome, where thanks to his exceptional knowledge and abilities,
he became the personal physician to several emperors, including Marcus Aurelius.

Medicine in ancient Rome had regressed, reintroducing elements of divination and mysticism, Galen
fought an uphill battle to apply and perfect the Hippocratic theory of disease based on the four humors.
In addition to surgery, Galen strongly promoted venesection and bloodletting as an approach to
disease as opposed to divination. GALEN is famous for his approach to complex formulations of
remedies and elixirs. And to date, the field of drug formulation is often referred to as galena ax in his
honor. GALEN ZZ work the Galena corpus is truly immense. It was written in Greek which was the elite
language in ancient Rome, and it was believed to amount to over 500 treatises, equivalent to almost a
million pages. As the Western Roman Empire collapsed, the political center of the Western world
migrated to Byzantium, the eastern capital of the Roman Empire, and to the Arab world surrounding it.
The Materia Medica a medical Compendium widely employed in the West, and based on Caitlin's
work was the Bible of the medical profession until the 17th century, when elements of modern
science were finally introduced. His work was translated into Latin and Arabic, and his tradition was
slowly embraced by the Arabs who took his work a step further in the centuries that followed. As the
Arab world became the center of excellence in medical treatment during this era, let's move forward
and learn all about that time period.

The mission for Novartis is to help the patient overcome a disease and improve their quality of life . The
drug development process is designed to ensure that innovative new medicines are effective, safe and
available for patients in the shortest possible time. The first step in drug development is to discover
the best targets for treating or preventing disease. Targets are usually proteins in the patient's body,
which are associated with a disease or proteins and microorganisms causing a disease. That challenge is
to identify which proteins are relevant, and more importantly, confirm their role in a disease.
Increasingly Novartis focuses on understanding cellular networks of proteins or pathways. A single
protein may transmit messages to several other proteins, sometimes in multiple pathways affecting
their function. Knowing how these pathways work and interact, helps to identify the most appropriate
target for a drug. But bathroom pathway approach allows Novartis to better understand the
mechanisms of a disease. This knowledge together with the desire to address unmet medical needs,
determines the priorities in target discovery.

In drug discovery, several methods like high throughput screening and computer based design are
used to find chemical compounds or biologics that bind to the identified target. If a compound
modulates the target in a way that is expected to alter the disease, this so called hid will be refined to
improve its safety and effectiveness, eventually becoming a drug candidate. Discovering and bringing
one new drug to the market typically takes an average of 14 years of research and clinical
development efforts and costs around 2 billion US dollars 10,000 or more hits tested in early drug
discovery, only one may eventually lead to a drug that reaches the market. In the late preclinical
stage, further experiments are conducted on the drug candidate to ensure it is safe for patients and
has the required pharmacokinetic properties, like appropriate absorption and metabolism by the
human body. These experiments are executed with extraordinary diligence to minimize any risks to
human test subjects. Animals play a critical role in the drug discovery process as well. Although much
research and development can be done using various experiments, or using computers, complex disease
mechanisms can often only be understood through the use of animal studies. Also, governments and
regulatory authorities require that medicines be tested in animals before they are tested in humans.
Novartis keeps this research as limited as possible and always ensures that animal research is
scientifically acceptable, according to current standards and regulations. But these reasons, Novartis
continues to use animals in its quest to find innovative, safe and life-saving medicines for patients.

At the same time, Novartis is committed to refining, reducing and replacing the use of animals in
research and upholding the highest standards in animal welfare. Clinical Trial programs consist of
several phases, each of which is focused on evaluating drug safety and effectiveness or efficacy.
Information on ongoing clinical trials can be found at ww.clinicaltrials.gov. In phase one of clinical trials,
the drug is usually tested in healthy volunteers to determine its safety and pharmacokinetics. In phase
two, the drug is given to a group of about 100 to 250 patients with the disease graduated efficacy and
to determine the optimal dose. In addition, the safety of the drug and its side effects are evaluated as
these may be different in patients compared to the healthy volunteers tested in phase one. Novartis also
conducts trials called proof of concept or POC trials, which are often a mix of phase one and phase
two studies. A group of well-defined patients is treated with the drug candidate to provide an early
indication whether it actually affects the target in the intended way or has a beneficial impact on the
disease. These studies allow Novartis to rapidly invest resources on drug compounds which are effective
and safe. This way the appropriate medicines can reach the patients faster. That data from phase one
and phase two studies provide the scientific confidence necessary to continue the development of the
compound in larger clinical trials. In phase three clinical trials 1000 to 3000, or even more patients are
recruited for research with the investigational drug. Phase three clinical trials are undertaken to
confirm the effectiveness of the new drug, monitor side effects, compare it to established treatments
and gather additional information to allow the drug to be used safely.

To bring a new medicine on the market, every new drug needs to be registered by the Health
Authority. Data from all clinical trials are collected and compiled into a document called registration
dossier. The registration dossier will include efficacy and safety data to support the final intended use
of the drug. The dossier is then customized for different regions and countries around the world to
meet the requirements of health authorities. This is a crucial step to ensure that patients all over the
globe can access the innovative medicines that have made it through the complex drug discovery and
development process. Once the registration dossier is approved, and the product is launched, several
activities will continue like drug safety monitoring, which is mandatory. Post authorizations, safety
updates, annual reports and any additional information required by the Health Authority must be
provided at defined intervals as long as the drug remains on the market. Often, Phase four clinical
trials are initiated to gather additional data not collected in the phase three program. This may
include efficacy, safety, additional benefit and risk information as well as pharmaco economic data.
Our mission is to provide safe and effective treatments that benefit patients and improve the quality of
their lives.