In 1901, the average life expectancy in the United Kingdom was 47 years. By the year 2000 it had risen to 77 years. New medicines, improved air quality and better public hygiene has contributed to this 64% increase in the life-expectancy. The twentieth century has seen some major advances in healthcare. These have included the development of:

• penicillin: the discovery and development of antibiotics by Fleming, Florey and Chain.
• insulin: Banting and Best's work to show that insulin can be used to treat diabetes.
• other medicines: pharmaceutical laboratories around the world are constantly producing new treatments for diseases.

Vaccination: although first described by Edward Jenner in the 18th century, mass vaccination programmes were undertaken to prevent deaths from diseases such as yellow fever, poliomyelitis, measles, mumps and rubella. In 1980 the World Health Organisation announced that the deadly smallpox virus had been completely eradicated.

Medical imaging: physicians can now call on a range of techniques to see inside the body of their patients. X-rays, discovered by Roentgen, were the first but now sophisticated computer technology allows surgeons to plan operations and radiologist to target tumours with pinpoint accuracy. Ultrasound, magnetic resonance imagery (MRI) and computer tomography (CT) scans are all part of the doctor's diagnostic armoury.

Technology: advances in bioengineering, computing power, materials technology and many other areas of science have led to the development of many medical devices. During heart surgery, an artificial heart and lung machine keep the patient alive. Kidney damage can quickly kill but renal dialysis can keep patients alive even though their kidneys have failed. Hearing aids and cochlea implants bring sound to the hard of hearing. Biotechnology is allowing pure drugs, such as human insulin, to be produced in large quantities.

DNA: the human genome project is unlocking the secrets held within our DNA. It will lead to a much better understanding of the genetic basis for many diseases and may enable the development of new cures in the 21st Century.

The past half century has seen a tremendous advance in medicine. The first heart transplant was performed by Dr. Christian Barnard in 1967 and on July 25th 1978, Louise Brown was the first person to be born after in vitro fertilisation. Research and development of modern medicines has made a massive contribution to the improvement in health and life expectancy.

Sadly, it is not all good news for medicine in the 20th Century. Many diseases can be controlled and treated but this takes money. In places such as Africa, South America and Asia, the levels of healthcare are below those found in the more well off Western nations. Diseases like HIV/AIDS, cholera, tuberculosis, pneumonia and malaria remain major killers in these regions. The challenge of medicine in the 21st Century is to make high quality healthcare available to all.