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The Hindu
The Hindu
Saumya Kalia

The story of Svetlana Mojsov, and the controversy around revolutionary diabetic drugs | Explained

The story so far: In October, biochemist Katalin Karikó became only the 23rd woman in Nobel’s 122-year-long history to have won the prestigious award in science and medicine. Her three-decade-long investigation into mrRNA vaccines ‘almost didn’t happen’: she struggled with funding, her institute demoted her and rejection letters from publications piled on. Dr. Kariko’s historic recognition reminded the world that scientific research is driven by “prestige, power and privilege”, she writes in her memoir.

Miles away from the spotlight, a familiar story fought for attention, concerning a different woman and a different disease. Last month, three corrections in leading publications (Nature, The New York Times and Cell) admitted to omitting a key name in the discovery of revolutionary drugs to treat diabetes and obesity: Svetlana Mojsov. Dr. Mojsov in the 1970s helped discover GLP-1, a hormone that has transformed the treatment of these non-communicable diseases today. However, recognition, patents and awards lagged in crediting her for her work. Two news stories traced how Dr. Mojsov’s pioneering contributions were systemically erased from scientific literature, denying her a place in history.

Who is Svetlana Mojsov?

Born in Yugoslavia, Dr. Mojsov finished her undergraduate degree in chemistry in Belgrade and in 1972, moved to New York’s Rockefeller University, an article in Science states. She worked with biochemist Bruce Merrifield, who earned a Nobel Prize for his work on peptides (the ‘building blocks of protein’). There, she trained her attention on synthesising glucagon, an alpha-helix-shaped hormone released by the pancreas that raises blood glucose levels. Scientific research was circling around the premise that suppressing glucagon could help treat Type 2 diabetes. The two doctors published a paper in 1981 documenting their “rapid and efficient” synethsis of glucagon.

She moved to the Massachusetts General Hospital (MHG) where a small group of scientists led by endocrinologist Joel Habener were already working on unravelling the mysteries of glucagon-like peptide-1 (GLP-1). Dr. Habener’s team studied anglerfish to clone GLP-1, hoping to link the hormone with the release of insulin, but was unable to locate GLP-1’s presence in the human body. “Then, I went to prove it,” Dr. Mosjov told Science. Even before she officially allied with Dr. Habener’s team, she had already established a method to detect GLP-1’s presence and agreed to work with Dr. Habener’s lab to test this further. A notable paper published in 1986 documents their discovery, mapping out the exact amino acid stretch of GLP-1 which could trigger insulin release in the pancreas — a paper that names Dr. Mosjov as the primary researcher followed by Gordon C. Weiner and Dr. Habener. Subsequent research into this field has built on this finding, inching towards drugs like Ozempic and Wegovy that emulate the action of GLP-1 which can in turn help treat obesity and diabetes.

“She was involved in the beginning, pioneering work, deciphering what the real active GLP-1 peptide is,” Dr. Habener told Science. Further research would use GLP-1’s insulin secretion powers and ability to suppress appetite to develop drugs called GLP-1 agonists, what we know as Ozempic and Wegovy. The estimated market size for GLP-1 receptor agonists in 2022 stood at $22.4 billion.

By 1992, she had returned to Rockefeller, but managing work with two children meant moving out of the spotlight. She continued researching GLP-1 properties in fish, and also “offered lab members help with peptide biology, finding that mentoring and collaborating with junior women scientists brought particular fulfilment,” the article noted. 

Was she excluded from patents and awards?

It was only in 1996 that, upon enquiring about patenting her research, Dr. Mojsov found that GLP-1 derivates were patented with Dr. Habener as the sole creator. “I just thought it was all in the papers, that it was obvious,” she told Stat News when asked why she didn’t seek recognition earlier.

Research highlights that women are less likely than men to pursue patents; lack of awareness, in addition to Institutional biases, financial restrictions and ingrained sexism have contributed to an ‘innovation gender gap’, evidence reveals. Women were named on only 13.2% of all patent applications in 2019, per data from the European Patent Office. Dr. Mojsov successfully waged a legal battle to amend four patents to include her name, and MGH agreed to share one-third of its drug royalties for a year.  

This pattern of exclusion repeated over the years. Her role was not only been omitted but also mischaracterised as that of only a “post-doctoral fellow in the Habener laboratory,” and not as a researcher working with her own funding. The clarification issued in the Cell journal article states, “The original article inadvertently omitted that Dr. Mojsov is registered as a co-inventor on the first and additional subsequent patents... The text now correctly identifies both Dr. Habener and Dr. Mojsov as co-inventors.” 

A pattern in scientific literature

Women’s representation in scientific literature echoes this pattern: less than half of the first authors and almost a fourth of the last authors were women, a 2023 analysis of papers published in journals of the Public Library of Science found. Some have called attention to the barriers around the funding process itself. Data from the U.K. showed that “women win fewer grants and are awarded proportionately less of the requested sum than men when applying for grant funding.” Linguistic barriers further impact non-native English researchers, like Dr. Mojsov, who relied on the support of a friend to write her dissertation in English, the Science article stated. Researchers from non-Western countries face similar challenges of needing more time to read papers, write their own, and prepare for presentations; the frequency of language-related rejections was 2.6 times higher, a study found.

Publications, patents and promotions work to create visibility in the field — a sort of industrial popularity — further paving the way for awards and citations.  “It’s easier to get credit if you then have built the field for decades. You have greater visibility,” said Jeffrey Flier, a former dean of Harvard Medical School. Between 2017 and 2021, three prestigious accolades have been bestowed upon Joel Habener, Daniel Drucker and Jens Juul Holst for their work on gluconate-like peptides. Dr. Mojsov was excluded for not being credited as a ‘discoverer’ because “her name did not come up during discussions,” said Dr. Flier. She had moved away from MGH circles by then.

When her name did come up, her contributions were recorded as “insights into peptide biology as part of MGH’s larger GLP-1 effort, in the group led by Habener.” The only memory of her detective work that unearthed GLP-1’s potential was held by her confidantes and journals carved with diagrams of proglucagon amino acid sequences.

“I’m sure you can find throughout history, and even now, many other examples where men and women worked side by side, and the man gets the prize,” said Claudia Rankins, co-founder of the Society of STEM Women of Color, in 2019. One example: Austrian-Swedish physicist Lita Meitner, famously known as “the mother of the atom bomb,” helped discover nuclear fission along with Otto Hahn, but later refused to work on the Manhattan Project to develop the bomb. In 1944, the Nobel Prize for Chemistry went to Dr. Hahn for this work.

The Nobel Prize itself has a stark history of underrepresentation: in 2019, Donna Strickland became the first woman to receive a Nobel for physics in 55 years. This was a prize lineup of 11 men and one woman; the trend is ascribed to lower participation of women and people of marginalised identities in STEM fields in high-income countries. The theory doesn’t quite hold: an analysis of 141 prizes awarded between 2001 and 2020 found the proportion of awards given to women still fell short of the proportion of total female academics. Gender disparity in awards is more often a result of a gender bias, evidence also shows. Awards nomination and selection criteria are designed in a way that women are less likely to be nominated than men. Institutes and organisations may favour the visibility Dr. Flier spoke of; in other cases, male researchers tended to favour their own gender while making nominations, data from the European Geosciences Union (EGU) showed.

A story that repeats itself 

The patent for GLP-1 lies with two inventors: Svetlana Mojsov and Joel Habener. But science prizes and patents raise complex questions about assigning credit. When was GLP-1 discovered? Was it when Dr. Habener theorised its ability to secrete insulin, or when Dr. Mojsov located the peptide in the human body? Who worked on proving its future significance? And whose work meets the threshold for claiming the ‘inventor’ title?

Critics, however, note that measuring innovation is as much about the researcher as it is about the research. Dr. Mojsov’s narrative contoured the workings of a system that often fails to recognise women’s research. Anecdotes and studies spotlight how these blind spots are created as many in STEM spend decades fighting for representation, mentorship, awareness, funding and higher bargaining power. Science has a history of sidelining women researchers; . encouraging gender diversity can further help derive “an ‘innovation dividend’ that leads to smarter, more creative teams, hence opening the door to new discoveries”, research has found.

As reports documenting Dr. Mojsov’s note, this is a story of a revolutionary drug, omissions and corrections, and a fight for recognition. What one also finds is the longer shadow of entrenched power imbalances in science. In an interview with Stat News, Dr. Mojsov said, “This is not about me getting prizes. It’s about me actually not being erased from the scientific literature.”

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