The spectre of famine has returned to the Horn of Africa nearly a quarter of a century after the world’s pop stars gathered to banish it at Live Aid, raising £150m for relief efforts in 1985. Millions of impoverished Ethiopians face the threat of malnutrition and possibly starvation this winter in what is shaping up to be the country’s worst food crisis for decades.

Estimates of the number of people who need emergency food aid have risen steadily this year from 4.9 million in January to 5.3 million in May and 6.2 million in June. Another 7.5 million are getting aid in return for work on community projects, as part of the National Productive Safety Net Program for people whose food supplies are chronically insecure, bringing the total being fed to 13.7 million.

Donor countries provided sustenance to 12 million Ethiopians last year, more than half of it through the UN’s World Food Programme (WFP). Having passed that total only eight months into this year, and with the main harvest already in doubt, aid agencies fear the worst is still to come. “We’re extremely worried,” said Howard Taylor, who heads the Department for International Development’s office in Ethiopia. DfID has given £54m in aid to the country this year, and Britain has also contributed through the EU. “This is

“Critical water shortages” were reported in some areas by the UN’s Office for the Co-ordination of Humanitarian Affairs last week with water-borne diseases such as acute diarrhoea spreading as communities resort to drinking from insanitary wells and ponds. Unicef said that the outbreaks are putting extra pressure on its Out-Patient Therapeutic Programme, which provides healthcare in some of the most needy areas.

In Somali, the hardest hit region with a third of the humanitarian caseload and complications caused by a low-intensity insurgency, the mortality rate for infants has risen above two per 10,000 per day according to a regional nutrition survey, which gives newborns roughly a one-third chance of dying before their fifth birthdays. While there is no clear definition, one widely used threshold for famine is four infant deaths per 10,000 per day.

Declaring a famine is a political decision. While it can galvanise public opinion and bring millions into aid programmes, it is widely seen as a political failure. President George Bush challenged his officials to avoid the word, a policy known as “No famine on my watch”. Ethiopia’s Disaster Prevention and Preparedness Commission is charged with preventing famines of the 1984-85 type, the sort that bring down governments, argued Tufts University academics Sue Lautze and Angela Raven-Roberts in a 2004 paper.

Dismissing the warning signals, Ethiopia’s Prime Minister, Meles Zenawi, said earlier this month that there was no danger of famine this year. And Berhanu Kebede, Ethiopia’s ambassador to Britain, said at the weekend: “We are addressing the problem. Food is in the pipeline.”

The main practical difference between a food crisis and a famine is whether enough aid arrives to keep the starving alive. So while the scope of the problem can be measured in the number of hungry people, the severity depends on the generosity of those in the rich world. And this year they have been miserly. Despite the promise of G8 leaders at their summit in L’Aquila, Italy, last month to provide $20bn (£12bn) to improve food security in poor countries, contributions have slumped dramatically this year as donor states have shifted priorities to supporting banks and stimulating their own economies. “The international community is not living up to its promise to the World Food Programme,” Mr Kebede said.

The WFP had little trouble raising its $6bn budget last year, but in 2009 it has collected less than half of that. Its Ethiopian operation, which had $500m in 2008, is short $127m this year, equivalent to 167,000 tonnes of food. The Famine Early Warning Network forecast this month that the shortfall would reach 300,000 tonnes by December. Rations for the 6.2 million people receiving emergency food aid have, as a result, been slashed by a third from a meagre 15kg of cereals, beans and oil a month to just 10kg. Even if the shortfall were made up today, it would take three months for supplies to be loaded on to ships bound for Djibouti, then transferred to trucks for the arduous overland journey to land-locked Ethiopia.

Aid agencies are worried about the main harvest this autumn, arguing that the time for action is now, not when the food runs out in November – usually the driest month – let alone when starving children with distended bellies capture the attention of the West’s television viewing public. Despite its good intentions, Bob Geldof’s Live Aid came towards the end of the 1984-85 famine, which killed more than a million people. Since then, Ethiopia’s population has doubled to 80 million.

Mr Zenawi’s government has set up a strategic food reserve which has at times reached 500,000 tonnes – though it is currently thought to be just 200,000 tonnes – which it uses to speed up delivery. As soon as they get funds, aid agencies can borrow food from this reserve, replacing it with supplies from abroad when they arrive. Although the government could release this food without promises of replenishment, it would soon run out; after covering the WFP’s 167,000 tonne shortfall, the stockpile would be barely enough to feed a million people for three months.

The underlying problem for Ethiopia is the erratic behaviour of the country’s climate, or rather its regional micro-climates. Moisture-bearing clouds scudding in from the Indian Ocean can pass over the parched eastern lowlands to dump generous amounts of rain on the fertile western highlands. The famine of 1984-85, revealed by BBC reporter Michael Buerk, was actually two separate famines, one in Tigray, in the north, the other in Somali, in the south-east.

Two main rains sustain the people of Ethiopia, the belg in spring and the kiremt, which usually start in July. Both are influenced by variations in sea-surface temperature. The El Niño phenomena in the eastern Pacific usually bring droughts to Ethiopia, and America’s National Oceanic and Atmospheric Administration predicts that the current El Niño will strengthen over the next six months. The belg has failed for two years running now, while the kiremt started three weeks late this summer and the amount of rainfall when they did come was below normal. Aid agencies fear that the season could end early, or, equally bad, produce delayed downpours just when farmers need dry weather for the harvest. Even if the kiremt ends on time in October, some crops may not reach maturity because of the late planting.

Ethiopia is overwhelmingly dependent on agriculture, and some 90 per cent of its crops are watered by nature rather than by man-made irrigation systems. During droughts, farmers and nomadic herders tend to sell off their assets to buy food, leaving them with nothing when the next growing season begins. It can take three to five years for pastoral tribes to rebuild their herds.

Although Ethiopia is particularly hard hit, drought has also affected neighbouring countries. Resources in Somali are under additional strain because nomadic tribesmen from Somalia and Kenya have driven unusually large numbers of cattle across the border in search of water and pasture. Estimates of the number of cattle coming into the country range from 95,000 to 200,000.

The spike in global food prices in 2008 exacerbated a worsening situation, hitting the urban poor particularly hard. While they have fallen back this year, the price for grains in the markets of Adis Ababa are still some 50 per cent higher than their average in the four years to 2007.

The Ethiopian government is acutely aware of the danger of famine, not least to itself. Emperor Haile Selassie was deposed a year after the 1973 famine and the Derg military junta led by Lt Col Mengistu Haile Mariam was overthrown in 1991 after a civil war driven in part by the 1984-85 famine. While most other countries with food shortages allow charities to distribute food, Ethiopia’s government insists that the bulk of food aid must pass through its hands.

The irony is that the Zenawi regime has done a reasonable job of boosting food production, achieving self-sufficiency in the late 1990s. One agency described it as the “bread basket” of Africa, harvesting more grain in a good year than South Africa. The government promotes best practices and distributes fertiliser to farmers. It also has an ambitious scheme to relocate 2.2 million people to more fertile areas. But even it can’t control the rains.

Many Africans blame climate change for the erratic weather patterns and resulting food shortages. Jean Ping, the chairman of the African Union, said last week in Adis Ababa: “Although Africa is least responsible for global warming, it suffers most from a problem it didn’t create.”

Thousands of infertile couples could be spared the pain, anguish and expense of fruitless IVF treatments, thanks to the discovery of a lock-and-key mechanism between sperm and egg cells.

The research could explain why so many couples with no apparent reproductive problems are unable to conceive. Although more than 40,000 in vitro fertilisation cycles are prescribed in Britain each year, only 10,000 births result.

In addition to the £5,000 cost of each cycle, the couples face huge amounts of stress and can suffer severe depression and in some cases divorce. “Our work has quite a lot of relevance for humans and society and one of the main ones is infertility,” said Dr Martin Brinkworth, a member of the team at the universities of Bradford and Leeds that discovered the lock-and-key mechanism.

Some 15 per cent of couples have trouble conceiving, about half of them because the man has a problem. But in only one third of cases is the cause obvious, such as a low sperm count, malformation or poor swimming ability. This leaves 2 per cent of the male population, about 330,000 adult men in the UK (not all of whom will be trying to have children), who are infertile for no discernable reason.

Dr David Miller at the University of Leeds thinks the secret could be that the genetic keys in their sperm don’t quite fit their partners’ locks. “Our research offers a plausible explanation for why some sperm malfunction,” he said.

His colleague Dr David Iles added: “There is a definite pattern to the way DNA is packaged in sperm cells. It is the same in unrelated fertile men, but it is different in the sperm of infertile men.”

If a test could be developed to identify these men, up to a quarter of women who have intrusive fertility checks would be spared the procedures. It could also sharply decrease the 75 per cent failure rate of IVF by filtering out male candidates who have no chance of success. Private patients and the NHS could save as much as £50m a year if all cases of male infertility were identified in advance.

The Leeds-Bradford research, and parallel work by a US team at the University of Utah, fundamentally changes our understanding of the importance sperm has in the developing embryo.

Although the egg and sperm each supply half the DNA for the new baby, the egg provides all the cellular support systems, including enzymes and proteins. Until now, it was thought that sperm simply delivered the father’s tightly packed DNA to the egg, leaving control and regulation of the process to the mother’s DNA.

But the two teams of scientists, have found that some genes are left exposed in sperm, in an “open conformation”, allowing them to play an important role in the development of the embryo. “It contradicts the dogma that the egg does everything,” said Dr Brinkworth, a senior lecturer at the University of Bradford.

The British team has also identified how these “open” areas are formed and evidence that they can be read by the egg, suggesting that they act as a signature or key, revealing the species the sperm comes from and signalling whether the DNA is in good shape.

Although no clinical test is available now, the researchers are hopeful that one can be developed after they’ve identified all the DNA bases in the open areas, some of which might be usable as markers.

The molecule at the heart of the lock-and-key mechanism is a protein called CTCF, say the scientists in a paper published in the journal Genome Research. “CTCF sets the stage during sperm development,” said Dr Iles. “And open bases can be recognised by CTCF in the egg.”

If stretched out end to end, the DNA from a single human cell would be about 1.8m long. But in the cell nucleus, it is wrapped around molecules called histones, which link up to form an efficient three-dimensional scaffold, 40,000 times shorter than the unfolded DNA. Histones also play a role in turning genes on so that their coded instructions can be copied and sent to other parts of the cell.

But sperm don’t have elaborate cells, just a tightly packed nucleus and a tail for swimming to the egg. So when they form, the histones are stripped off and replaced with another molecule called protamine, which shapes the DNA into an even tighter bundle, where the genes cannot be read.

The British researchers have found, however, that CTCF protects some histones in sperm from being replaced, leaving about 4 per cent of the genome in an open conformation, so that its instructions can be copied. Since the pattern of exposed areas is not random, they believe it must have a purpose, and the simplest explanation is that it is a key that influences the developing embryo even before the father’s genetic contribution has been unpacked.

The discovery has implications for research in fields other than human reproduction. Although the bulk of their work involved 50 million human sperm cells from several donors, the Bradford-Leeds team also found similar structures in mouse sperm.

The lock-and-key mechanism could help to explain how closely related species maintain their separate identities, even when individual members have sex. “DNA from different organisms can be extremely similar,” said Dr Iles. “Why do they not produce offspring, or if they do, why is it sterile, like mules and donkeys?”

The team speculates that this may have been the fate of prehistoric couplings between humans and their close cousins, Neanderthals, with incompatible keys and locks ensuring that any offspring would be unable to breed.

This would explain why the human genome has no trace of Neanderthal DNA despite the two similar species living close together for millennia.

(Co-written with Kyoko Nishimoto)

Japanese popular culture has few courtroom dramas. There is no Rumpole of the Tokyo Bailey, no Perry Mason in Osaka. Juninin no yasashii nihonjin, a 1991 remake of Henry Fonda’s jury-room classic Twelve Angry Men, is a comedy, its title translating as “Twelve Gentle Japanese“. And Shun Nakahara’s film is also a fantasy; for the past 66 years, no jury has sat in Japan.

Screenwriters and defendants alike should therefore embrace the country’s looming judicial reform. Currently, the pinnacle of court excitement comes when the prosecutor files a stack of summarised affidavits with the judge’s clerk. This is trial by paperwork. Oral testimony is rare, and cross-examination all but unheard of. Trials not only lack drama, they give defendants little hope. Prosecutors have a better than 99.5 per cent chance of winning.

From next month, however, panels comprised of six lay jurors, called saiban-in, and three professional judges will hear serious criminal cases such as murders and rapes. In some ways, they will be even more powerful than their British counterparts, handing down sentences as well as determining guilt .

The potential for unsafe convictions under the existing system is huge. Suspects can be interrogated for 23 days, without counsel, before they’re charged. Witnesses are interviewed by police and prosecutors, but not necessarily the defence. Evidence dug up by the authorities that could help the accused is often kept secret. More than 80 per cent of cases rely on a full confession.

Old-school prosecutors insist that their success rate reflects how careful they are to bring only iron-clad cases to court. “One of the concerns is that defence counsel co-operate [with prosecutors] in most cases,” said Daniel Foote, professor of sociology and law at the University of Tokyo. “And there have been no claims for ineffective assistance of counsel.” Indeed, Japanese has no such term.

Japan’s first experiment with citizen juries came in 1928, but their impact was limited. True, the conviction rate was a more reasonable 82 per cent. But only 460 cases were contested before a jury, probably because defendants were expected to carry the extra cost. The system was dropped, “temporarily”, during the Second World War. Since the list of potential jurors was almost identical to the list of men who could be conscripted, by 1943 few were available.

For liberal Britons, whose right to a jury trial was enshrined in Magna Carta, the need for 12 good men and true may seem obvious. But reform has deeply divided Japan. Some potential jurors worry that they will be asked to make life-or-death decisions in capital cases. Many more simply don’t want to lose their income and freedom for no personal benefit. Critics fear that deferential laymen will convict the innocent, or that – intimidated by yakuza – they will free the guilty. “There is no denying that great submissiveness is part of the national character,” Judge Tomonao Onizawa, the councillor general to the Supreme Court, told The New York Times. “But this will change gradually.”

In the cavernous atrium of the Kyoto train station late last year, members of the Bar Association tried to nudge that change along by staging a not-so-traditional kabuki play about a court case. At the end, the audience were invited to vote on the defendant’s guilt. Lawyers handed passers-by goodie bags labelled “Are you ready?” with Q&A booklets and a manga comic book about a murder on the golf links. Nintendo DS has just launched a new game called Guilty or Not Guilty.

The public education campaign includes three films commissioned by the Supreme Court and the Justice Ministry. Yet many people remain bemused. Unlike LA Law, there are no plot twists. The cinematic jurors end up being reassured that, “yes, the defendant was guilty”, Professor Foote says.

In fact, the reforms are the result of two decades of debate within the legal community after a scandal in which four men on death row were found to be not guilty. One common thread was that their confessions, later recanted, kept shifting so that they matched new evidence found by the police. The Japan Federation of Bar Associations is calling for interrogations to be videotaped, but the Justice Ministry has conceded only that the final signing of statements should be recorded. Trying suspects before a jury of their peers is only one step towards giving defendants their day in court.

Once upon a very recent time, Vancouver had a clean, safe image. Nestled between a spectacular bay and snow-capped mountains, this Canadian city, which is twice the size of Birmingham, was described by The Economist as the most liveable in the world. Not any more. As it prepares to host the 2010 Winter Olympics, what it’s got now is not cuddly, eco-friendly publicity, but blood-spattered streets littered with shell casings and corpses.

Vancouver is the battlefield in a war between myriad drug gangs, which include Hell’s Angels, Big Circle Boys, United Nations, Red Scorpions, Independent Soldiers and the 14K Triad. Guns – often machineguns – are fired almost daily. “We’ve always been told by media experts to never admit that there is a gang war,” the chief of police, Jim Chu, said last month. “Let’s get serious. There is a gang war and it’s brutal.” Vancouver’s Mayor, Gregor Robertson, confessed that the police are fighting a losing battle. Since mid-January, the city has recorded 50 gang-related shootings, 18 of them fatal. And the violence is not confined to seedy neighbourhoods. The cross-fire is happening in quiet, residential cul-de-sacs and the car parks of up-scale shopping centres. It’s a suburban civil war.

Nor are hardened criminals the only victims. An attack on one gangster’s car killed a 24-year-old man hired to fit it with a new stereo. In February, Nicole Alemy, 23, the wife of another gangster, was gunned down in her white Cadillac – with her four-year-old son in the back seat. On Friday, police arrested James Bacon – one of three brothers who left the United Nations gang to join the Red Scorpions, intensifying the rivalry between the two – for conspiring in the deaths of four gangsters in their flat in Surrey, south-east of Vancouver. Two innocent men were forced from the hallway into the flat and also killed. Police said they intend to make more arrests over the weekend.

As Vancouver has boomed over the past two decades, attracting wealthy immigrants from across Canada and the Pacific, so too has the illegal drugs trade. It is now the third largest industry in the province, generating between C$7bn (£3.8bn) and C$8bn a year. A young, party-loving population with liberal attitudes to drugs has created strong domestic demand, while the province’s mild climate and a ready supply of well-educated horticulturalists has led to supply of a premium brand of cannabis called “BC bud”, produced mostly in hydroponic “grow-ops”.

The drug’s superior quality – “one puff and you’re anaesthetised,” reported one academic – also found favour with customers in the US, encouraging an imaginative corps of smugglers. Customs agents have found shipments in church vans, hollow logs and even kayaks. One enterprising crew emulated the prisoners of Stalag Luft III, digging a 110m tunnel “under the wire”. The bigger problem for Canada, though, was the return trade. The US drug distributors preferred to pay in kind, with cocaine and guns.

Many commentators think Vancouver’s violence is just a skirmish on the fringe of the much larger war in Mexico, where 6,000 were murdered last year as the state tried to reassert control over territories seized by drug lords. The result has been a 50 per cent rise in the price of cocaine in Canada, and correspondingly higher profits to fight over. But not everyone is convinced. Experts at Simon Fraser University argue that the problem is home-grown, and that it’s exacerbated by police efforts to bang up mob leaders. “All you do is create vacancies as you put people in jail,” said Ehor Boyanowsky, an associate professor of criminology. “Suddenly there’s an opportunity.”

In the short term, say the academics, Vancouver’s problem is one of unco-ordinated enforcement. By one count, as many as 11 different agencies, including the Royal Canadian Mounted Police and local police forces, were responsible for suppressing the drugs trade. The courts are almost as confused. Canadian justice is more tolerant than America’s. No one has been successfully prosecuted for simple possession of marijuana in years, and Amsterdam-style hash cafés operate in a grey zone, only occasionally being shut down. Because of judicial leniency, officers prefer to see their targets collared in the US. The “Great Escape” gang were under surveillance on both sides of the border, but were arrested in Washington.

In the long run, many British Columbians, on both left and right, accept that legalisation and regulation are the answer. Just the sales tax on C$7bn of drugs would pay for several hospitals and schools, policing costs could be reduced, property crime by addicts to pay for their drug habits would be slashed, and the gang wars could be quickly reined in. “But the international politics are unbelievable,” said Dr Rob Gordon, director of Simon Fraser’s school of criminology. “The DEA [US Drug Enforcement Administration] starts to foam at the mouth at the idea of there being a huge, legal marijuana farm just north of the border. Under George Bush, the concensus was that if Canada ever moved to exercise its economic sovereignty, they would shut the border down by searching every vehicle.”

Until then, the best hope may be that one gang or another comes out on top, allowing it to impose stability, much as the Hell’s Angel’s bike gang used to do up to 15 or 20 years ago. Professor Boyanowsky said: “Those were the good old days.”

For the lucky, a check-up at the GP consists of nothing more sophisticated than a blood-pressure cuff, an icy stethoscope and a jar to pee in. For those with bigger problems, it can involve medicine’s heavy artillery, from bedside ultra-sound devices to giant metal doughnuts that generate magnetic fields several times stronger than the Earth’s.

Medical imaging has come a long way since Wilhelm Roentgen took the first X-ray of his wife’s hand in 1895. Until then, doctors had no way to tell what was going on inside a living body. Autopsies (often illegal) could show them where organs were but not their functions.

If today’s scanning technologies – X-ray, positron emission, magnetic resonance (MRI), computer-aided tomography (CAT), ultrasound and single photon emission – seem impressive, tomorrow’s promise to be wondrous. Doctors will be able to detect not just large-scale structures but the microscopic interplay of proteins and enzymes as they react to diseases and treatments. Early screening will spot many problems before they become terminal. Diagnostic scans will predict which therapy will work best on a given patient, while follow-up images will determine whether all is going to plan.

From biotech start-ups to pharmaceutical and medical equipment giants, all want a piece of this new action, but one British-based company seems particularly well positioned. GE Healthcare, formerly Amersham, the first company to be fully privatised by Margaret Thatcher in 1982, was sold to the Americans in 2004 for $10bn. Back then, some in the City professed confusion about a company with a wide range of businesses lumped under the catch-all heading “diagnostic life sciences”. They may still be nonplussed, but one set of numbers is crystal clear. GE Healthcare’s sales have soared from $9bn in the year before the sale to $17bn in 2008.

“We’re at a tipping point,” the company said in a paper last May, comparing the coming transformation to that brought about by Thomas Edison when he invented the light bulb. “To take healthcare into the future, we do not have to wait for technologies that will be available in 2025. We need only look at the technologies we have today and act.”

GE Healthcare’s main campuses are scattered around the Chalfonts, a huddle of leafy villagesnorth-west of London. Dr Patrick Grove, then a 26-year-old organic chemist, established the company at Chilcote House in 1940 to refine radium for instrument dials on aircraft and ships. After the Second World War, it became a national centre for the development of radioactive materials and is still a licensed nuclear site.

Chilcote House is now the campus reception centre; security is tight and before visitors can enter some buildings, they must pin on a dosimeter to measure their radiation exposure. The office of Dr Marivi Mendizabal, GE Healthcare’s head of discovery, is in a less glowing building. Still, the main room is divided in half by a glass wall inscribed with a double helix at waist height, with her lab on the far side. In a soft Spanish accent, Dr Mendizabal introduces a series of techniques, some developed in-house (the R&D budget is $1bn), some by partner companies, and others licensed from academia. They range from products approved for use to those still in early trials. What they share is a simple logic – better imaging means earlier diagnosis and more effective treatment.

While hardware has improved, the big change is in what Dr Mendizabal calls “wet science”. One characteristic of chemistry, and particularly large biological molecules, is that they have counterparts that fit like keys in locks. Find the right key and it will latch on to a particular lock. It’s the same technique used by the body’s immune system to send antibodies after the antigens on invading cells. “It’s not just antigens, though,” she says. “This works on other molecules too.”

Consider AH118635, a synthetic molecule invented at GE Healthcare that’s so new it doesn’t even have a catchy name yet. It reveals whether cancers are growing or not by latching on to a marker called integrin alpha 5 beta 3, which regulates blood-vessel growth. Most tumours are only alive near their surface; the centres die because they can’t get enough blood, says Dr Mendizabal. AH118635, if it gets regulatory approval, will be able to tell how successful a tumour is at building new vessels, both by itself and after it’s attacked with drugs designed to disrupt the process, such as Roche’s Avastin.

Or take Hexvix, a chemical which accumulates in tumour cells and glows when exposed to blue light. Developed by PhotoCure, a Norwegian company, and distributed globally by GE Healthcare, Hexvix is already in clinical use. It increases the number of potentially cancerous cysts detected during optical bladder inspections, reducing the risk to the patient.

Another collaboration, this one with InSightec, combines two technologies, MRI and ultrasound, to replace the knife in treating uterine fibroids, a condition which often leads to hysterectomy. Instead, surgeons locate the fibroids on an MRI scan and focus a beam of high-intensity ultrasound to raise their temperature until it destroys the cells. The procedure takes just three hours and the patient is off work for a day, as opposed to four to eight weeks after a hysterectomy.

Even Roentgen’s X-rays are becoming more useful. Nano agents, the first major development in X-ray technology since the invention of computer-aided tomography 30 years ago, promise to give doctors 1mm resolution of soft tissues as well as bones. The trick is to bundle up a tiny but dense ball of iodine atoms in a shell. Injected into the body, the iodine atoms act as tiny shutters, blocking the X-rays and revealing the internal shapes of organs.

Elsewhere in the Chalfonts, Robert Dann is showing off a virtual colonoscopy. Early treatment of colon cancer is 90 per cent successful, compared with 10 per cent if it is caught late. But the screening process is intrusive and unpleasant, so the take-up rate is low. The virtual colonoscopy turns a CAT scan of the large intestine into a movie, allowing the doctor to “fly” through the colon looking for colour-coded, pre-cancerous polyps. If this raises the screening rate from 30 to 100 per cent, more than 10,000 lives a year could be saved in the UK alone. 

Saving lives is the popular measure for medical successes, but cutting costs is also important. The new wave of scanners promises to do this in two ways. By helping researchers evaluate drugs at an earlier stage, they reduce the cost of pharmaceutical development. And by catching diseases earlier and allowing more targeted treatments, they reduce direct clinical costs.

After generations in which technology drove the cost of medicine ever higher, it’s about time the pendulum began to swing the other way.

The company – which uses barcodes and a bank of computers at a secure facility in Britain to check for fake medicines – already has operations in Belgium, Greece and Italy and is looking to roll out its system in another three to four markets this year, said managing director, Gary Noon.

Its expansion into Ireland involves hooking up all 1,500 chemists in the country. Initially, pharmacists will only be able to confirm the batch that the medicine comes from, but within a year, each individual packet will have a unique 74-digit number.

Spun off from PA Consulting two years ago, and backed by venture capital outfit Ipex Capital, Aegate offers a secure system similar to those used by banks to confirm debit and credit cards used in shops and cash machines.

Counterfeiters have built on their success in selling fake Viagra over the internet and are now targeting the world’s top-selling drug, Lipitor, as well as medicines to treat heart attacks, cancer and even schizophrenia. Some packaging is so convincing that it takes a lab test to show that the pills inside are phoney.

The World Health Organisation estimates that 1 per cent of drugs sold through legitimate channels in the developed world are counterfeit. In Britain, over the past three years, the authorities have identified 14 batches of drugs as fakes.

Half a million counterfeit medicines were seized at the EU’s borders in 2005 and officials expect recent figures to be higher. The WHO estimates the illegal trade will be worth $75bn (£50bn) globally by 2010.

If, as expected, Günter Verheugen, the EU enterprise commissioner, recommends legislation requiring point-of-sale authentication in his pharmaceuticals proposal due to be published in April, Aegate is in a strong position. While several other companies have tested systems, the British firm is the only one in Europe with operations up and running.

Criminal gangs that cut their teeth selling fake Viagra on the internet and went on to push dummy drugs in poor countries are now suspected of infiltrating the supply of medicines in the developed world.

“Counterfeit drugs could be compared to arms trafficking. It really is the same kind of dangerous crime,” said Françoise Grossetête, a French MEP and member of the parliament’s public health committee, at an international conference on the problem in Brussels. “It could become a form of terrorism.”

The Medicines and Healthcare products Regulatory Agency (MHRA) has recalled 14 batches of counterfeit drugs in the past three years, compared with none in the previous decade. These included fakes claiming to be the world’s best-selling drug, Lipitor, which cuts cholesterol, Plavix, which helps to prevent blood clots, and Casodex, which fights prostate cancer. Criminals have also targeted Zyprexa, an anti-psychotic prescribed for schizophrenia and bipolar disorder.

The MHRA described the situation as “serious”, and said its enforcement and intelligence unit was dealing with the problem.

The World Health Organisation (WHO) estimates that 1 per cent of drugs in the developed world are counterfeit. In Britain, that would mean up to seven million fake prescriptions a year, almost all of them undetected. Illegal pills may contain little or none of the real medicine’s active ingredient, and because they are manufactured in unhygienic conditions, could have dangerous contaminants. Often the fakes can be spotted only with laboratory tests.

Patients who report to their doctors that a drug isn’t working are likely to be put on a higher dosage than they need, or be switched to alternatives that could be less effective or have more dangerous side effects. No Britons have died yet because of counterfeit drugs, the MHRA claims. However, any deaths would almost certainly be attributed to the patient’s illness. Medicines taken by people who appear to die of natural causes are not routinely checked.

The WHO has reported several cases where counterfeits have led to mass deaths. More than 2,000 people died during a meningitis epidemic in Niger in 1995 after being inoculated with fake vaccines.

Prescription drugs are traded throughout the EU and around the world. Often a packet of pills will pass through dozens of companies between the manufacturer and the chemist. They are frequently repackaged, with labels and instructions in different languages. Although British drug traders need a licence from the MHRA, it has no control over who handles the pharmaceuticals elsewhere in the EU.

Many of the fakes are produced in India or African countries, and then imported into the EU. John Taylor, the head of the anti-counterfeiting team in the EU Customs Department, said national authorities seized four million fakes last year, up 50 per cent on 2006. “Once they are in the EU, they travel around freely,” he said.

Aegate, a British company, has recently completed an audit of its successful system in Belgium, Greece and Italy that uses a bar code to check whether a drug is authentic. No counterfeits made it through to patients. Although the firm’s high-security computers are in the UK, efforts to provide the service to British pharmacies are at an early stage, partly because chemists here do not have integrated computer systems. Most still rely on paper prescriptions.

Dame Mary Perkins adamantly denies she’s the Imelda Marcos of spectacles. Unlike the former first lady of the Philippines, who had 1,060 pairs of shoes in her wardrobe by the time her husband was deposed, Dame Mary insists she has “just” four dozen eyeglasses.

On the day we meet, she’s sporting a semi-rimless pair with a light-green metallic frame, fashionable letterbox lenses and broad armatures with a horizontal slit along the middle to allow just a sliver of peripheral vision. “For years I used to tell people not to choose frames with thick arms, because if you’re reversing your car you’ll have a blind spot,” she says, tucking the Supras back into their case. “And now, what’s the fashion? Thick arms,” she laughs. “So what if you crash your car?”

If her personal collection is – relatively – modest, her company stash is not. “Over the past 15 years I’ve kept every single frame we’ve carried. It’s all in boxes and I’m trying to find the best way to display them,” says the co-founder of Specsavers, Britain’s largest chain of opticians. Possibly at the V&A, I suggest, thinking that if the country’s leading design museum can make room for Kylie Minogue’s gold lamé hotpants, it could surely spare a rack of display cases to exhibit a few thousand snazzy frames.

At first glance, Dame Mary, 64, is an unlikely champion for the fashion industry. Her personal style is a businesslike twinset-and-pearls look (accented with a Guernsey flag pin) and her manner reminds me more of a wise elder aunty than, say, Dame Vivienne Westwood. Yet her influence has surely been more far reaching than her punk contemporary’s.

The two-for-the-price-of-one deals at the heart of Specsavers’ aggressive marketing campaigns have led to a revolution in eyewear, turning a once-ugly prosthetic into a must-have fashion accessory. The chain sold 18 million prescription lenses last year, all of them made – under licence from Pentax – at its three UK factories.

Glasses are no longer a sign of geekyness and are regularly worn by people with 20-20 vision. The likes of Tommy Hilfiger, Red or Dead and, in an exclusive deal signed last year, Jasper Conran now design frames. Gone are those NHS specs for children, with the springy wires that looped over the ears and dug painfully into the flesh. Or at least, they were gone for a while. “Who would have thought Harry Potter would have brought them back into fashion?” she says.

Like some early 20th-century Bolshevik, Dame Mary is already exporting her revolution. Specsavers had more than 1,000 stores in nine countries at its year-end in February, and is aiming to double that in the next four years. Its latest expansion is into New Zealand, where it plans to open 60 outlets this year. In Australia, it has been on an acquisition spree, picking up 40 outlets from Vision Centres and Vision Crest Optometrists. Turnover also crossed the £1bn mark last year, two years ahead of schedule.

The main obstacle to global growth is the structure of national markets. “What we like is where the optics model is similar to the UK’s,” she says. “In Italy or France or Germany, most people would go to an eye doctor to get tested, then go around the corner to buy their glasses. We prefer to have a fully qualified optometrist on the premises, owning that practice and both testing and dispensing.”

Domestically, the company is still expanding, though slower than it is abroad. Dame Mary thinks it will benefit from the downturn in the economy as shoppers look for cheaper options without sacrificing style. “Our typical customer has a very similar profile to an Asda customer,” she says. Already the chain has introduced a new Star range of glasses, frames and lenses, for just £25. “We managed to hold prices for 10 years but six months ago we could see people starting to think, ‘I’ve only got so much money in my purse.’ ”

She’s also optimistic about the future of her digital hearing-aid stores – after five years, already the largest private providers in the country – and positively bullish about a varifocal lens, called Occupational Tailormade Multifocal, that is due to be rolled out this autumn. And despite the downturn, the company is investing in technology. It is introducing fundus cameras, a microscope that takes pictures of the retina, as standard in many of its shops.

Specsavers is Dame Mary’s second chain. The first she formed with her husband, Doug, whom she met while they were studying to be optometrists at Cardiff University. Based in her home town, Bristol, it grew to 23 stores before they sold it in 1980 for a reported £2m. Soon after that, the family moved to Guernsey, where her father, also an optometrist, had retired.

“I thought I might do something different,” she says. But after a spell doing charity work for the Citizens Advice Bureau, and a term studying to be an accountant (”ghastly thought”), she returned to optics.

The lure was Margaret Thatcher’s plan to liberalise the business in 1984. “Before that, you could not advertise – not even an announcement in the local paper for a new shop opening. You couldn’t put frames in the window with prices on them.”

Many in the industry decried the reforms as the end of the small, family optician. “It was like asking turkeys to vote for Christmas,” she says. But the flip- side, she realised, was that a chain could lift the burden of boring business bits so opticians could spend more of their time gazing into eyeballs.

Her vision was a chain of joint partnerships, similar to franchises. Most of her shops are half owned by Specsavers and half by the resident optician. The company looks after such back-office operations as marketing, payroll and the warehousing of frames at the headquarters in Guernsey, where it is the island’s largest private employer.

The result is that some 1,000 opticians have survived instead of being squeezed out by chains of wholly owned shops.

The irony for Dame Mary is that all this means she no longer does eye tests herself. Instead, she contents her self with “secret shopper” expeditions, which she finds far more informative than focus groups. “You wouldn’t believe the things people will tell you if you’re just sitting next to them.”

Entrepreneurial success has come at a price. Her children suffered when she was building her first chain, because the business had priority, she says. “When I give speeches, I always tell people not to do what I did.” Still, her offspring have not disowned her. All three have gone into the family business and her son, John, became joint managing director last year. Though she’s cagey about when, or even whether, she’ll retire, the company clearly has an in-house succession plan. For good or ill, we can all expect to hear her catchphrase for years to come: “Should have gone to Specsavers”.

Nigel Mason is apologetic when he arrives at GE’s British head office in Berkeley Square, central London. This isn’t his building, explains the boss of GE Healthcare UK as we wait for security to sign him in. Once his visitor’s badge has been clipped to his jacket, we’re ushered into G4, an ultra-modern but poky little room. By then, though, he’s done saying sorry. And by the time we get to the subject of the much-criticised NHS computerisation project, he’s bridling a bit at the very suggestion that he should be on the defensive.

“I’m proud of our role,” he insists. “It’s a positive story.”

Mason has been head of GE Healthcare International’s Public-Private Partnership team since 2004, two years before he added the title of country manager to his job description, and he clearly takes the project personally.

His company is responsible for the picture archive and communications system (Pacs) in the southern cluster, one of five broad NHS regions. Every one of the hospitals had their Pacs delivered both on time and on budget, he claims.

“As a result of the successful roll-out, we were asked to take an active part in the North-west and West Midlands, where a previous incumbent had been struggling.”

Pacs has had two technical failures in the past 18 months, he admits, but in both cases the backup kicked in immediately and the medics using the system to look up patients’ X-rays or scans weren’t even aware there was a problem.

GE Healthcare, which has its global HQ in Chalfont St Giles, Buckinghamshire, is one of the biggest players in the medical technology sector, supplying a wide range of equipment including big-ticket items such as magnetic resonance (MR), positron emission tomography (PET) and computed tomography (CT) scanners. Since 2004 when it bought Amersham – the first company privatised by Margaret Thatcher – GE has also had a presence in the pharmaceutical side of medicine. Worldwide, it has earnings of $17bn (around £8.5bn); in the UK, it has 2,800 employees.

And even in with recession starting to bite in the US, the American conglomerate is unlikely to retrench in its core market. “The UK is relatively small in global terms, less than 10 per cent of our business. But what that masks is the importance of the international market relative to the US. We genuinely do see ourselves as a global company, rather than a US company doing business overseas, which is what it might have been five years ago.”

Mason’s job is to figure out which of a dizzying range of technologies is best suited to a particular task, and then persuade NHS trusts to see things his way. “Healthcare cannot go on expanding its budget for ever,” he says. “For example, we produce six diagnostic tools that can be appropriate for coronary artery disease.”

He starts ticking them off on his fingers without pausing to explain what they do, let alone how they work: “echo cardiography, stress ECG, myocardial scintigraphy, multi-slice CT, cath lab and PET”. Each is understood well individually, but until recently there has been no assessment of their relative merits. Mason’s team has now developed a model showing which works best for patients in different risk groups, and will be sending it out to cardiologists for trials within the next few months.

Appropriate technology is also central to GE Healthcare’s response to the Government’s proposals for polyclinics – super surgeries with 20 or 30 doctors. Although critics complain that these would herald the end of personalised GP services, Mason thinks they would have the opposite effect, bringing medicine closer to patients.

“After you see your GP, if you need anything more elaborate than a pill, you have to get an appointment and go to a hospital five or 10 miles away,” he explains. “But patients who don’t need to go into an acute setting should never go there. This will be a lot better for the patient and from a cost point of view.”

The only question is whether a given polyclinic will need its own MR scanner (price tag £700,000) or just a bone densitometer – a low-level X-ray machine that can detect osteoporosis or identify “tofis”, people who are Thin on the Outside and Fat Inside. “Potentially, people like me, who look relatively slim, could be at risk because they have a build-up of fat around key organs,” he says.

In his late forties with a thick head of silver hair, Mason prides himself on being a walking endorsement of “early health”, and still pursues windsurfing – a sport he took up at university. His other great interest is restoring and racing classic cars. In 1998 he co-drove a blue 1959 Jaguar Mark 9 in the classic Monte Carlo Rally, finishing a respectable 36th out of 200.

Such competitive, adrenalin-fuelled sports just add to Mason’s image as a confident, go-ahead corporate executive. But hidden inside is something less common. Unlike most people at his level, his degree was not in business or finance but science, specialising in nuclear medicine. “I studied biophysics [at York] in the second year it was offered, before it was even known as a viable subject,” he says.

His Masters thesis, completed while he was working at Barts hospital in London, was the development of a “tissue equivalent phantom for CT” – in essence a three-dimensional test card for the scanners. Although he demurs when it is suggested that he actually understands all his products, Mason admits to deriving pleasure from being able to keep up with developments in his field.

He is also enthusiastic about ultrasound and uses it to illustrate several of his points, such as the pace of miniaturisation and convergence. “Five years ago, ultrasound was the size of a domestic fridge, wheeled around on a trolley,” he says. “Now it’s not much bigger than my portfolio here and soon it will be the size of my BlackBerry.”

Images of Dr McCoy’s tricorder on Star Trek spring to mind, but Mason immediately brings me back to Earth. “Several ambulance trusts are looking at ultrasound,” he says. “It could be life-saving with appropriate training, but we don’t want to put this diagnostic tool out into the hands of anybody.”

By convergence, he means that separate technologies are being used together to get results that neither could achieve alone. One example is the combination two years ago of PET scans and CT scans. “PET looks at function, down to molecular pathways, but you end up with a bright dot in the middle of blackness. That’s not much use to a surgeon,” Mason explains. “By using a CT scanner, which gives good spatial resolution, he’s able to see that hotspot in full three-dimensional context. Ultrasound could be next, he says, combining with the catheters and X-ray machines used in cath labs to investigate heart function.

Other than that hint, Mason is cagey about what his fellow scientists are working on in their labs. But he’s optimistic that the pipeline of ideas will continue to flow. “We’re moving from a world of ‘I believe our technology can do that’ to ‘I can prove our technology can do that’.”

Once 3D entertainment meant fumbling aroundwith a pair of multi-coloured spectacles that made you dizzy, before settling down in the cinema to watch a plotless film that involved a giant plastic shark coming out of the screen to get you.

But not even desperate 1980s cinematic experiences such as Jaws 3-D were enough to kill off our desire to feel part of the action. Now, after almost two decades on the audio-visual scrapheap, 3D is mounting a comeback… straight into your living room.

This summer, owners of a specific model of plasma TV screen will be able to marry it to a PC for the price of a couple of video games and create an instant 3D multi-media centre capable of showing films, games, TV programmes and eventually web pages. The sense of depth promises to be so realistic that viewers will want to reach out and grab the images, say the firms behind the technology.

A whole range of new films are being made as the new wave of 3D cinema allows such realism to be created on much lower budgets than in the past.

And while viewers will, for the next few years at least, have to wear a pair of glasses, the manufacturers promise that these bear little resemblance to the geeky goggles with red and green plastic lenses that fell between the cinema seats all those years ago. A recent demonstration of the product by Samsung in Seoul, revealed the pictures to be sharp, and the company insists that you can watch for hours without getting a headache.

The system is expected to attract hard-core gamers. New titles such as Medal of Honour are already 3D-enabled. But much broader appeal is predicted. Last week, one of Hollywood’s biggest studios threw its weight behind the 3D revolution. Disney subsidiary Pixar has announced that all its future films will be in 3D, with the first release, Up, set for July 2009. It follows in the footsteps of Shrek creator DreamWorks, which made a similar decision in 2007.

“I have seen the future of movies, and this is it,” Jeffrey Katzenberg, DreamWorks’ CEO, said at an industry event last summer. “I couldn’t be any more confident or certain about it.”

Live-action Hollywood also sees huge commercial potential in 3D. For example, a big-budget family version of Jules Verne’s Journey to the Centre of the Earth is set for release in July.

The BBC is also at the 3D cutting edge. It used pairs of special cameras to film Scotland’s victory over England in the Calcutta Cup rugby international at Murrayfield earlier this year. 3D images were beamed to a cinema at its Riverside studio in London. The audience reported it was much more like being at the game than watching it on ordinary television.