How it began
Ivars Kalvins graduated from the chemistry faculty of the University of Latvia in Riga in 1969 and joined the Institute of Organic Synthesis, where its founder became his mentor. He invented meldonium there in the early 1970s. It was first intended for use on livestock, and its use in humans followed about a decade later. Kalvins went on to head the institute's Department of Medicinal Chemistry and, from 2004, the institute itself.
How it works
Meldonium suppresses the oxidation of fatty acids in the body's energy metabolism. According to the European Patent Office's account of Kalvins's work, that oxidation is a major source of toxic by-products that collect in heart tissue and can lead to heart attacks. By reducing those by-products and increasing the oxygen supply to cells, the drug is meant to restore balance to the energy metabolism. It is sold under the medicinal name Mildronate as a cardioprotector.
How it spread
The drug is manufactured and marketed by the Latvian company Grindeks, founded in 1991 on the basis of the institute's former experimental plant. Mildronate became one of Latvia's most successful medical exports, with export turnover of around 60 to 70 million euros in 2013, or 0.6 to 0.7 percent of all Latvian exports. It has not been approved by the Food and Drug Administration for sale in the United States.
Who pushed back
The World Anti-Doping Agency moved meldonium from its watch list to its banned list in January 2016. Soon afterward the tennis player Maria Sharapova said that she had taken the drug since 2006 for a heart condition. Kalvins has argued that meldonium does not enhance athletic performance and that athletes used it to prevent damage to the heart and muscles from lack of oxygen during intense exercise.
Where it stands today
Kalvins was a finalist for the European Inventor Award 2015 in the lifetime achievement category, with Mildronate named as his biggest success. Grindeks reported revenues of 118.5 million euros in 2013, the largest share from Mildronate, and employed around 1,000 people.
