The provocative title The Debt Crisis and the Human Genome belies Mike Mandels underlying message. I do worry that articles like this and the recent NY Times article A Decade Later, Human Genome Project Yields Few New Cures feed the cynics. Our society is so enamored with immediate gratification. Rome wasn’t built in a day and the Notre Dame Cathedral in Paris took over 400 years to complete! Imagine the patience that took? So why can’t our society be patient as we fix healthcare?
I think the problem is one of expectations. Understanding the genome won’t cure any disease, but it can help determine dosing levels for prescription drugs. Big payer companies like Medco are on record that pharmacogenomics reduces hospitalization rates.
I think people also underestimate the complexity of the genome and the technology needed, on top of the regulations and the need for training more doctors. I love the passage in Thomas Goetz book The Decision Tree on how to apply the genome to enable personalized medicine. There he points out that (I’m paraphrasing ) “only the comparison of variation of 10, 100, 1000 and more genomes holds the promise of personalized medicine—hypothesize the association of a set of variations to a disease, and let the statistics tell the story. The more genomes, the better the statistics.”
Doesn’t it follow that before you can attack this problem, you need many genomes? How could we get where we are without the investments in Genomics? Now the 1000 Genomes data are being published and we are working on it! As the data flows forth, we should be able to deliver personalized medicine research leading to (hopefully) more efficient healthcare delivery.
