technology will change health..?

I just saw a neat talk by Eric Schadt, PhD who is the Chief Scientific Officer of Pacific Biosciences.  First he showed off the new sequencing technology they are developing, which promises to absolutely blow away the current “next-generation” sequencing technologies.  They use a micro (or maybe nano?) fabricated waveguide to isolate a single polymerase molecule, then they use fluorescently labeled nucleotides with a cleavable linker.  When each nucleotide comes into the polymerase for incorporation into the growing DNA string, there is a short pulse of light from the fluorescent marker, before it gets cleaved.  This platform is now coming to maturity for real-world DNA sequencing.  It will probably be the next “next generation” sequencing.  Or should it be called “third generation” sequencing?

So, that’s neat and all, but what I want to discuss is the second part of his talk.  They combined the genome information from this new approach with other types of “systems biology” data to begin finding gene networks that were perturbed in health conditions.  He showed results of one study focused on obesity, where they pinpointed several new genes associated with adipose (fat) storage.  From that, they have developed a drug that may prevent obesity and weight gain.

I saw this talk after just having biked into work, having hundreds of cars zoom past with people in them getting no exercise whatsoever.  So here this company is – like many others – developing a new drug that may prevent weight gain, when the real problem for many people (except the rare few with a genetic condition) is lifestyle.

I’ve just read the book “Vitamin D Cure” that discusses how many “modern diseases” (you know, the ones that didn’t much exist 100 years ago) are associated by lack of sunlight and hence lack of vitamin D.  So it turns out that many diseases – ranging from heart disease to cancer to gallbladder disease – are associated with chronic D deficiency.  That’s a lifestyle issue.  Are we going to “drug” that too?  Artificial sunshine in a drug?  Wait, that’s already been done, and it is called vitamin D.

I get frustrated at the prevalent point of view that we can “drug” every problem known to humankind.   For one, if we do “drug” every problem, then people’s lifespans will get longer.  Now that may be ok if the population didn’t keep growing, but it does.  The world already has 7 billion people, and it is increasingly clear that our ecosystems are being quite strained by that.  If people live longer – and nobody stops having kids – then we’re going to be in ever and ever bigger mess competing over scarcer and scarcer resources (think oil, fisheries, natural gas, water – basically, all the stuff that keeps us alive and healthy).  This will be especially true if people keep driving cars everywhere.

On the one hand, it seems good to help people by making a new drug.  But on the other hand, it may not help in the big picture.  I don’t know how to reconcile these two views.

But there’s also another issue, which is cost.  New drugs are extremely costly to develop.  Once this new drug is developed, who will be able to afford it?  Maybe a few rich people will be able to pay for this, and a few rare cases of medically necessary/genetically obese people.  But will the rest of the population, who are overweight simply because of their lifestyle choices?  Should health insurance pay for a very expensive new drug just because many people choose to drive everywhere and never get exercise?  I don’t think so.  Why not ask for health insurance to just start paying for cosmetic surgery as well?  I think it would be better for folks to just start riding their bikes more.

My research is fun, and will hopefully benefit people – but will it really help in the big picture?

Sometimes I wonder about that.