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[Please feel free to comment, criticize, edit, etc. Thanks!] | | | Second, the broader information and communications revolution is fundamentally reshaping medicine. Twenty years ago, the molecular understanding of human health was limited to a few metabolites and protein levels, like glucose concentration and insulin levels. Now we are aware of the billions of bases in the human DNA sequence, and of the importance of the dynamic expression levels of 30,000 genes, hundreds of thousands of proteins, thousands of small molecule -- and even beyond that, the identities and dynamic function of the bacteria that live within us. And, the technologies to actually measure all of this information are becoming better and cheaper at an exponential rate. In addition to providing the means for storing and analyzing massive data sets for individuals, the global information revolution means that all of these data can be recorded and compared with data from other people in other conditions. | |
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< | Third, the basic nature of the diseases that are important in medicine is changing. Medicine's future is dealing with chronic diseases that are a function of heredity, lifestyle, and environment: diabetes, asthma, cardiovascular disease, COPD, long-term infections like HIV/AIDS and hepatitis, and cancer. These are not really "diseases"; in the way we understand an infectious disease like flu. Chronic diseases have no discrete causative moment, particular group of symptoms, specific range of outcomes, and most importantly of all, a definable "cure." Chronic diseases involve a complex of molecular pathways, and disease etiology and progression vary highly between individuals. So, all that information about genetics and complex molecular dynamics of cells matters for prognostication, prevention, and treatment. | >
> | Third, the basic nature of the diseases that are important in medicine is changing. Medicine's future is dealing with chronic diseases that are a function of heredity, lifestyle, and environment: diabetes, asthma, cardiovascular disease, COPD, long-term infections like HIV/AIDS and hepatitis, and cancer. These are not really "diseases" in the way we understand an infectious disease like flu. Chronic diseases have no discrete causative moment, particular group of symptoms, specific range of outcomes, and most importantly of all, definable "cure." Chronic diseases involve a complex of molecular pathways, and disease etiology and progression vary highly between individuals. So, all that information about genetics and complex molecular dynamics of cells matters for prognostication, prevention, and treatment. | | |
Big Pharma has responded by considering and applying these transformations separately in the context of conventional drug development. This approach has failed, because there is so much information for a drug to interface with, and the information varies between individuals. So, they made statins, like Lipitor, that have at best an uncertain impact, despite their ubiquity and cost. They made drugs like Vioxx, designed to be more specific than its predecessor, but which through that specificity somehow causes more serious side effects. Moreover, drug pipelines are running dry, as most projects fail despite the use of expensive new technologies in the development process. | | | Since the necessary technologies are constantly getting better and cheaper, the hardest work will be educational, cultural, and political. The alternative is a less effective and more expensive -- ultimately crueler -- system relying on monopolizing DNA sequences, tissue from patients, naturally occurring molecules, and treatment algorithms. Instead, Free Medicine takes advantage of sharing and distributed invention. And, it works on health as a process, rather than just making drugs as products. Free Medicine will lead not to just better health care, but to better health. | |
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Comments
I do have more to say about vaccines than I have discussed here.
http://www.forbes.com/sites/matthewherper/2011/11/10/what-bill-gates-says-about-drug-companies-2/
Left unsaid in this article is that vaccines often have production issues that are different from that of most drugs. So,some of the most valuable information is in how you make the vaccine as opposed to what is in it. This can also be the case for biologics as well.
-- BahradSokhansanj - 15 Nov 2011
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