Take a look back on our world before modern science. It was a world gripped with apocalyptic fears where natural phenomena and unusual circumstances were explained with imaginative tales. A world where witches, goblins, elves, and demons took center stage not just in the private mind but in serious public intercourse. In this backdrop of scant scientific knowledge, terrifying outbreaks decimated entire populations.
In the middle of the 14th century, a horrifying outbreak of an invisible killer, the Black Plague, decimated a third of Europe's population (25 million people). We now know the identity of the killer, i.e., the flea-borne bacterium Yersinia pestis. But the revulsing terror that it visited upon people of that time cannot be fully grasped. Many villages and towns were wiped out--Florence's population was reduced by 75%. Entire economies were completely demolished. Mass graves were common occurences and so overfilled that bodies were thrown instead into rivers, the stunned survivors left to live in penitence, resorting to desperate measures to assuage the angry god that they thought was punishing them.
The trivial diseases of today were real, unforgiving horsemen of the apocalypse to people of the past
In the 16th century, a combination of smallpox and enteric fever (think typhoid) reduced the population of Mexico by more than 90% (over 20 million dead) in just a few decades in the wake of Spanish arrival. More recently, in 1918, the first H1N1 influenza pandemic killed 50 to 100 million people (3 to 5% of the world's population) and dropped life expectancy in the US by 12 years. It was popularly termed the "spanish flu" as Spain was one of the few major countries to not dissimulate details about the outbreak.
Again, it is hard to fathom how traumatic these medical disasters must have been and on which vast scale they filled people with despair for several reasons. One, those times seem far removed to us. Two, we live in an age where smallpox has been fully eradicated, germ theory is well understood, vaccines are on deck for seemingly every pandemics, and a well choreographed international research apparatus is at the ready to produce solutions for any new outbreak. Three, thanks to education, our age is one of increased enlightment where generally less time is wasted on imaginary causes like witches or blaming the neighbor's sins instead of taking real medical precautions.
People of the future will look at cancer with the same triviality we see the flu today
People of the future will look back on our time with the same incredulity we look back on these past times. They will do so because in their time, cancer will be as the common cold is to us today. When a loved one has a cancer diagnosis, it will not shake families to the hilt as if they've been handed a death sentence. Cancer will not rob people like me of two sisters in the span of a year. Alzheimer disease will not rob people of their memories and confuse their cognition. Macular degeneration will not steal poeple's vision. Medicine in this future age will not only truly cure, but it will be specific to the unique genetic make-up of the person taking it.
Accelerating to this exciting health future
So when is this future going to be here? Soon. And that isn't a far flung estimate based on hope. Rather, it is based on a survey of current scientific capabilities and ongoing efforts. Let's look at what is required for the described health future to come to pass. There are three necessary ingredients:
- We need to be able to produce health data at scale (e.g., genome sequencing). We can already do this.
- We need to have the tools to take action on the insights drawn from the data. We can already do this using an arsenal that is as vast as it is varied--from the type of agent (e.g., oligonucleotide, peptide, small molecule) to the type of effect (e.g., temporary effect on proteins or the genome, non-integrative supplementation of the genome, permanent change to the genome though this latter one needs more tuning to prevent issues such as mosaicism).
- We need the capability to correctly analyze and draw actionable insights from the produced health data. This is the key ingredient holding back the exciting health future we spoke of. And there is a lot of noise, not to mention strong skepticism, born from the many failings and false promises of the past. Yet, it remains that biological and computational knowledge must be expertly integrated to actionably pinpoint causal genes, their attendant regulatory factors, and the molecular networks upon which they act to achieve higher order phenotypes. This is the hill we are climbing at Genetic Intelligence to make the health future described above a reality, no matter what obstacle stands in our way, technical or political. The present health reality is simply unacceptable to us, just as succumbing to smallpox en masse was unacceptable to people of the past.