Oh, the Possibilities
Pamela B. Davis, MD, PhD
Before you begin reading this letter, do me a favor: Go back and look at the picture of the baby on the homepage for the feature "The Future Face of Medicine." Go on ... I'll wait.
Now, come on, admit it: You find it's almost impossible to gaze at that baby without feeling a small burst of hope. The slight dusting of hair on his head … the intense focus in his eyes… the pudgy legs and tiny foot resting casually on the ground. Even without the accompanying text, the image evokes a palpable sense of possibility. A young life, just begun, an entire world awaiting his accomplishments.
As Tamar Nordenberg makes clear in her cover story, medical research today is much like that child. Breakthroughs such as the completion of the Human Genome Project have opened new vistas of promise. Today's pharmaceuticals stand, on average, a 50 percent chance of working on a person because of individual biological differences. At the same time, we now have more than 1,300 genetic tests that provide insight regarding personal tendency to develop a particular disease or problem. Our primary challenge now is to develop approaches that allow physicians to provide responses that are customized to the unique needs of each patient.
Such solutions are not the stuff of science fiction, or even decades away. Our own faculty have begun to identify select proteins and other markers that foretell not only specific looming diseases, but the degree of aggressiveness of that person's illness. This knowledge can inform decisions regarding which therapies to pursue when—and, in the best of circumstances, how to stop diseases before they even emerge. We are hardly alone. As I write this in late December, scientists from the National Cancer Institute have just announced the discovery of a gene mutation evident in a certain form of hard-to-cure cancer (diffuse large B-cell lymphoma). The finding means that doctors someday will be able to target proven therapies to patients whose tests reveal this indicator. This is only the latest extraordinary achievement in our understanding of the nature of specific markers; from 2000 to 2005, U.S. researchers described more than 1,300 protein structures—10 times the number of the previous five years.
As many of you recall, funding for the National Institutes of Health doubled between 1998 and 2003. The agency specifically credits those budget increases for the protein structure results, among many other advances in the treatment of cancer, diabetes and stroke. At the same time, every dollar invested in medical research stirs more than twice that amount in economic output. Not even Google or Apple can claim that kind of return on investment. Longer term, imagine the savings from avoiding lengthy hospital stays, lost work time and the like.
Financial arguments matter. Taxpayers should know what their money buys. But in the end, the most important reason to support strong federal funding for medical research can be found right back on the cover of this magazine. We can give him and his peers a better chance at a healthy life than ever before in our history. If that's not a worthy cause, what is?