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Genetic drugs

Traditionally, doctors have treated illness by responding to its outward signs and prescribing quantities of a particular drug according to such things as a patient’s age and weight. Adverse reaction to one drug tells the doctor to try another. This somewhat hit-and-miss approach leads to a high number of deaths, and many more hospitalisations, due to the unforeseen side-effects of medication.

But what if doctors could predict, even before it is born, a baby’s chances of contracting a particular disease or an individual’s response to medication? With the recent completion of the Human Genome Project and the mapping of the combinations of human DNA such a possibility is now within reach. It will soon be possible to tailor drugs to an individual’s genetic profile.

The new science of pharmacogenomics promises several benefits:

			More accurate targeting of drug therapies for such conditions as cardiovascular disease and breast cancer
			Safer prescription of drugs because it is easier to determine the correct dosage
			The development of better vaccines
			The ability to advise a patient to alter their lifestyle years in advance, to lessen the chances of certain behaviours exacerbating their susceptibility to a particular disease
			The targeting of specific population groups for treatment based on their shared biological characteristics

All these should lead to a decrease in the costs of health care amongst the population. But how near is all this to becoming reality? Unsurprisingly, there are several practical implications to consider:

			We may have the complete code for a human being but we’ve only just started isolating the individual genes which affect a patient’s response to a drug. This will still take many years.
			If a drug affects a small section of the population, rather than people in general, will it be financially worthwhile for drug companies to invest in such products?
			Much more research is required, both through epidemiological studies and clinical trials, to determine how drug response varies between individuals and within groups, and how genetic factors work in combination with the environment, diet and with other drugs.

And then there are various moral implications that follow from exposing the secrets of our DNA:

			Will advance knowledge of an individual’s genetic defects or propensity to disease exclude them from getting life insurance or long-term credit? And who can demand access to this information?
			When does a disorder become a disability and therefore not worthy of treatment? Or will all disabilities now become potential cases for treatment? Who ultimately decides - the doctor, the patient, the general public, the government?
			If we can predict much more accurately who will fall ill and when, at what stage are we willing to ‘fix’ the defective gene - in an adult patient, or in the parents of a future child to prevent the need for pharmaceutical intervention later on?

Comprehension: Click here to check how well you have understood this text by completing this letter to a newspaper on the subject of genetic drugs.