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Health Promotion on the Internet <[log in to unmask]>
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Joseph Levy <[log in to unmask]>
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Fri, 4 Jan 2002 15:39:24 -0500
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Yes, she's really a very caring journalist.
Joe

Dennis Raphael wrote:
>
> Toronto Star -- Judy Gerstal  Jan. 4, 01:19 EDT
>   Mapping human genes has few human benefits
>
> http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_PrintFriendly&c=Article&cid=1010056689709
>
> [consider sending her an email thanking her for covering these issues -- her
> address is below]
>
>   There's no doubt that we'll hear more about the human genome project in 2002,
> a process that one scientist compared to "reassembling the complete text of the
> Bible from 10 copies that have been torn to shreds."
>   It is, we've been told, a breakthrough of incomparable significance. It's been
> reported as the medical story of our time.  Unquestionably, the genome project,
> described as the code of life or the hand of God, is valuable and meaningful.
>   Decoding the universe, whether by delving into DNA or scoping distant galaxies
> or soaring to sister planets, defines not   only our intellectual curiosity and
> therefore our very humanness but also our future. However, mapping the human
> genome  is no more of a solution to many of the medical and health problems that
> now plague us than is a trip to Mars.
>   Knowing the map of the gene simply doesn't seem to make much difference. It
> has not translated into great therapeutic advances. The first mapping of a
> single gene disease
>
>   ------------------------------------------------------------------------
>
> Ñ cystic fibrosis Ñ was identified 10 years ago by Lap-Chee
> Tsui  and John Riordan at the Hospital for Sick Children. Despite the promise
> that this would lead to a cure and the disappearance of the disease, and despite
> millions of dollars in research spent since then, no effective treatment has
> been developed, gene modification has not been successful, and cystic fibrosis
> still occurs about as often as before the discovery.
>   The same is true of the identification of a gene associated with the tendency
> to have rheumatoid arthritis and with a gene   characterized as an
> anti-arthritis gene. The most effective forms of treatment for the disease are
> still anti-inflammatories, methotrexate and steroids, medications that pre-date
> the identification of these genes.
>   In fact, the new genomic information doesn't even tell us much about
> ourselves.
>   "The reaction to the discovery that human beings do not have much more genomic
> information than plants and worms has  been to call for a new and even more
> grandiose project," evolutionary biologist Richard Lewontin wrote in The New
> York  Review Of Books in July. "It is now agreed among molecular biologists that
> the genome was not really the right target and that we now need to study the
> `proteome,' the complete set of all proteins manufactured by an organism."
>   And journalist Jerome Burn, writing recently in the Financial Times, questions
> the hype surrounding the human genome  sequencing and the way it is being used.
> "The new genetics is a billion-dollar project driven largely by drug companies,"
> he writes.
>   Burn suggests that it might be relevant to ask whether the most cost-effective
> way of using genetic information is simply to develop new drugs. "Could some of
> the money be better spent looking at the way nutrition and vitamins can target
> the same pathways that drugs are aimed at?" he asks. "Should more research be
> devoted to the environmental factors that change the way various genes behave?"
>  He gives the example of the genetic predisposition to high cholesterol. It was
> not a risk factor in the 19th century but
>   became one in the first half of the 20th century. "Knowing what made the
> difference Ñ diet? a chemical? Ñ could help save lives, but genetic research of
> that sort is of little interest to pharmaceutical companies."
>   Of even less interest to pharmaceutical companies that support most medical
> research are the psychosocial factors that  profoundly affect health, disease
> and mortality. Yet researchers reaching across interdisciplinary lines and
> stretching past the biomedical model are piling up evidence proving that health
> status is directly linked to income, education and social status.
>  A U.S. study 15 years ago in the Journal Of Chronic Diseases revealed that most
> chronic diseases are reported more frequently by people with less than 12 years
> of formal education in the 18- to 64-year-old American population.
>  Isn't it ironic that we've known for 15 years that more years of formal
> education will help to prevent chronic disease and  yet it's desperately hoped
> that an important result of the billion-dollar genome project in some distant
> future will be to  prevent chronic disease?
>   Throughout the '90s, socio-economic and psychosocial factors began to be
> recognized, not just by social scientists and epidemiologists but also by
> enlightened physicians, as crucially influencing the onset, course and outcome
> of disease.
>  Some of these factors: poverty, literacy, nutrition, access to medical care,
> learned helplessness, social barriers.
>  Studies in this week's editions of medical journals corroborate the evidence.
> Middle-aged men who have symptoms of psychological distress, such as depression
> and anxiety, are more than three times likely to have a fatal stroke than
> middle-aged men who are not depressed, according to research reported in Stroke:
> Journal Of The American Heart Association. And the British Medical Journal
> reports a study showing that lack of high school education resulting in income
> inequality is a powerful predictor of mortality in U.S. states.
>  While we wait for the completion of the genome project and then perhaps the
> proteomic project, while we wait for the
> research to be translated, perhaps, into treatment and maybe, eventually,
> prevention, wouldn't it be wonderful if the
> medical/political establishment began to act on the knowledge we already have?
>  Instead, we are subject to what Lewontin calls "a pervasive error." In his
> just-published collection of essays, "It Ain't
> Necessarily So: The Dream of the Human Genome and Other Illusions," he refers to
> "the pervasive error that confuses the genetic state of an organism with its
> total physical and psychic nature as a human being."
>
>   [log in to unmask]

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