Ozempic and Wegovy have already changed the obesity landscape in the United States, a breakthrough that has been described and debated so much in terms of cosmetic benefits and medical moral hazard that it can be easy to forget that obesity is among the most important risk factors. of preventable death. in the U.S. State-of-the-art alternatives can be even more effectiveand there are signs of huge off-label implications: at least anecdotally, in some patients the drugs appear to curb compulsive behavior in a variety of difficult-to-treat addictions.
And while the first person to receive Crispr gene therapy in the United States received it just four years ago, for sickle cell disease, it has since been implemented for testing for congenital blindness, heart disease, diabetes, cancer and HIV. Only two applications for such treatments have been submitted to the FDA so far, but in all, some 400 million people worldwide suffer from one or more diseases stemming from single-gene mutations that Crispr could theoretically easily fix. And when Doudna allows herself to imagine applications a decade or two from now, the possibilities sound almost heady: offering single-gene protection against high cholesterol and thus coronary artery disease, for example, or, in theory , insert a kind of genetic prophylaxis. against Alzheimer’s or dementia.
‘Can we really do it?’
In January, a much talked about paper in nature suggested that the rate of what the authors called disruptive scientific advances was steadily declining over time: that, partly as a result of dysfunctional academic pressures, researchers are more specialized than in the past and often playing on the margins of science well understood.
But when it comes to the arrival of new vaccines and treatments, the opposite story seems truer: entire branches of research, cultivated for decades, are finally bearing real fruit. Does this mean that we are riding an exponential upward curve toward the radical extension of life and the total elimination of cancer? No. Progress is more piecemeal and scattered than that, and indeed there are those who believe that progress should move even faster.
Amid the pandemic, a number of calls for further acceleration have been issued, some emphasizing the need to reduce drug development costs, which have doubled every decade since the 1970s, perhaps by redesigning clinical trials or employing what is called human-challenge testing, or simplifying the drug approval process. Graham, who is now a senior advisor for global health equity at the Morehouse School of Medicine, emphasizes the questions of global distribution and access: Will new technologies really reach where they are needed most? “The biology and science that we need is already in place,” he says. “The question now for me is: Can we really do it?”
