Promises, promises, and precision medicine
A very interesting commentary on the impact (or lack of) genomics has had on human healthcare. J Clin Invest. 2019
The promises of precision medicine are to dramatically change patient care via individually tailored therapies and, as a result, to prevent disease, improve survival, and extend healthspan.
However, nearly two decades after the first predictions of dramatic success, we find no impact of the human genome project on the population’s life expectancy or any other public health measure, notwithstanding the vast resources that have been directed at genomics. Exaggerated expectations of how large an impact on disease would be found for genes have been paralleled by unrealistic timelines for success, yet the promotion of precision medicine continues unabated.
In light of the limitations of the precision medicine narrative, it is urgent that the biomedical research community reconsider its ongoing obsession with the human genome and reassess its research priorities including funding to more closely align with the health needs of our nation. We do not lack for pressing public health problems. We must counter the toll of obesity, inactivity, and diabetes; we need to address the mental health problems that lead to distress and violence; we cannot stand by while a terrible opiate epidemic ravages our country; we have to prepare conscientiously for the next influenza pandemic; we have a responsibility to prevent the ongoing contamination of our air, food, and water. Topics such as these have taken a back seat to the investment of the NIH and of many research universities in a human genome–driven research agenda that has done little to solve these problems, but has offered us promises and more promises.
The human genome project was undoubtedly a magnificent achievement, but has the investment in genomics delivered?
There is an extended discussion on In the Pipeline https://blogs.sciencemag.org/pipeline/archives/2019/01/31/precision-medicine-real-soon-now.