A while back, I commented on the development of BiDil, a heart drug developed specifically for African-Americans. Last week, the FDA approved BiDil for use. No big news there. What was news was that the FDA heralded the approval as the beginning of a new era of “personalized medicine.”
Medical practice that works with your unique biology and your unique circumstances is a good idea. But what’s coming at us is not likely to fulfill that promise. What the FDA is talking about is more accurately described as an era of “personalized drugs.”
I’m not reassured by the prospect of drugs with my name on them.
In a review of the FDA approval process, the editors of the NewScientist magazine note some problems with BiDil and what is sure to be other drugs targeted for use by specific races. The biggest problem, as I noted when I first commented on BiDil, is that race is not a biological fact, but a social construct. The NewScientist editors agree and speculate that this race-based drug for heart failure works not because of biology, but because of discrimination.
An active ingredient in BiDil is an antioxidant. Stress, including psychosocial stress from discrimination, causes oxidative damage. So BiDil might work, not by countering biology but by countering the effects of society. Disturbing visions of drugs for inequity dance before me.
What’s most frightening about this emerging era of “personalized drugs” is a field of study called pharmacogenomics: the study of the human genome in order to tailor drugs to individual genetic variations. I wasn’t’ kidding. Soon, there really will be a bunch of drugs with your name on them. Brought to you by, guess who, the great white hunter of health care, the pharmaceutical industry.
If “personalized medicine” is such a good idea, what’s the alternative of pharmacogenomics?
From the work of Dr. Richard Kunin, let me suggest five factors that affect health: unique biology, nutrients, pollutants, stress, physical fitness. All of which have to do with your biological, social, and environmental history. Including the history you’re making now.
Brilliant people are working within this paradigm of “personalized medicine,” mostly on a shoestring. It’s difficult, and even dangerous, for them to get attention what with the pharmaceutical great white hunter on the prowl.
If you want to dodge the drugs with your name on them that will be coming at you from the pharmaceutical great white hunter, you’ll have to pay attention to your unique biology, nutrient needs, pollutant exposures, psychosocial stress, physical fitness. None of these need to have anything to do with “personalized drugs.”