Look at the Human Genome Project. We now have a list of our genes; we have libraries of their common variants; we have micro-array technology to screen for these variants at ever lower prices. And we are developing the bioinformatics capabilities to make sense of the tsunami of information that is about to sweep over us.

The greatest immediate consequences of genomics, then, will flow from widespread and inexpensive personal genetic testing that will arrive over the next five to 15 years. One near-term result of such testing will be a dramatic shift toward preventive medicine. This will not only mean nutritional and lifestyle interventions, which are notoriously hard to adhere to, but long-term pharmaceutical interventions. This shift will be a huge scientific, clinical and political challenge. Who will pay for such measures? How will people make informed decisions about what to do?

Pharmacogenetics, the tailoring of drugs to our individual genetic constitutions and biochemistries, is another likely development. It will no doubt bring more and better drugs, but they won’t be cheaper, and it is not clear how we will test them. The current regulatory environment simply is not equipped to test personalized preventive interventions. One thing we can count on, though, is that in the decades ahead we will spend more of our Gross Domestic Product on health care and more of our health-care dollars on drugs.

Our ideas of political correctness also will be challenged. As we uncover the constellations of genes that help to shape us, we will find many differences among individuals and among populations. We’ll have to come to grips with the fact that these differences often have biological underpinnings. Some worry that we are not up to this task and fear that the coming storm of knowledge will tear apart the human family. But why should it? Many societies already deal with such differences quite well within the egalitarian framework we so value.

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