In
the recent debates about the quality of health care, its availability, and its
cost, it is striking that the major focus was on the mechanisms of payment
rather than on actually trying to achieve improved outcomes at lower costs.
Unless
inhibited by regulatory and litigation barriers, stem cell technology, personal
genomics, and nanotech-based therapeutic and diagnostic systems — combined with
disruptive business models — will dramatically lower the cost of healthcare
beginning in the coming decade. Medicine, in other words, is fast being
transformed from an art or a craft into a standardized technology, and
standardized technologies inevitably experience dramatic declines in price as
they improve in quality and availability.
A
driving force behind this trend will be the ability not just to cure, but to
prevent, disease. This will not only dramatically reduce the direct costs, but
by avoiding side effects, it will eliminate indirect suffering and the related
costs.
Over
the past century, nothing has done more to prevent disease and promote good
health than vaccines. Today, it’s hard to imagine that Native American
civilization was decimated by smallpox, that bubonic plague killed nearly
one-third of the European population, or that as recently as 50 years ago,
Americans were left paralyzed by the effects of polio.
The
recent H1N1 flu scare brought back memories of the great 1919 pandemic that
killed tens of millions, including the two founders of the Dodge automobile
company in the same week. Mumps, measles and whooping cough were all major
threats.
Despite
the enormous progress of the past century, the HIV AIDS pandemic now threatens
to kill off a whole generation in Africa. But there is now hope for a vaccine
even against that deadly disease.
Researchers
at the National Institutes of Health recently announced in the journal Nature
Medicine1 that they have found a new way to fight
the HIV virus. Most vaccines against viruses depend on developing proteins called
antibodies, which kill off viruses. But attempts to do this for HIV have not
worked.
In
fact, the researchers found that some people naturally make antibodies against
HIV. The trouble is that the human immune system makes antibodies only when...
