Contradictions and extremes
Authors: Inder M. Verma
Journal: Molecular Therapy (2003)

As the curtain falls on 2003, it is time to pause and reflect on a year that was ushered in under the gathering clouds of war, pessimism over the state of the economy and job loss, fear of bioterrorism, and increasing desperation over our inability to control the continuing AIDS epidemic. In retrospect, I am struck by the contradictions we live with. War did come in Iraq, but continues with no end in sight. In fact, since President Bush's dramatic announcement of the end of major conflict in Iraq on an aircraft carrier on 1 May 2003, more American soldiers have died than prior to the supposed “end” of the war. Science gives us the hope to feed the hungry, cure the sick, and relieve the suffering–or, in the words of the 16th century philosopher Sir Francis Bacon, “to relieve man's estate.” Jonas Salk once told me that his proudest moment was when he was introduced to a teenager as the discoverer of the polio vaccine. The teenager stared blankly at him and asked what polio was. However, that dreaded disease–once nearly wiped out–has recently struck over 15,000 people in Niger, raising the specter of another public health nightmare in central Africa, where AIDS remains rampant. While President Bush and Congress have allocated large sums to provide life-saving drugs to the world's poor, a third of the money must go to promote abstinence until marriage, a requirement that has little meaning to gay men or to women who are forced into prostitution due to poverty. U.S. funds have been withdrawn from those family planning groups overseas that advocate abortion or condoms, affecting countries with the highest rates of AIDS infection. Meanwhile, American consumers and health providers have found that drugs can be bought in Canada for a fraction of the U.S. cost. Sadly, the response of “big pharma” has been to threaten to reduce sales of drugs to Canada. We witnessed a medical miracle with the separation of Egyptian twins conjoined head to head–an operation that has a success rate of only 2%. At the same time, the Pope beatified Mother Teresa for such supposed miracles as having “shrunk overnight a football-sized tumor in a woman's stomach by merely touching it with her hands.” Most of us thought that Mother Teresa's miracle was providing care for the destitute in the streets of Calcutta. There has even been controversy following this year's awarding of the Nobel prizes in science. The prize in physiology or medicine was awarded to Paul Lauterbur of the University of Illinois and Sir Peter Mansfield of the University of Nottingham, for the invention of magnetic resonance imaging (MRI). Normally, the news is greeted with joy–but not this year. Full-page advertisements appeared in the New York Times and the Washington Post, proclaiming “The shameful wrong that must be corrected.” The aggrieved party is Raymond V. Damadian, who claims to be the real inventor of MRI because he holds the basic patent. It is neither the first nor the last protestation over an award, but such a noisy public display is neither elegant nor graceful. A report of the President's Council on Bioethics, under the leadership of Leon R. Kass, has just been released. Entitled Beyond Therapy: Biotechnology and the Pursuit of Happiness, it is a profound and scholarly document that I urge the readers of Molecular Therapy to review (www.bioethics.com). Dr. Kass states, “Like Achilles, many of the major beneficiaries of modern medicine seem, by and large, neither grateful nor satisfied with the bounties we have received from existing biomedical technologies. We seem in fact, less content than we are 'worried well.' Perhaps more aware of the hidden ills we might be heir to, or more worried about losing the health we have than we are pleased to have it.” Science alone can not “relieve man's estate.” We will also need man's goodwill, his willingness to share and his tolerance of race, color, caste and creed. Let us hope that 2004 will bring us closer to stability in the world and to greater peace and happiness for all its inhabitants. Happy 2004!