the chronicle
THURSDAY, OCTOBER 25,2007 | 15
commentaries
Genomics: making a world of difference
Less
than a decade ago, the completion of the Human Genome Project signaled that the genome revolution was here to stay and symbolized its promise—that knowing the DNA sequenceof our genomeand thoseof hundreds of other organisms would allow us to take on the greatest challenges of human health and alleviate human suffering, both Wat home and around the
Chronic diseases also present a significant global health problem. Developing countries suffer a “double hit”—countries with emerging economies like China, India and Brazil not only have a high incidence of infectious diseases but also sufferfrom a rising tide ofcardiovascular disease, cancer and diabetes. Studying genetic variation associated with these common diseases in different populations, and how people differ in theirresponses and reactions to drugs, is an area of active research at Duke. In addition, using genomic approaches, IGSP researchers have identified molecular “signatures” for several common cancers. These significant breakthroughs will help physicians predict the In Durham and across this country, there is grow- CjIODSI nGditn clt QUK6 chance of recurrence for a tumor and how well the patient will respond to certain treatments, allowing the deing momentum toward part VI 111 3 Series using the fruits of the gesign of more effective and individualized therapies. nome sequence to guide The influence of genomics on global health certainly health care, ushering in the early stages of a new form ofperextends well beyond our ability to better diagnose, presonalizedand prospective health care. At Duke, championed vent and treat human disease. Genomic research on agricultural crops and livestock by the Institute for Genome Sciences and Policy, the genome revolution is evident across campus, from bold plans for transcould help provide solutions to nutritional deficiencies wideforming medicine at the Duke University Health System to spread in severallow- and middle-income countries. Genomic the student-run Prospective Health Care Club. analysis of plant, animal and microbial species may also offer Yet, millions around the world remain afflicted today insights into how we might betterutilize our naturalresources by HIV/AIDS, malaria and a host ofother infectious disto prevent, limit and even reverse environmental damage. eases. So what does the genome revolution offer them? Science alone will have little impact on global health Genomics plays a significant role in the search for vacwithout policies to foster its use. The 2002 World Health cines and cures to control HIV/AIDS. Recently, Duke reOrganization report on Genomics and Global Health, searchers reported significant discoveriesabout how human while affirming the importance of genomics, also warned genetic variation plays a role in determining the viral load of a “genomic divide”—poor countries may be unable of HIV patients during infection. The study identified genes to share the benefits of genomic research, thus further that are likely to be involved in HIV control and that maybe exacerbating the inequities in global health. Researchers targets for future vaccine and drug development, research at the IGSP’s Center for Genome Ethics, Law and Policy that is possible because Duke has one of the largest facilities have come together with colleagues across the Duke camof its Idnd for measuring DNA variation at millions of sites pus to investigate how policies effect the dissemination around the genome simultaneously. of and access to genomic technologies and information. In the last decade, genomic research on microbes that They hope to inform institutions about practices and polcause diseases endemic to low- and middle-income counicies that will help new diagnostics, therapies and vaccines tries has grown at a steady pace. The example of malaria reach people who need them the most, faster. perhaps best illustrates the immense potential of genomBig challenges, to be sure. At the IGSP we strive to ics. In 2002, the genome sequences of the malarial para“Ask Big” as we harness powerful genomic tools to drive site and the mosquito vector were published. Combined the engine of discovery and, with our partners across the with our own genome sequence, this trio of genomes has Duke campus, seek out interdisciplinary and innovative solutions to, yes, the “big” problems of global health. provided a wealth of valuable information that researchers worldwide are using in their search for novel strategies for disease treatment and prevention. For example, ongoShubha Chandrasekharan is a fellow in the IGSP Centerfor ing research at Duke uses genomic approaches to study Genome Ethics, Law and Policy. Hunt Willard is the director of malarial resistance in sickle cell disease. These studies the IGSP. Information on all theIGSP’s programs can be accessed at www.genome.duke.edu. hope to uncover new pathways to malaria treatment. .
Apocalypse now? Monday:
I really wanted to write a column that actually pertained to Duke. Unfortunately, my family just got the “reverse 911” call to evacuate northern San Diego because the witch fire was spreading west. Needless to say, that’s the only thing that’s on my mind right now. It’s currently 9 p.m. San Diego time, and as of now every single person I went to high school with—my family and theirs—has been forced to evacuate. My ex-girlfriend’s house is yards from the frontline. The fire is zero-percent contained, and I’m sitting here in Durham, 3,000 miles away, biting my nails and
chain-smoking cigarettes. Justifiably, I’m having a
dan belzer w.w.j.dL
little trouble concentrating. Granted, this isn’t the first time we’ve dealt with fire. My senior year of high school, the entire county had school cancelled for a week because of a massive collection offires fueled by the Santa Ana winds. But then it was different. We lived too far west, it was impossible for the flames to threaten our houses. It was THEIR problem, East County. They shouldknow better to live so close to the desert. Fire is always a threat. Sure, we felt the ashes and had to stay indoors that week for safety. However, my friends and I have always remembered that week—not as a time of tragic loss as it rightfully should be considered—but as an unexpected weeklong, party-filled vacation from senior year. This past Sunday, before the fires truly flared beyond containment, I spoke to a friend from home briefly, joking about the last time we had huge fires and how much fun it was. He laughed cautiously, although he clearly did not seem at ease. Another friend sent me a message saying she was scared of the fires, and my response was to tease her worries as nonsense. Boy, did I feel like an asshole this morning. Now the freeways are jammed. There are two inches of ash covering the city. You can’t see the sun, or the moon, or anything except a disgusting cloud of brown/gray enveloping the sky. You have snow days, we’ve got inferno. My dad’s watered the yard, house and roof three times the last 24 hours. I thought about telling him to save water, or maybe mentioning the futility in his actions. But, why bother? He thinks it helps. Should I really take that satisfaction away from him as he sits at home with the city paralyzed—completely shut down by the 13 fires raging around the county? Tuesday; At 2 a.m. this morning the fires were zero-percent contained. By the afternoon, they upgraded it a whole five percent. This morning, President Bush declared the situation a national state of emergency. The winds are not supposed to change direction (back to the normal west-to-east pattern) until Thursday, and firefighters are predicting “full containment” by November. That’s over a week away. Meanwhile, the house toll is rising rapidly and a metro area of nearly 3 million is at a complete standstill.What can we do? Really, not a lot. This isn’t Katrina, it’s not the poor, disenfranchised minorities who are being terrorized. The areas most affected epitomize whiteness, wealth and privilege in Southern California. But guess what? It’s my friends, and family, and high school classmates who are losing their houses. And it hits home. A part of me still wonders if this is even a big deal. I know Larry Moneta, vice president for student affairs, sent an e-mail, but Christ, the death toll is what? One. Six, if you count the 90-somethings who died while being evacuated from their hospital beds. Although this is a horrible natural disaster, and the loss of beautiful property is certainly a tragedy, I am trying to maintain a bit of perspective. Unlike with previous natural disasters, the San Diego response has been swift and proactive. With limited resources available to physically stop the fire amid the roaring desert winds, the focus has been on precautionary evacuation. The result is a minimal loss of life in the wake of such a massive catastrophe. Regardless, my beautiful city is now torched, and 500,000 homes have been evacuated. I hear Durham’s got a little water shortage, but tonight I will be praying for rain in San Diego. Dan Belzer is a Trinity senior. His column runs every other Thursday.