Future of Genomics Vigorously Discussed at Symposium
One month after the most complete publication of the human genome to date, experts discussed the future of genomics and its impact on the developed and developing world to an HSPH audience so large that a second room was used to broadcast the lectures on March 15.
Nearly 300 people attended "Genomics: A Population Perspective," the latest installment in the Future of Public Health Symposium series hosted by Dean Barry Bloom in Snyder Auditorium. The Robert Wood Johnson Foundation provided funding for the event.
Elucidating the genomes of humans and pathogens will shed light on the workings of the immune system and may help vaccine development, said J. Craig Venter, president and chief scientific officer of Celera Genomics, one of the groups that published a draft of the human genome last month. Their paper is in the February 16 issue of Science.
"The challenge of the future will be to understand how pathogens interact with the human genome," he said.
He offered the example of HIV, where a variation of a gene is known to provide significant resistance to HIV infection. Understanding how the variation stymies infection may help lead to an AIDS vaccine. From that standpoint, genomics could have "a tremendous impact on disease in the third world," he said.
Richard Lewontin, Alexander Agassiz Professor of Zoology at Harvard University and evolutionary biologist, said that mapping the human genome will make a lot of difference to understanding evolutionary biology, but added that there has yet to be a successful disease treatment or cure based on knowing the genes involved in the illness.
Lewontin focused his comments on the impact of genomics on the developed world. He said there is strong evidence that high-tech science has done nothing for the health of Americans.
"That's not where it's at, and it never has been," he said.
He showed a series of graphs, each depicting the rise and fall in death rates from the turn of the 20th century to the 1970s for diseases such as tuberculosis and measles. For each disease, death rates started to decline before the identification of the cause of the disease or the implementation of public health measures such as vaccinations. Scientific medicine does not explain the changes, he said.
He urged scientists and the media not to promise great scientific advances until they are sure they can be fulfilled, saying that unfulfilled scientific pledges make the public skeptical and then cynical. Cynicism, he said, is the enemy of science.
Lewontin added that the human genome should not be touted as the answer to human disease until some segment of the population has been saved by medicine's knowledge of it.
Gerald Keusch, director of the Fogarty International Center at the National Institutes of Health, addressed how genomics may influence the health of people living in developing countries. Like Venter, Keusch described how understanding genomics may lead to vaccine development, which can then be used in poor and wealthy countries alike.
For example, he said, the genome of Anopheles gambiae, the mosquito that transmits malaria most effectively, will be sequenced soon. (Malaria kills nearly three million people every year and many of the victims are in Africa, according to the Malaria Foundation International). Elucidating the insects' genetics may help scientists block its ability to infect humans with the malaria parasite.
Keusch emphasized that having a vaccine is not enough to stop disease in developing countries and said that infrastructures should be built to sustain public health measures. Local scientists who can identify and conduct research that will benefit their own countries also need to be trained, he said.
Keusch added that having a gene for a disease is not enough to cause the disease. The gene must be expressed, or turned on, which usually results from a cascade of chemical reactions within cells. Finding out what factors turn specific genes on and off may help treat diseases, he said.
The next installment of the Future of Public Health will be organized
by the Department of Nutrition on Thursday, May 3.
