The times they are a-changing
As not only another year but another decade slips into history, it is all too easy to focus on the future and fail to recognise the enormous changes that have altered the face of modern medicine for ever.
As not only another year but another decade slips into history, it is all too easy to focus on the future and fail to recognise the enormous changes that have altered the face of modern medicine for ever.
Ten years ago the human genome project had just been completed in draft form, and this has led to increased understanding of many common diseases with a strong genetic element and a number of new treatments for a range of conditions from cancers and heart disease to diabetes and obesity.
If genomics was the groundbreaking development of the past decade, then it seems likely that regenerative medicine will be among the major breakthroughs of the next 10 years. And when you combine stem cell technology and genomics with rapid advances in diagnostic techniques, the prospect of genuinely personalised medicine is now much more than a distant vision.
Not all the advances have been in the area of drug discovery. The decoding of the human genome has brought with it the development of powerful DNA sequencing technology, allowing faster identification of viruses and more rapid development of the means of both treating and preventing them. Faster and more efficient data handling has made it easier to identify which leads are most likely to succeed in the clinic, and may in time contribute to faster, cheaper and more effective routes to market. Meanwhile nanotechnology looks set to bring about more accurate and effective delivery of therapeutics to the target site.
The closing days of 2009 saw the first steps towards reform of the US healthcare system and other countries will also be looking to respond better to the real needs of patients. The technologies of the "noughties" have gone some way to assessing which patients will benefit from a treatment and which would benefit from a different approach.
There is still a long way to go to reach the goal of personalised medicine, and no doubt there will be a number of obstacles and blind alleys along the way. But at least the direction seems clear and we have a basic map - although there are many details to be filled in during the journey. The conventional economic model that relied on a pipeline of blockbusters to fuel future developments is now being rapidly left behind, but there are new vistas waiting just around the corner.