--- Alberto Monteiro <[EMAIL PROTECTED]> wrote:
> Gautam Mukunda wrote:
> And I have a suspicion as to _why_.
> 
> Every other science has progressed geometrically
> over the past
> 50 years. If Medicine had advanced the way computers
> have, we
> would have a life expectancy of 500 years [except
> that once every
> 42 days our bodies would burn, and we would have to
> be rebuild
> from the clone backup :-)]

I was about to make that joke...

First, I don't think every other science _has_
progressed geometrically over the past 50 years.  I'm
not sure that theoretical physics, for example, is all
that far advanced today over where it was in 1960, say
- Dan M. can confirm or deny that statement.

But the reason for that is because biology doesn't
have the theoretical foundations that physics and
chemistry do.  It doesn't have anything to do with the
pharmacos, it's just that this stuff is harder.  We
don't have a theoretical model of any high degree of
usefulness for the brain or the liver, for example. 
We still don't understand how proteins interact.  We
only sequenced the human genome a few years ago, and
we've barely begun figuring out what proteins are
expressed by it, much less how those proteins will
interact with each other.  That puts biology in about
the place physics was...before Newton.  So _of course_
medical science hasn't advanced geometrically yet.  

> I am not blaming them for _not_ doing this. I am
> blaming
> everybody else that allows them to control medical
> research.

But they don't.  They're pretty good at it, but I
doubt that even half of the US's research spending is
from the pharmacos.  What they do control is
_development_, but they control it because they're the
only people who are any good at it.  Medical research
is still heavily the province of governments and
universities, so if we're not finding "cures", it's
because _they_ haven't found them.

> Did they? What about the new superbacterias that
> resist every
> antibiotic?

What about them?  There are almost no cases of such
bacteria actually doing much outside the laboratory. 
As it is, we got 50 years of virtual freedom from
bacterial diseases, which was pretty good, and we can
still knock them back much more often than 999 times
out of 1000.  The reason that those "superbacteria"
aren't killing many people yet is, again, because of
the fecundity of the pharmacos, developing not just
one antibiotic (penicillin), but everything from
amoxicillin to cipro, so we have many different ways
to attack a bug.  Not enough, and we need to develop
more, but the ones we have are because of private
industry efforts.

> No, I am not. But there is no _cure_, just expensive
> drugs
> to turn cancer into a chronical disease.

Alberto, I don't understand what you mean by this. 
One of my aunt's had breast cancer a few years ago -
she had surgery, took chemo for a while, and now she's
not.  It's past the five year point, so statistically
her likelihood of a recurrence is (IIRC) about the
same as that for a person who has never had cancer. 
She's not taking any drugs right now.  If that's not a
cure, what is?  Cancer isn't a bacteria, we can't kill
it with a single pill.  It's hard to do.  What's
amazing is how far we've come.


> Who extract huge profits from drugs that keep cancer
> patients bound to them _forever_.

Except they don't.  To pick an example, one of my best
friends in high school had pediatric cancer as an
infact - something in his eye, I think.  He wasn't on
any drugs.  He had been "cured", for all practical
purposes?

Now, if a pharmaco could create a drug that could turn
every cancer into a chronic condition - what a
blessing that would be!  If only we were somehow able
to do that.  But we can't.  The record so far is
pretty good, though.  Not good enough, but it gets
better every day.  I would not be stunned to see most
cancers treated exactly that way - turned into chronic
conditions - in my lifetime.  I _expect_ to see heart
disease treated that way in my lifetime (if the
results from the Phase II clinical trials on Pfizer's
HDL enhancing drug end up being as good as some people
hope, that result might actually be in sight.)

> Ok, but then it's still 0 x 0 :-)

Yeah, but the record of people trying to run a 2
minute mile is also pretty bad.  We don't tell runners
to stop running because of it, or call them
incompetent for failing to do it.

> Do you think you are so much smarter than any
> advisor
> that has ever counseled the drug companies? Don't
> you think
> any other intelligent consultant could duplicate
> your reasoning
> that it's a bad idea to research a drug that cures
> disease X
> instead of a drug that keeps a X-patient forced
> _forever_ to buy
> drugs that will extend his life?

I was a very average consultant, so I'm sure plenty of
other consultants have made this calculation.  Here's
the thing, though.  If pharmaco A has a drug that
converts a life-threatening condition into a chronic
one...then pharmacos B, C, D, E, and F have an
incentive to develop that one pill cure you're talking
about.  That's where the money will be.  If they
haven't developed those drugs, it's probably because
they _can't_, not because they don't want to.

Now where your criticism might be right is if you said
then pharmacos have an incentive to focus their
research on chronic problems instead of acute ones. 
There's absolutely truth to that.  But if you look at
the major killers in the developed world, they tend to
be chronic issues (lifestyle issues most often).  So
what else can you do given current technology?  The
developing world is very different, of course.  So I
guess if the developed world wanted to deal with those
diseases we might be able to cure by your definition,
the best way to do it would be for massive government
spending to create a market for these drugs, so that
the pharmacos would have an incentive to develop drugs
to do that.  But that's a tax issue - the developed
world has to be willing to spend that kind of money. 
It's not a criticism of pharma that they don't do that
kind of research, because no one else is willing to
spend the money to do it either, and they're the only
people who _could_ if the money was there.

> Capitalism has no compassion :-/
> 
> Alberto Monteiro

Absolutely true.  Pharmacos do, though.  Merck, for
example, spent hundreds of millions of dollars
developing a drug for river blindness...and then gave
it away for free.  That's pretty compassionate.

Beyond that, though, it's true that capitalism has no
compassion.  What capitalism has a surfeit of, though,
is competence and innovation.  Now, if I ever got
cancer I would like to be treated by compassionate
doctors.  But if I had to choose between compassionate
inept doctors, and brilliant uncompassionate ones, I
wouldn't even have to think twice.  People who are
_good_ at their jobs are much preferable to people who
care about their jobs but can't do them.  Private
sector health companies might not be compassionate,
but they're very good, and they're the only things
that are.

=====
Gautam Mukunda
[EMAIL PROTECTED]
"Freedom is not free"
http://www.mukunda.blogspot.com


                
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