Digital Matters - Issue 29

In My Humble Opinion: Genomics is the most important economic, political, and ethical issue facing mankind.

Everybody knows that the information-technology revolution changes everything that it touches -- and that it touches almost everything. Information technology isn't a business category or an industry. It's a crosscut that changes every business and every industry -- and, in so doing, it changes how societies function.

When the history of our time is written, however, the digital revolution will not be the lead story. The lead story will be the genomics revolution -- a crosscut that really changes everything. And virtually no one knows anything about it.

For the moment, the best primer on the genomics revolution is a Harvard Business School case study. Titled "Gene Research, the Mapping of Life and the Global Economy," case N9-599-016 was written by Juan Enriquez, a researcher at the David Rockefeller Center for Latin American Studies at Harvard University, under the supervision of Ray A. Goldberg, a legendary HBS professor. Once you have a copy of the study, read every word of it. The case -- which is being read by top people at major companies in the fields of health care, agriculture, energy, chemicals, and defense -- will change how you think about the future.

At his home office near Boston, Juan Enriquez works amid a collection of maps. He is finishing up a book about international borders and the cartography of the new economy, and he drew on that work to write the lead article in the Fall 1999 issue of Foreign Policy. But it is the mapping of life that has captured his imagination. He is working with his friends Claire Fraser and Craig Venter -- whose company, the Celera Genomics Group, is attempting to sequence the nearly 3.5 billion nucleotide base pairs contained in every human genome. Scientists expect to complete this work by 2002.

In his HBS case study, Enriquez describes Fraser and Venter as the "new cartographers. Instead of mapping continents, oceans, peninsulas, rivers and lakes, they are mapping the four base pairs that make up the DNA of living organisms. This is the source code for all forms of life on the planet. Their work will change the way we look at and live with every other person, animal, plant, bacteria, and virus on this planet.

"These discoveries," he continues, "tell us about the past, who evolved from whom, and how. Even more important, they are changing our future." And, as scientists discover the fundamental code of DNA, other disciplines and discoveries are giving mankind the ability to study, design, and build at the molecular level: "By understanding and being able to recreate and modify the instructions that make life, humans will soon be able to directly and deliberately influence their own evolution and that of other species."

And that, as they say, changes everything. Today, about one-half of the soy planted in the United States is genetically engineered. In the not-too-distant future, two-thirds of all U.S.-grown corn, soy, and cotton will most likely be genetically engineered -- either to help those crops fight off pests or to increase their nutritional value.

Companies like Monsanto are experimenting with so-called agriceuticals -- agricultural products that double as pharmaceuticals. Seed companies are experimenting with genetic-enhancement technologies that make coffee beans less or more caffeinated, or that make carrots better for your eyesight. In the near future, most of the frozen foods that you eat will be genetically engineered or enhanced.

In Europe, the genetic engineering of food has engendered a huge backlash. European political elites, sensitive to agricultural constituencies at home and wary of U.S. economic hegemony, have raised a huge fuss over the sale of what they call "genetically modified" foods. As a result, trade relations between the United States and Europe have been strained almost to the breaking point.

This backlash is a pillow fight compared with what will soon follow. Before it is through, the genomics revolution will cause a massive restructuring of several major industries. It will change the health-care business. It will change the insurance business. It will change the pharmaceuticals business. It has the potential to reconfigure the energy, chemical, and petrochemical businesses. And it will completely change national defense.

Just follow the genomics trail through health care, a field that has annual revenues in excess of $1 trillion and that accounts for about one-seventh of U.S. GDP. To be sure, small pieces of the health-care puzzle will not be changed by genomics. If you break your leg, you'll still have to go to the emergency room. Rehabilitation will still involve exercise and personal attention.

But everything else in the health-care industry will change. The genetic code of every patient will be known, and it will be digitally imprinted on his or her genetic-identification card. That card will spit out reams of data regarding the patient's genetic predisposition toward certain diseases and illnesses, and that information will enable the patient to know well in advance that he or she is at risk for breast cancer, alcoholism, high blood pressure, or heart disease. And genomics-based medical specialists will use that information to prescribe a program of preventive medicine to keep such diseases at bay. In the near future, health care will be organized around genomics-based preventive medicine.

All of which raises enormous moral and political questions. But for the moment, let's keep following this trail. Think about the impact that genomics will have on the insurance business, which most people believe drives the health-care business. The insurance business is all about math: actuarial tables, probability studies -- all combining to set a price on a policy that gives you "coverage." With genomics, that kind of math becomes irrelevant. It doesn't matter if you're 45 or 55; what matters is your genetic makeup. In the future, coverage decisions will be based on your genetic code.

That, too, raises enormous political and moral questions -- but the trail continues. Consider the pharmaceuticals business. Not long ago, the big idea that was supposed to change the industry was the development of generic drugs. Genomics-based medicine will turn that idea upside down: Pharmaceutical products will be designer drugs, targeted to individual genetic codes and prescribed to fight diseases for which people are specifically at risk.

These designer drugs will overturn the drug-approval process. Today, pharmaceuticals companies spend hundreds of millions of dollars on drug development. Once a drug has been developed, it is tested on a sample population. If the drug proves safe and effective for most people in the sample population, and if the potential benefits outweigh the risks, then the FDA approves it. Otherwise, the FDA rejects it. But just because a drug doesn't work for one person, or because it makes 10 other people feel nauseated, that doesn't mean that it isn't the right drug for you or me. The use of genomics to prescribe medication will mean that drugs can be genetically targeted to "fit" individual patients. As a result, pharmaceuticals companies around the world will be able to recoup billions of dollars' worth of drug research. Which is why so many pharmaceuticals companies are becoming "life sciences" companies.

Follow the string: If you can design pharmaceuticals for individual patients, it stands to reason that genomics will soon usher in genetically engineered agricultural products that can double as pharmaceuticals. If you know that you have a genetic predisposition toward stroke, you'll be able to buy and eat agriceutical broccoli or spinach -- which, over time, will lower your blood pressure.

All of this affects perhaps one-fourth of the U.S. GDP -- and it's just one exit ramp off the road of genomic knowledge. Remember the bigger picture: By understanding, re-creating, and modifying the instructions that make life, humans will soon be able to influence -- directly and deliberately -- their own evolution and that of other species. Think about what that means. Think about the moral issues that it entails. And recognize that there is no turning back.

There is no turning back for three reasons. First, as a matter of national security, sequencing and decoding the human genome is as important as the Manhattan Project was during World War II. Biological warfare has become a terrifying threat. As Enriquez writes, "Gene technology is creating nightmares for military officials throughout the world. . . . As bioweapons become stable, easy to disperse, and have specific and limited time effects, some nations may be tempted to develop them as strategic weapons. Technology is increasing their military value, particularly since they can be dispersed quietly and are hard to trace. . . . If gene research can target medicines to particular individuals, it can also target weapons. Conceivably, specific ethnic groups could become targets."

The only antidote to this national-security nightmare is genomics research. As Enriquez argues, "Non-military genetic research will provide critical insights into how to prevent and cure deadly threats. . . . George Vande Wounde, of the National Cancer Institute, has, in the course of unrelated research, found the key to anthrax' toxicity. This could eliminate any threat from these [biological] weapons."

The second reason why genomics will become a central fact of modern life is more mundane: money. Genomics makes possible the extraordinary creation of wealth. The information-technology revolution created vast pools of wealth in a very short period of time. Genomics will create the same kind of wealth in even less time.

The third reason is that humanity simply has to know. Enriquez quotes Claire Fraser as follows: "In the next ten years we will see some of the most extraordinary discoveries in the history of science. We can give evolution a shove in the right direction or in the wrong direction depending on whether we know what we are doing. . . . We will bring good things to life." No one turns away from an opportunity as big and as important as that. Because it is human nature to want to know, the genomics-knowledge revolution will remain utterly unstoppable.

Which brings us back to an earlier point. Virtually no one knows anything about genomics. It isn't being discussed in politics. It isn't being addressed by the major religions. But it is the most important economic, political, and ethical issue facing mankind today. The absence of a broad-based discussion about genomics and what it means for the future is almost eerie. Eventually, it will become a huge social issue -- either because an incident occurs that frightens the general population or because a breakthrough captures public attention. In the meantime, the revolution gathers momentum.

Get your hands on a copy of Enriquez's case study. Read it. Then start a conversation about what it means.

John Ellis (jellis@fastcompany.com) is a writer and consultant based in New York City.

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