The Secret of Life

Think about drugs. What many people don't realize is that most drugs are effective for only 30% to 50% of the population. Consider the notion that taking one baby aspirin a day is effective in preventing heart attack and stroke. It's true -- but only for about 33% of the population. One gene, one letter change, determines whether you're part of that 33% or not. Our medical establishment tells all of us to take a baby aspirin a day -- mainly because, without genetic testing, there is no way of knowing who belongs to the category that the drug works for and who doesn't belong to it.

The baby-aspirin example highlights the way medical decisions are made today: They aren't made with you or me in mind as individuals; they're mere guesses about statistical populations. For instance, there's a Type 2 diabetes drug that's very effective. But in one out of 10,000 cases, it's lethal, so it was recently taken off the market. In that one case, it's clearly not very effective. In future diagnostic tests, genetics will allow for advance screening to determine whether you're the one in 10,000 for whom that diabetes drug is lethal. Soon medical decisions won't be about statistical odds -- they'll be about you.

Your personal genetic-information card would not only identify your individual reaction to a specific drug; it would also be a digital record of your personal health information: what other drugs you're on, and what the implications are of drug interactions. Taking two different drugs together may not affect me, but taking those same two in combination could be lethal to you. Your card would serve as a digitized health record. And the foundation for this advancement is the human genetic code, because it's the only thing that's truly unique to each of us.

In your view, what kind of political reaction is the Genetics Revolution likely to generate?

The politics are hard to estimate. In Europe, and in England in particular, the reaction has been almost hysterical -- in part because of a distrust of government that stems from the mad-cow disease incident. It wasn't exactly a confidence builder, and it was handled poorly. Should people have an inherent distrust of government officials, especially when those officials say that everything is fine? Yes. I think we all should, to some extent.

Yet there are other people who have a very different view of things -- particularly in societies where people are not overfed. In some countries, eating is almost a recreational sport. But I've been to parts of Africa where there are droughts and massive starvation. Somehow, I don't think that those starving people would be too worried about the perceived dangers of genetically modified foods.

With disease, it's a different situation, because disease is very personal. People who live with cancer want to try anything that might help them. When something affects your own health, your political views and attitudes tend to change.

When people talk about the Web, they argue that knowledge is power. Does that opinion apply to the Genetics Revolution too?

Giving people information about their own genetic code is the most important thing that we can do to alter the balance of power between the individual, the government, the insurance industry, and the health-care establishment. Once you have information about your genetic code, you have power over your own life. You're no longer just some statistical aberration in somebody else's study. If you know that you have an increased risk of colon cancer, for example, you can go do something about it. You can be aware of the possibility and watch for early symptoms -- because, if you catch colon cancer early, it's totally treatable and curable. There are millions of different attributes linked back to genetic code. By using Web sites and certain information services -- which Celera plans to provide, by the way -- you can look up that information.

Today, you can tell Amazon.com which kinds of books you're interested in, and the company will notify you about new books on those topics when they become available. In the future, you'll be able to specify to a research company the diseases that you're concerned about, and when a new study on, say, diabetes comes out, you'll be able to have that study sent to you automatically by email. Instead of relying on physicians, hmos, and governments to provide you with information that you need to have about your health, you can personally make sure that you have that information. After all, what's right for 99% of the population may not be right for you. And the government may not really be interested in that point. It's not that the government doesn't care -- it's just that individuals don't happen to fit within its statistical paradigm.

Having access to such information gives you power over something that is uniquely yours: your genetic code.