Deceptive promises of cures for disease: the great majority of the world's diseases are caused by environmental, not genetic, conditions. A frenzied search for genetic therapies could steal resources from billions in order to serve only a few.

AuthorSexton, Sarah

Billions of public and private dollars are now being poured into genetic research. Even some critics of new human genetic technologies seem to concede that these massive investments may be worthwhile. The Catholic theology professor David Tracy, for example, has said that "Opponents of human cloning (as I am) cannot afford to ignore the benefits that such cloning might provide for all humankind." His comment is easily extended to the drugs and tests that might be realized through the new technologies. But will the products of genetic research in fact be accessible to "all humankind"?

Probably not, because both the public and private health services that would disseminate the new drugs and procedures make cost-benefit decisions and value judgements about who should get what treatment. Many of the groups now considered to be the biggest potential beneficiaries of genetic research, such as the elderly and the seriously ill, are left by the wayside as treatments are rationed. In contrast, however, health services and insurance companies may vigorously promote some products, such as prenatal and adult gene testing, if they believe they might save the costs of supporting people in the long term.

Moreover, the increasing privatization of health care services around the world means that access to health care and medical products, including drugs and tests, is increasingly based not on need but on ability to pay, or to get health insurance. Private insurers tend to select the best risks--people who tend to be healthy anyway--and to reject those who have chronic illnesses or who cannot afford the insurance. The more health care financing is based on insurance, the more it will rely on assessments of individuals' presumed risk of ill-health--something gene testing is poised to make enormously more complicated and supposedly accurate.

Even without widespread gene testing, about one in six people in the United States does not have health insurance, while millions of others are underinsured. With genetic screening becoming more widespread, that number will only grow, as more people are rejected by insurance companies or fall to keep up premium payments that will undoubtedly increase after "susceptibilities" are discovered.

Just as private health services and insurers leave out people who can't pay, biotech research leaves out the illnesses from which those people suffer. Because large numbers of the people who can't pay suffer from tropical diseases, those diseases are largely ignored by researchers. While pneumonia, diarrhea...

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