Cameron Neylon

There has been a lot of commentary around the blogosphere about [Sergey
Brin](http://too.blogspot.com/)â€™s [blog
post](http://too.blogspot.com/2008/09/lrrk2.html) in which he announced
that his SNP profile includes one variant which significantly increases
his risk of developing Parkinsonâ€™s disease. The [mainstream
media](http://www.smh.com.au/news/biztech/google-founders-shock-announcement/2008/09/19/1221331178163.html?page=fullpage#)
seem mostly to be desperately concerned about the potential for the
ignorant masses to be misinformed about what the results of such tests
would mean and the potential for people to make unfortunate decisions
based on them (based on that argument Iâ€™m not sure why we are allowed
to have either credit cards or mortgages but never mind). The other,
related stream, which is found more online is that [this is all a bit
meaningless](http://www.thehealthcareblog.com/the_health_care_blog/2008/09/23andme-gets-un.html)
because the correlation between the SNPs
[23andMe](https://www.23andme.com/) measure and any disease (or indeed
any phenotype) are weak so itâ€™s not like he *knows* heâ€™s going to
get it â€" [why not get a proper
test](http://www.thinkgene.com/i-dont-want-a-23andme-i-want-the-real-genetic-tests/#)
for a proper genetic disease?

I think this is missing the point â€" and I think in fact, his post
could represent the beginning of a significant change to the landscape
of medical funding â€" precisely because that correlation *is* weak.

In the western world we have been talking for decades about how
â€˜prevention is better than cureâ€™ yet funding for disease prevention
has always remained poor. Itâ€™s not sexy, it is often long term, and it
is much harder to get people to donate money for it.Â  Rich people
donate money because relatives, or they themselves, are already ill.
They are looking for a cure, or at least a legacy of helping people in
the same situation.

The [Health Commons](http://sciencecommons.org/projects/healthcommons/)
project run by [Science Commons](http://sciencecommons.org) has as its
aim the reduction of the transactional costs involved in getting to a
drug. If you can drop the cost of making a cure for a disease from \$1B
to \$1M you have many orders of magnitude more people who can afford to
just â€˜buy a cureâ€™ for a loved one, themselves, or to make themselves
feel better.Â  This vision, and what it does to global health, even if
the success rates are relatively low, is immensely powerful. And it
needn't apply just to drugs, or to cures.

But Brin doesnâ€™t want a cure necessarily. Actually thatâ€™s not true
â€" Iâ€™m sure he does, his mother has Parkinsonâ€™s and his great aunt
suffered from it as well. Anyone who has seen someone suffer from a
degenerative disease would want a cure. But equally, heâ€™s a smart guy
and knows just how tough that will be, and how much money is already
going into such things.Â  But he can now look at his genetic profile
*now* and look at which diseases he is predisposed to get. He can look
at which of those he is really worried about. And then he can dig into
his pocket and decide what the most efficient use of his \$15B fortune
is. Sure he will put millions into developing treatments, but the smart
money will go on research into prevention or slowing onset. He has the
time before any likely onset to allow programmes on prevention to run
for 10-20 years before he will need to take a best guess on
implementation.

And the point is that there will be a growing number of people having
only the probabilities based on SNP data to work on making similar
judgements about a range of diseases. And don't believe that if we have
full genome sequences those probabilities will get any better either.
More precise yes. Better linked to phenotype? Not for a while yet.
People who get these tests done donâ€™t know exactly what they will get,
but they have an idea, and they might have that idea up to 50 years in
advance. Now consider what happens if the costs of developing methods to
prevent or delay onset drops to the point that millionaires can make an
impact. A thousand or maybe a miillion-fold more people with a deep
interest in preventing the onset of specific diseases, an understanding
of risk-based investment, and the money *and the time* to do something
about it.

Preventative medicine just became the biggest growth area in medical
research.

p.s. [Attilla gets
it](http://pimm.wordpress.com/2008/09/19/sergey-brin-gly2019ser-a-real-chance-against-parkinson-diseaseaging/)
-- he's just thinking regenerative rather than preventative -- maybe
they are the same thing in the end?


There has been a lot of commentary around the blogosphere about Sergey Brinâ€™s blog post in which he announced that his SNP profile includes one variant which significantly increases his risk of developing Parkinsonâ€™s disease.

Messages de Rogue Scholar

Why a 25% risk of developing Parkinsonâ€™s really does matter