At a time when the gap between the super-rich and the poor is getting dangerously wide, it’s good to hear that Mark Zuckerberg, the billionaire founder of Facebook and his wife are giving $3bn to medical research over the next ten years, to “cure, prevent or manage all diseases” in their children’s lifetime. It’s a nice gesture, suggesting that perhaps capitalism has a more acceptable face, too, yet after a few moments of feeling nice about it, I begin to experience some doubts.
It’s not just that $3bn sounds less impressive if set against, for instance, the $6bn to be spent over five years by the British Wellcome Trust; it’s the grandiose aim of the donation that bothers me. All diseases? Is there anyone who can even begin to list them? Another generous billionaire, Bill Gates, has been spending billions over 15 years on trying – and failing – to wipe out nothing more than malaria or polio, never mind the whole blooming lot. Surely Mr Zuckerberg (German for Sugar Mountain) should think up a less ambitious project to support?
And while I am in the mood for cutting things down to manageable sizes, allow me to jump on my hobby-horse whose name is prevention, the poor relation of the cure and management of disease. “Prevention is not sexy,” says a disillusioned doctor friend of mine, “so no-one is taking it seriously.” And yet and yet the evidence is piling up to show that an alarming lot of our diseases are caused by ourselves out of sheer ignorance, or as a result of having poisoned the world which now, in turn, is poisoning us. There is nothing new about this: poor lifestyle, suicidal diets, obesity, too much alcohol, stress & co. add up to a litany piously recited by official voices, but there is no official action to rein in the misbehaviour of the food industry, to name only one major culprit. Cynics claim that Big Food is in cahoots with Big Pharma: if you consume enough processed stuff, you are bound to end up with a fistful of prescriptions for the rest of your life. Elementary, my dear Watson.
Maybe so. But what’s more alarming, because less obvious, is the piecemeal emergence of new health hazards. For instance we’ve just been told that dementia has overtaken heart disease as the biggest cause of death in England and Wales, a staggering development – how come, what has changed to cause this rise? The next day a newspaper report provided a possible answer. According to some researchers, particulate matter, typically released by diesel engines, can enter human brains, suggesting that there is a link between traffic pollution and dementia. Magnetite, a by-product of traffic pollution, has been found in the brains of people with Alzheimer’s, and there’s evidence that people living in areas with high levels of airborne pollution are more likely to get the disease. Ironically, diesel has been promoted for years now as being less harmful to health than petrol…
Another example of the hidden link between innovation and health damage cropped up some years ago, when a Europe-wide research programme tried to establish the cause of poor sperm production by otherwise healthy males. In the end the men with the best sperm production, both in quantity and quality, turned out to be Danish organic farmers, namely men who never worked with herbicides, pesticides, fungicides or anything else ending with -cides; nor did they eat food treated with those same agri-poisons, which were hailed as the essential tools of modern farming, leading to bigger yields and healthier plants. Since then the popularity of organic foods, guaranteed to be poison-free, has grown enormously, but it’s still a minority trend. As far as the manufacturers of agricultural chemicals are concerned, they keep producing ever stronger poisons, as weeds and pests adapt sufficiently to the current range to survive them. Never mind the humans who are the last link in the toxic food chain.
We’ve made a real mess of things, and surely trying to undo the damage and prevent further disasters should have absolute priority in medicine. But it hasn’t. Perhaps it never had. I recall a cartoon, used many years ago by that great medical maverick Denis Burkitt, whenever he gave a talk on the need for prevention. The cartoon showed an overflowing hand basin with both taps full on, and two doctors in white coats busy mopping up the flooded floor, but not turning off the taps. “You get paid more for mopping up,” was Burkitt’s devastating comment.
Despite all this, I hope Mr Zuckerberg’s project will do some good in the hellishly difficult area of health in our not so brave new world.