On Wednesday, Mark Zuckerberg announced his most ambitious goal yet, and that's saying a lot. The Facebook founder wants to "cure all disease in our children's lifetime," or at least be able to diagnose and manage them so that they are no longer harmful. Picture it: Ringing in the 22nd century with no disease to speak of, and a life expectancy that stretches well past 100.
To that end, Zuckerberg and his wife, pediatrician Priscilla Chan—who in 2015 said they'd give 99 percent of their Facebook shares to charity, shortly after they became parents—pledged $3 billion to be spent over a decade through the Chan Zuckerberg Initiative, which is their philanthropy LLC. "We'll be investing in basic science research with the goal of curing disease," Chan said at an announcement in San Francisco.
It's a noble ambition. Funding for basic research is always welcome—and Zuckerberg is pushing for more from governments, companies, and non-profits, too. Beyond that, criticizing anybody for giving more money to basic science is in bad form. But the language around "curing all diseases," and doing it within a timeline that's tantalizingly easy to picture, is misleading.
Part of what's happening seems to be a disconnect between "Silicon Valley language," as Jim Woodgett, director of research at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, put it, and the realities of health research.
"It's possible to cure, prevent or manage all diseases by the end of this century"
"They are recognizing the importance of basic science, and that's a good thing," Woodgett said. But he carefully put the money in context. "It's $3 billion over ten years, and just the [National Institutes of Health] spends $32 billion a year on health research," he pointed out. The NIH hasn't managed to stamp out all disease, nor would it claim to.
The Bill and Melinda Gates Foundation, which was founded by another super-successful tech entrepreneur, has made strides in tackling HIV infections (among other afflictions) in developing countries, where targeted efforts like condom distribution can go a long way. Better drugs have also greatly extended life expectancy of HIV patients.
Zuckerberg and Chan's grandiose pledge to stamp out all diseases, no matter how well-intentioned and aspirational it is, oversimplifies what this would mean.
"Priscilla and I have spent the last few years talking to dozens of top scientists and experts who believe it's possible to cure, prevent or manage all diseases by the end of this century," Zuckerberg said. "That doesn't mean no one will ever get sick, but it does that mean that we'll get sick a lot less," and that diseases will be manageable and non-life threatening.
With the confidence of an engineer tackling a faulty piece of software, Zuckerberg boils this down to the four major kinds of diseases that kill most people, as he elaborates in his Facebook post: heart disease, cancer, infectious disease, and neurological disease, including stroke. "I don't want to oversimplify," he writes, noting that these are all very different. Yet he feels there are common strategies for fighting them.
He's right that things aren't so simple—as much as scientists, doctors, and most importantly, patients, would like them to be. Take cancer: not only is every single type of cancer different, whether it's breast, colorectal, or brain. Every single patient is different, too.
That's one of the reasons why, when President Obama announced the "moonshot" to cure cancer earlier this year, a lot of observers were skeptical of the choice of words.
"The growing cancer epidemic is not a problem that medical science is about to solve. In fact, it is a problem we are about to make worse," medical professor Jarle Breivik wrote in a New York Times op-ed in response. "The better we get at keeping people alive, the older they will get, and the more cancer there will be in the population."
"Alzheimer's is a disease we've got no clue as to how to treat"
Many of these diseases pop up most frequently in old age, and we're all living longer. Alzheimer's is another example. (Wednesday, the day that Zuckerberg and Chan made their announcement, was coincidentally World Alzheimer's Day.) "This is a disease we've got no clue as to how to treat. We've got no effective therapies for it," Woodgett pointed out.
Then there are the challenges of drug-resistant bacteria, or global pandemics that seemingly come out of nowhere (like Zika)—but maybe most importantly, the fact that, research aside, humans don't always play along. Zuckerberg noted that we're close to eradicating polio, which is a huge achievement. But one of the reasons we haven't yet succeeded is because vaccinators have been threatened or murdered by militants in some parts of the world.
"It's horrible to criticize somebody injecting money into science and research," Woodgett said. Chan and Zuckerberg are off to a good start: they'll be setting up a "Biohub" in California that will bring together researchers from different disciplines, and give them cutting-edge laboratories and tools to do their investigations. New tools and techniques, whether gene editing, stem cells, synthetic blood, or other techs we haven't even dreamed up yet, will surely change healthcare in ways we can't comprehend today.
Ultimately, Zuckerberg's announcement is partly about convincing others to believe it's possible to rid the world of disease, in order to beef up support for more research (he promises to invest more himself, "billions of dollars over decades"). But it's still important to understand that fighting disease isn't only, or inherently, a technology problem. And it's not like going to the moon.
"This would be like going to the moon if the moon could fight back," Woodgett said, "and prevent us from getting there."
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