the ratio of dollars spent to drugs approved. But without undue breathlessness, the authors look ahead to fuller use of what’s already begun, and they ask the right questions: “Would a shift to developing drugs against targets informed by human genetics rather than animal models raise the chance of clinical success?”
The answer isn’t an unqualified yes. Sure, biomolecular miniaturization—cells, tissues, and “organs on a chip”—are allowing ever-more precise analysis of our biochemistry and physiology, “but Moore’s law seems unusually alien to conventional drug development, at least to the industry that emerged in the late nineteenth century and is today’s vast global enterprise.”
The breakup of that monolith is underway, to some extent, but the authors leave it an open question whether drug makers, whatever their future size and shape and headcount (and geographic location), can square new bioinformatics and other technologies—nanotechnology, pattern recognition and deep learning through artificial neural networks, remote patient diagnostics and monitoring—with faster, cheaper, more efficient drug development. What new forms and entities of R&D would be better suited is a large part of the discussion, but remains rooted in the experimental business models and private/public or for-profit/non-profit re-arrangements we’re already seeing on a frequent basis.
As noted earlier, if you’re looking for detailed visions of the future, this isn’t your book. The farthest the authors venture are scattered references to neuroeconomics: the way our brains process incentives and seek reward, for example, perhaps becoming targets for therapeutic intervention or alteration. The oddest reference is their summation (and, I assume, endorsement) of a British study called the Foresight Project that called for shoring up a nation’s “mental capital.”
“Interventions,” write Hoffman and Furcht, “including behavioral, educational, social, and pharmaceutical, are entirely justified under appropriate circumstances to keep a country mentally healthy and competitive.” (Less creepy is their enthusiasm for the age-old neurostimulant caffeine, and its omnipresence in the London coffeehouses where stock markets were born and Adam Smith worked on The Wealth of Nations.)
And if you’re looking for not just acknowledgment but fiery critique that technological progress has wrought crises of climate change, a looming sixth great extinction, an epidemic of obesity—this isn’t the book for you, either. There are small, often off-handed references to worrisome trends. The potential for malicious engineering of bioweapons gets barely a mention. Practically the only reference to the human toll of technological displacement comes when the authors quote J. Craig Venter as he boasts about his firm Synthetic Genomics:
“‘You know, this is the most futurist manufacturing planet on the planet right now,’ Venter said in describing his genomics center while inadvertently revealing the toll automation takes on the scientific workforce. ‘You’re seeing Henry Ford’s first assembly plant. What don’t you see? People, right?'”
They don’t gloss over all problems, to be sure. They are clear, for example, that we still have no idea what most genes do, and that 23andMe’s service was about as useful for assessing health risks as a trip to the local fortune teller. Or that, while next-generation DNA sequencing has already passed the price/performance pace of Moore’s law for semiconductors, there’s a long road ahead in separating the signal from all the genomic noise. That discussion then steers just a bit wonky, into the College of American Pathologists’ laboratory accreditation process and CLIA certification. A necessary diversion, probably, but such diversions keep The Biologist’s Imagination from being as imaginative as one might hope.
One passage in particular sums up the tension between the two ambitions to stay grounded and soar. It’s in the section where the authors quite thoroughly and responsibly lay open the crucial question of intellectual property rights over the very basics of our biological stuff. There’s excellent historical background on the origin of the American patent system, on the 20th century rise of tech transfer and venture capital, on the political fragility of the legislation that became the seminal Bayh-Dole Act of 1980, and on more recent Supreme Court actions to strike down key patents of genes. But they refuse to come down on either side.
“The courts have ventured into terrain from which no uniform and consistent position or test can be easily derived and applied,” they write, and then a few pages later: “Sorting out legal claims for bioproducts and their methods would be an enormous task under ordinary circumstances, but we are in extraordinary times.”
Indeed we are, and extraordinary times produce extraordinary innovation from extraordinary imaginations. Hoffman and Furcht have done a fine and detailed job describing how we’ve reached these times and the platforms upon which the next century of innovators will build. It’s a work of great service to anyone, like me, who is scrambling to keep up with so many complex, interdependent layers of science and strategy. And sometimes that’s even better than a flight of imagination.
