Monday, June 18, 2012

Underserved Diseases

I've been reading a lot about underserved diseases recently, as part of the work I'm doing on the our CCM project. CCM is a DARPA program that's working on synthetic biology approaches to human medical problems, and one of the things the program manager has been very clear about is that he want to make sure what we do is actually aimed at solving real disease problems faced by the military. Not by coincidence, it seems that a lot of the things the military is worried about are widespread diseases in the developing world: that's where our soldiers tend to end up, and when they live there, they suffer the same things that the rest of the people living there do.

So I guess that's got me thinking a lot about the whole larger issues of society and medical care. You see, a lot of these diseases are on the WHO's list of "underserved diseases," meaning that they don't get a lot of funding relative to the number of people who suffer from them. Just why that is, I don't know the medical funding world enough to judge, but I'd guess it's no coincidence that a lot of the people who suffer from them are very poor.

The amazing thing, too, is how many of these diseases could be seriously mitigated just by improving public health facilities, or infrastructure, or other relatively simple actions that become not so simple when you need to carry them out on a national or regional scale. I remember my own experiences in Kolkata, visiting my in-laws. Both my wife and I were struck down and hospitalized by a nasty viral gastroenteritis, and we were never really well again until we got back to the US: every time one of us was getting better, the other picked up another round of something that just pounded on our weakened immune systems again. How, why? It was simply that all of the infrastructure we take for granted was not there in Kolkata, and it was so hard to maintain a clear chain of provenance on anything we consumed. After we arrived home, we opened up a big "Infrastructure" coffee-table book I've got and read with fascination about how clean water is actually assured here in the US. Something so simple that we take so much for granted turned simply magical in the wake of that experience.

So... now here I am, as a researcher, thinking about these things again, from a different angle. These problems are so big, so infrastructural: what am I realistically like to accomplish? Well, not much. At least, not soon. I'm not a doctor, I'm not a disease specialist. What business do I have looking at these problems at all?

What I am, though, is a computer scientist, and one with (I think) a good understanding of complex systems, emergent interactions, and automated reasoning. I'm not going to cure any of these diseases myself. But with the techniques we're working on, and the new tools that I and my colleagues can provide, maybe we can make it a lot easier to study and attack these diseases... and that might turn out to make a big difference somewhere down the line.

And maybe even to those folks in the developing world who really need it. I was fascinated to learn, a little while back, that one of the big things that the US military does in places like Afghanistan is to provide health care to people in the villages that troops visit. From a cold realpolitik view it can be viewed as a sort of trade: I heal your sick child, you're more likely to be on my side in some future conflict. But at the same time, I don't really care about the motivation: the basic human diplomacy of health care still brings tears to my eyes... we all deserve to have people and institutions that care for our health, and it's a damned shame so many are underserved. I just have to do my damnedest to make sure the resources that I'm being given to help are being used as best we can...
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