Taking Life-Saving Science from Lab to Village
Written by Abdallah Daar and Peter Singer
Format: Trade Paperback, 304 pages
Publisher: Anchor Canada
ISBN: 978-0-385-66719-7 (0-385-66719-1)
Pub Date: January 15, 2013
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The Grandest Challenge begins with a simple premise: that every person's life is of equal value, regardless of where in the world he or she lives. It also begins with an alarming fact: that in this age of spectacular scientific advances, it is still those who live in the developed world--mainly the west--who overwhelmingly benefit from our enormous new power to combat disease and enhance food, while those in the developing world are far more likely to die for lack of basic health care and inexpensive nutrition.
As personalized medicine, designer drugs, and high-quality nutrients become more readily available than ever in the richest parts of the world, distinguished doctors Abdallah Daar and Peter Singer urge us to pause and ask these vital questions: Who will have access to the life-enhancing advances of biotechnology? And who are these advances ultimately meant to help?
In this challenging, controversial, thought-provoking, and humane book, Daar and Singer inspire us to look more deeply at our new science, and at the revolution that is already changing all of our lives.
In 1990, one study revealed that only 10 percent of global spending on health research was used to study conditions in developing countries, even though people there suffered 90 percent of the global disease burden. This became known as the 10/90 gap. Citizens in the United States, Canada and Western Europe were getting the lion's share of health research dollars even though their people suffered only a small fraction of the world's diseases. In other words, if you were an impotent, depressed, rich adult man living in the West, science delivered for you, in the form of Viagra and Prozac and a host of other remedies. If you were a poor person in Tanzania, you likely died long before you had to worry about the onset of midlife health concerns.
One big problem I started to see was that drug companies in the late 1990s felt the world's poor weren't a viable market because they couldn't ever pay back the cost of discovering, testing and bringing to market new drugs, a burden that the major companies claimed cost them up to a billion dollars for each new drug. In the last quarter of the twentieth century, pharmaceutical companies developed 1,393 new drugs, but only 16 of them were created to combat tropical diseases and TB.
Even when scientists discovered a remedy for a disease that affected both rich and poor, it took a long time to get it to the poor. When the hepatitis B vaccine was developed in the late 1960s,34 for instance, it quickly became widely available in the rich world, and today is routinely given to schoolchildren. In the developing world, however, where most of the world's hepatitis resides and where the virus is a common cause of primary liver cancer, the vaccine is still not widely available. In other words, the people who need the vaccine the most are the least likely to get it.
I became determined to change this, and in 1998, a year after my sister's death, I left my high-powered post as chief of surgery in Oman to begin an uncharted journey into the world of global public health. My move coincided with the extraordinary acceleration of the genetic revolution that had been building for a century, ever since Gregor Mendel conducted his meticulous pea-growing experiments to show how traits - or genes, as we now know them - are inherited. I knew that genetic science was still largely confined to the most sophisticated labs in the rich world, but I also saw that this revolution could offer hope to developing nations.
In 1998, I began working with my colleague Jean-François Mattei on a report for the World Health Organization. Together, we explored the ethical, scientific, social and legal implications of medical genetics and biotechnology, and how these might apply to global health.
From the Hardcover edition.
Praise for The Grandest Challenge
"The Grandest Challenge is not only enlightening, solution orientated and deeply personal but it also encourages the reader to challenge the existing norm and encourages us to ask ourselves pivotal questions."
—The Independent (UK)
ABDALLAH DAAR was born in Tanzania. He is a Professor of Public Health Sciences and of Surgery at the University of Toronto, and Director of Ethics and Commercialization at the McLaughlin-Rotman Centre for Global Health. He is the recipient of the UNESCO Avicenna Prize for Ethics of Science, and often advises governments and the UN, UNESCO, WHO and OECD on global health.
PETER SINGER is Director of the McLaughlin-Rotman Centre for Global Health and Professor of Medicine at the University of Toronto. He has advised the Bill and Melinda Gates Foundation, the UN Secretary-General's Office, the Government of Canada, and Pepsico Inc. He is also a sought-after commentator and public speaker.
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