Medicine Curing Disease

The Academy says scientific advances mean in future there will be more opportunities to intervene with treatment before there are any symptoms.

It argues developments in genetics present a great opportunity to develop highly effective targeted therapies, with a clear idea of who will benefit and who will not.

I think it's unarguable that prevention is better than cure, and if you wait until the patient presents with signs or symptoms of kidney disease, liver disease, heart disease, very often most of the damage is done and can't actually be recovered.

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So if it were possible to take steps while still in health to prevent or delay the onset of disease that seems to make very good sense.

Sir Robert says he does not just envisage drug interventions for pre-emptive treatment - but his comments have raised renewed concerns about people being over-medicated.

This issue has already provoked fierce debate over the use of statins for people at low risk of heart attack and stroke.

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Professor Carl Heneghan from the Oxford University Centre for Evidence-Based Medicine, says the focus with disease prevention should be on issues such as physical activity, smoking and diet.

What we have to do is look at clear lifestyle risk factors. The future of healthcare is a healthier lifestyle. Only in certain diseases such as cancer will we find personalised treatments are effective.

The fact that prescription drugs are the third most common cause of death after heart disease and cancer should make policy makers wake up.

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Having a real impact on reducing demand and improving quality of care in the NHS will only happen when the root cause of lifestyle-driven disease is tackled head on and through de-prescribing; that is reducing an increasingly over medicated population.

Sir Robert Lechler argues as long as patients are given the best possible evidence, they should be given a choice. He says he welcomes a public debate on this issue.

The academy is also calling for closer collaboration between the NHS, academia and the pharmaceutical industry in finding new drugs. It says the current model of development is ineffective.

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What we need is an independent organisation, something like the Bank of England, that makes key decisions, in the public's interest, about how best to prevent disease and advise the public at large.Medicine can prevent polio and heal stomach ulcers, but what if it could successfully nip all diseases as soon as they showed themselves? Preposterous, isn't it? Incurable sickness is a part of everyone's life. Who hasn't stayed home with the flu? Of course, some people lose more than office sick days to illness, like their ability to walk, their vision or even their life or that of a loved one. In this article, we'll consider a world where every disease has a cure.

It's tough to imagine. Cures for everything sounds great, but what does that mean? First, it doesn't equate to prevention. For example, to protect yourself from getting HIV, you could, among other things, abstain from having sex and from sharing needles or have protected sex. Second, cures differ from treatments: HIV therapies can reduce the amount of virus in the body or help the recipient physically cope with a weakened immune system. For our purposes, a cure for HIV would mean that you could have the virus, take a pill and then no longer have the virus in your body.

Although it's fun to ask what if…, we should balance our fantasy with some skepticism. Could we ever achieve remedies for all diseases? Not likely. Each age bracket comes with its own illnesses. Even if we could extend the human life span to 200 by preventing maladies that kill us before we reached that age, it wouldn't be a healthy 200, but one that came with its own ailments, maybe some we've never seen before [source: Kennedy].

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Another factor to keep in mind: Wealthy and poor countries have such different common diseases that we'll look at the scenario separately in each place. First up, a high-income nation where everyone's heart is healthy, even after all-you-can-eat burgers and fries.

The top cause of death in wealthy countries is coronary heart disease (CHD), according to 2008 data from the World Health Organization. That fact is a product of the long life span and lifestyle characteristic of high-income nations. In our hypothetical world, there would be a cure for CHD. You could eat steak subs every day, but with the help of a pill, your arteries wouldn't clog.

Another pill would protect smokers, people with high blood pressure and diabetics from strokes, the second-largest killer in rich countries [source: WHO]. If you assume people are inherently pleasure seekers, you'd expect them to eat whatever they wanted, exercise less and smoke more in a world full of magical medical bullets.

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More people also might light up because lung cancer and related cancers, the third leading cause of death in rich countries, would be curable [source: WHO]. Not that smokers necessarily would live excellent lives. Many would be diagnosed with lung cancer, take a pill and then get lung cancer again. They'd have to cyclically solicit treatments for their smoking-related problems.

So far, this hypothetical world looks pretty bad -- that is, until we consider modern incurable diseases. Children with cerebral palsy or muscular dystrophy could choose a different life, if they wanted. AIDS patients could swap a succession of hospital visits and expensive drugs for an immediate, sweeping fix.

Not only would our experiment imagine away the big burdens, but also the little annoyances, like colds, ear infections and the flu. Since all of these ailments are viral, today's best efforts typically center on treating the symptoms and waiting for your body to clear the infection [source: Fauci]. In our what-if world, you'd spend fewer days suffering and miss less work or school.

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What if mental illnesses became curable? Sure, many mental illnesses are controllable, sometimes to the point that the people who have them don't notice them, but for the top three mental illnesses in the United States -- anxiety disorders, depression and attention deficit hyperactivity disorder -- there can be a period of chaos before control is achieved, and control can involve lifelong medication or worries about relapse [source: Kessler]. Cures could lead to a better quality of life. We also suspect that by alleviating mental illness two institutions would lose residents: hospitals and jails [source: Harcourt].

Rich countries have a tidy system of doctors, hospitals, pharmacies and emergency crews. How would it change if every disease had a cure? If the medical system were interested in keeping the most people healthy, it might expand screening. Medical establishments tend to invest in screening when catching a disease early really helps the patient, as with breast cancer. In our world of cures, doctors would be trying detect all diseases early, except no country could afford to do that. So, the public and every other interested party you could imagine would fight over how much to spend and which illnesses to include.

As in wealthy countries, most people in poor countries die from curable illnesses, such as lung infections and diarrheal diseases [source: WHO]. That fact suggests that low-income nations need more than cures. They need preventions, like sanitation and health education. They also require the money to pay for treatments, and the experts and clinics to distribute them.

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In our imaginary world, we'll pretend cures come for free and with the necessary infrastructure. If so, children would benefit first. Children die at much higher rates in poor countries than in rich ones. If you live in Chad, you're about 50 times more likely to die before age 5 than if you live in Denmark [source: WHO]. The youngest ones pass on as babies because they're premature, weigh too little, or the mother or baby suffers stress during birth [source: WHO]. The rest expire mostly from pneumonia and diarrheal diseases [source: WHO].If these killers never existed, women would need fewer pregnancies to have families of the same size, which could allow them to spend less time pregnant or grieving.

If these sicknesses suddenly disappeared, there'd be more babies and children running around the developing world, at least at first. To explore what a lower death rate would do for low-income countries in the long term, see our article on a world without illness.

Put away your malaria pills and suit up for a futuristic voyage of the HMS Beagle. We'll now predict what cures could mean for human evolution.

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With a cure for every disease, our evolutionary future might change. To understand why, we need to talk about genes. Genes are like options on a car. Alleles, which are sequences of DNA, make choices for those options. Option: Sunroof. Choice: Leaky sunroof. Among humans, there are plenty of alleles that are bad for us, as a leaky sunroof is on a car.

Some alleles are bad for us because they kill us or prevent us from having children when we're young. People who have such alleles often don't pass them on to their children. They die, or their disease prevents reproduction, so their alleles don't become