x Abu Dhabi, UAESaturday 22 July 2017

Mirror, mirror … how is my health?

With P4 Medicine, in 10 years each of us will have a virtual data cloud of billions of data points and the tools to accurately assess that data to optimise our health and avoid disease.

One day mirrors could assess your retinas for high blood pressure and diabetes.
One day mirrors could assess your retinas for high blood pressure and diabetes.

Imagine a world where you wake up in the morning and can immediately check the quality of your slumber on a sleep chart.

Imagine a mirror that assesses your retinas for high blood pressure and diabetes, or a toilet that instantly evaluates the state of your insides.

And how about a handheld device that makes 50 instantaneous measurements of your health from one droplet of blood or a tiny detector injected into your blood that circulates non stop, scouting for cancer cells?

Such a world where you can self- diagnose the health problems you have that day or the potential diseases you might develop that month, that year or over a lifetime, is not a fantasy.

According to the US scientist Leroy Hood, a world-renowned visionary, that world will be with us in just 10 years with the first steps towards its initiation already taken.

"In the future we'll all have our genome sequenced early in life and will be able to look at those genomes and make strong predictions about our tendency towards certain diseases. Once we've identified things that are possible then we can prevent them," says Mr Hood, a genomics pioneer and founder of the Institute for Systems Biology in Seattle.

Mr Hood has devoted his life's work to bringing about a revolution in the healthcare system and is finally on the cusp of seeing his efforts come to fruition.

He delivers 60 lectures a year on his vision, even flying half way round the world to Abu Dhabi last week to speak at the city's Intercontinental hotel - an event sponsored by NYU Abu Dhabi Institute - an arm of NYUAD that manages public programmes.

That vision is P4 medicine, a new type of medicine developed over his 40-year career that takes a systems approach to disease, ensuring that healthcare is dealt with on a proactive, rather than a reactive level and treats the individual rather than the masses.

With P4 Medicine - the four P's stand for predictive, personalised, preventative and participatory - in 10 years each of us will have a virtual data cloud of billions of data points and the tools to accurately assess that data to optimise our health and avoid disease.

For example a patient destined to get colon cancer at 40 can have their first colonoscopy at 25 to prevent the condition.

In turn this will help the healthcare industry not only demystify and tackle disease head on but also produce more cost-effective and targeted drug treatments.

How P4 medicine will manifest itself is like a sci-fi adventure. Each of us will have our own genome sequenced and stored on our medical record giving an almost horoscope-like insight into our future health and likelihood of developing certain conditions.

Our blood will then be used "as a window" to constantly assess our wellbeing, with a single drop taken by a handheld device measuring 50 major organs to enable early disease detection.

"If you give patients information, they can change their behaviour in a fundamental way and make themselves healthier. Part of that is education and motivation and seeing that you can make a difference in yourself," explains Mr Hood, the son of an electrical engineer.

The foundations of the vision were laid in 1970 when Mr Hood joined the California Institute of Technology, where he had previously studied, and became involved in the first of what he calls "five paradigm changes" in his career.

Over the course of 23 years, he developed five key technologies, including the DNA gene sequencer, that not only laid the technical foundation for modern molecular biology but were instrumental in ensuring the human genome project - a monumental scientific achievement that deciphered the sequence of human DNA - actually happened.

The project had its skeptics, but Mr Hood believed it was crucial to creating information-based medicine that would ultimately allow the healthcare industry to treat disease at the genetic level.

When the project completed in 2003, it gave him the tools to develop his new approach to medicine.

And all this from an extremely, quiet, modest man whose only overriding characteristic is his utter conviction that his prediction will prevail, even if he is not here to see it.

"If I'm here that would be wonderful and if I'm not, it won't matter," says Mr Hood, who reveals he never talks of his incredible achievements with his wife, two children or five granddaughters. "What I do want to do is make sure it's on a good trajectory to get there."

When you ask him how important he was to the outcome of the human genome project, he, again, underplays his role saying his level of importance is hard to define.

The truth is he attended the project's first meeting in the spring of 1985; he developed the technologies that made it all possible and ran one of the 16 human US genome centres that sequenced the human genome.

"I was there throughout," he says, shrugging his shoulders. "It was a reasonable role."

He took that role a step further when in 2000 he created the Institute for Systems Biology - a centre that takes a cross-disciplinary faculty of biologists, computer scientists, chemists, engineers and physicists and delivers an integration of these different technologies with biology and therefore medicine - an approach that led to the development of P4 medicine.

For a man who has already achieved so much, it appears he has a long way to go before he completes his journey though he is adamant he has no intention of retiring.

Instead, he is extremely active in ensuring his institute forms the strategic partnerships it needs to achieve his vision.

He has the Ohio State Medical School on board and a smaller medical centre with plans to have up to eight major healthcare players involved in two years' time.

On a bigger scale, he has a strategic partnership with Luxembourg, a small European nation that could potentially implement P4 medicine nationwide.

"The US has a very chaotic system and it would be really hard to reform but appropriate small countries offer the chance of doing something on a national basis that could in a five or 10 years be transformational."

He says the Middle East is also full of suitable small nations, adding that his talk last week was a perfect opportunity to introduce the idea to this region - a part of the world he also believes will benefit enormously from family genome sequencing because of the high levels of consanguinity. .

But he admits he alone cannot change the mindset of the global healthcare industry.

Instead, he believes the driving force for medicine to change will be patient-activated social networks.

"Doctors are too conservative. A good example is the triple therapy for Aids - it was Aids activists' who pushed that against the best judgement of the physicians and the pharmaceuticals. That's people power."

Scepticism is probably his biggest enemy. As any great visionary knows, there are a number of hurdles to clear to get a new system in place and for P4 medicine there are not only social implications, but also ethical, regulatory and even legal.

For example how early in a new life do you carry out the genome sequence? To what extent should your data be shared with the world to ensure scientists can analyse it and take it to the next level? And how much do we really want to know about ourselves?

If we're going to develop an incurable disease in 30 years time, is that information we really want access to now?

"Many conditions can't be treated so the question of how much you tell the patient is a matter of enormous debate ," says Mr Hood. "If it was me, I'd want to know, even if you couldn't treat it."

Whatever the hurdles of the future, Mr Hood's work is already proving effective.

"An example of something we've done recently is to develop a biomarker panel that has the exquisite sensitivity for differentiating soldiers that have post traumatic stress disorder (PTSD) from those that don't. For the first time we have a quantitative blood criteria that can say whether a soldier has PTSD or not."

It's a major breakthrough but Mr Hood still needs to convince what he calls "an intrinsically conservative" scientific community that he is right.

"In the human genome project in 1985, I'd say 90 per cent of the biologists were opposed to it. I've run into scepticism and hostility all through my career and in the end you just have to go out and prove you really are going to change the world and that's when the sceptics become believers.

"I think many people believe that much of what I'm talking about will come to pass - they would just put it at 50 years rather than 10 and they are totally wrong. I think 10 years is too long."

arayer@thenational.ae