To those of us observing the advance of medical science from the sidelines - via the press, the scientific journals, our connections, and vague memories of being part of the scientific process ourselves at some point in time - progress is simultanously blisteringly fast and frustratingly slow. How can this be the case?

First the fast of it. The most advanced, most promising medical science is now tied to computer speeds and chip sizes, to the computer revolution. Bioinformatics and labs-on-a-chip mean that ever more biotechnology can be done ever faster and at an ever lower cost. The Internet and data mining methods mean that new advances are never consigned to isolation; if an advance published somewhere, any scientist can find it and improve on it. It is not uncommon to see the following sequence of events in medical science these days:

• An interesting new idea is explored in theory and published
• Three to six months later, someone is tinkering with tissues in petri dishes, showing that the idea has practical merit
• Another six months later, the idea is demonstrated in mice
• Six months after that, scientists in a new company are talking about setting up human trials

This sort of pace is insane, impossible, counter-intuitive to someone brought up the world of the 1960s and 70s. We're accustomed to think of any given major scientific development in medicine as being a process of rumination over the better part of a decade. Nowadays, researchers are turning out new science so fast that there is a growth industry in reporting on it!

(See Science Daily, EurekAlert, BreakThrough Digest, Science Blog, ScienCentral, and many, many other upstart organizations biting at the heels of the old, established science news sources).

Did you know that, during the past year of keeping the Longevity Meme up to date, I have seen reports on sixteen different potential cures for various classes of cancer in the works somewhere between the lab and human trials? Sixteen! With all this heat, light and noise, why is it that new advances are so slow to make it into the marketplace as therapies and medicine? We've been curing diabetes in mice using regenerative medicine for more than a year now, for example. Where is the human version of this cure? Likewise, as this article from SAGE Crossroads points out, "labs around the world are crawling with prodigiously long-lived flies, worms, and mice" in just the past few years. When do we humans get to see all this new life-extending medical technology?

Alas, the fast world of modern medical research - enabled by computers, bioinformatics, ingenious labor-saving devices and the Internet - is still bound to the old structure of business cycles, Big Pharma, heavy government regulation and basic human nature when it comes to bringing new medicine to the public. It doesn't matter how fast you can develop and improve major new medical product, it's still going to take the better part of a decade and a billion dollars to get it approved by the FDA. It's still going to take a few years to find investors, to build and capitalize a company capable of delivering that product. That company may fail, for any number of reasons, leaving it to another group to start over. If you have to build an industry first to support your new medical breakthrough - as is going on right now for stem cell research - well, you'll have to wait for a few more years for the toolmaking and basic infrastructure companies to get going as well!

Things slow down when you move away from a task that can be done by a few people. Modern medicine is complex. It takes many people and many interactions to deliver any new therapy from inception to final product. A scientist can often make major improvements to a medical product in a month - but you'd be lucky to negotiate a major deal between companies, or with a government, anywhere near as rapidly. I'm not going to claim that all of the time sinks mentioned above are necessary - in particular, the FDA is an bloated, self-interesting, uncaring bureaucracy that slows medical development to no good end - but all major efforts in this world take time.

Once you stop seeing the first rush of science news on any given hot medical technology, you can be fairly sure that there is a boil of activity going on where you can't see it; companies, investors, regulators, all slowly bringing the new product to market. A few years here, a few years there. It adds up, it's frustrating, but it's the way things are done today. We're all crossing our fingers and hoping that someone invents the equivalent of bioinformatics and labs-on-a-chip for basic business and regulatory processes. It might happen, you never know.

Posted by Reason at February 10, 2004 7:50 PM | TrackBack (4)