Why Personalised Medicine? A Short History of Commercial Interests and the Human Genome Project

The idea that people are genetically susceptible to common diseases was developed by the British eugenicist Ronald Fisher in 1918. In the 1950s, Fisher was employed as a tobacco industry consultant: his “constitutional hypothesis” was that smokers were genetically predisposed both to be more likely to smoke and to develop lung cancer, meaning the link being made with smoking was a ‘statistical coincidence’. Tobacco-funded scientists then laid the foundation for both behavioural and cancer genetics.

In the run up to the Human Genome Project in the 1980s, leading geneticists endorsed the idea that genetic screening would predict which smokers would get lung cancer, in order to convince the Reagan and Thatcher governments to fund their research. Their actions included secret meetings with the tobacco industry, jointly funding research, endorsement of false tobacco-funded findings in the press, and establishing a research institute and a journal, which discovered, published and promoted a string of misleading claims. They obtained support from a wide range of industries (tobacco, nuclear, chemical, food, pharmaceutical) by shifting the focus of the Human Genome Project away from genetic damage caused by radiation towards the idea that people who develop cancer, diabetes or obesity are born ‘one step on the way’ to developing these diseases through their own heritable genetic risk. Tobacco industry consultants argued that genetic screening of smokers would allow the one in ten at risk of lung cancer to be identified (and take individual preventive action) whilst the rest could ‘smoke with impunity’: a new concept of individualised prevention that would undermine attempts to impose tobacco control measures.

The food industry applied the same idea to hypertension, obesity and diabetes. The pharmaceutical industry became interested in using genetic screening to expand the drug market to rich healthy people, rather than poor sick ones, by treating genetic risk rather than symptoms of disease. Thus, controls on unhealthy products and pollution could be avoided and the drug market massively expanded: a “genomic revolution” in healthcare.

More recently, Web 2.0 companies have adopted the idea that collecting massive amounts of data (including whole genomes of whole populations) and feeding it into computer models will improve human health, in line with the Silicon Valley culture of “information science”, ignorance of history, and an individualised approach to understanding health and human behaviour. However, existing data shows that such computer models will inevitably have limited clinical utility, because Fisher’s underlying theory remains deeply flawed; complexity and indeterminism will limit predictability; and most early positive claims and findings are demonstrably false.