Session One Keynote: Cost Innovation, Preventing Rare & Common Diseases
George Church, Professor of Genetics, Harvard Medical School
Geneticist, engineer, and chemist, Professor George Church, kicked off the 2019 9th Annual U.S.-China Health Summit as its first keynote speaker on cost innovation, and preventing rare and common diseases. This first session addressed precision medicine and advancements in biotechnology in healthcare. Dr. Church is a Professor of Genetics at Harvard Medical School and Director of PersonalGenomes.org, and his research and work involve pioneering the fields of genome sequencing, molecular multiplexing, and barcoding, as well as contributing to the development of nearly all “next generation” DNA sequencing methods.
With the advent of innovations in biotechnology, approaches to achieve higher quality and efficacy of healthcare often turn to the discussion of precision medicine. Dr. Church initiated this conversation in the context of cost innovation and preventing rare and common diseases. As with most newly developed biotechnology and innovations, affordability remains a key concern. Dr. Church proposed two ways of bringing down the price: completely switching to prevention or switching some of therapeutics to prevention. Additionally, he suggested that a focus on common diseases, where the fixed cost of conducting clinical trials could be covered by dividing it across a larger population, possibly that of the world, could reduce cost from being the most expensive to least expensive. His concern, however, is that the most common diseases tend to pertain to aging.
Dr. Church continued to introduce the relatively recent high-tech innovations to address important issue of transplantation. To begin with, he discussed the Personal Genomes project, which is the only open-access information on human Genomic, Environmental & Trait data (GET). Until 2013, the only way for transplantations to be successful was through donor-recipient matching for immunological compatibility. However, 2013 saw the introduction of three different editing methods: zinc finger, Tallens, and CRISPR, which provided new methods that could take one person’s cells and engineer them for compatibility in another person. Gene editing introduced a new method such that transplantation is no longer limited to just human to human but can now also be conducted from animal to human. This can be achieved through innovations like 3D printing, scaffolding, development from stem cells, and humanized pig genomes. Within the past six years, gene editing technology has transformed from only being able to achieve a couple gene edits to then 62 edits, up to today’s limit of 13,000, and this is only the beginning. While currently, edited pig organs will likely continue to be the most cost-effective method for a long time, human organs grown from human stem cells – organoids – have the potential to be relevant to transplantation. Human organoid transplantation remains to be more difficult and raises ethical issues in the context of transplantation, but it has the potential to contribute as a method of modeling human disease and developing and testing therapies.
Dr. Church’s session was a hopeful reminder as the Summit began, that amidst the discussions of healthcare challenges in China and the U.S., there are promising new innovations and technologies that have the potential to be made affordable and accessible with the precision and efficacy to care ore and treat patients of the future.