To the Editor,
I vaguely recall the celebrations for the Apollo lunar landing and the Mets’ equally improbable World Series victory in 1969. It was not until the Saudi oil embargo of 1973, however, that a current event grabbed my attention and held on to it.
Of course, as I was only 10 years old, the explosion in oil prices was not personally meaningful; like the latest revelations about Watergate, it was just something else that grownups would grumble about. No, what stuck in my head were the gas lines.
It was while idling on such a line one day that I announced to my parents sitting in the front seat that I planned to invent a pill that could be dissolved in water and convert the liquid to gasoline.
“I sure hope not,” my father replied.
My mother asked him why he was so discouraging.
“Well,” my father said, “if Joseph were to invent such a pill, the oil companies would have to make him disappear before anybody found out about it.”
I have not inherited my father’s cynicism—or at least not all of it—but if one of our children were to announce plans for inventing the pill to cure arthritis, I would worry a bit about how the drug companies would take the news. After all, their business models are predicated on suppressing, not curing, disease.
A pill that cures arthritis would be embraced by the pharmaceutical industry with the same enthusiasm with which car manufacturers supposedly embraced the nascent Los Angles railroad in the 1940s. And if you are thinking to yourself, “But there is no Los Angeles railroad?” you can appreciate how unhealthful such an embrace can be.
Because I am not as cynical as my father, I don't believe that an arthritis-cure pill has been invented yet withheld from the market. Still, it is probable that there were projects abandoned and still other projects not started, despite good intentions.
Cures have not been a “specific aim” of our research efforts and serendipity has not been enough to bridge the gap.
As such, and as Dr. O’Keefe implies, an orthopaedic surgeon from 1969 traveling in a time machine 50 years forward to the present day would be completely at home with the contemporary approaches to managing arthritis.
We need to do better for the next generation.
Dr. O’Keefe contends, correctly, that the current system can yield major breakthroughs. Dr. O’Keefe also contends that by allowing inventors to retain intellectual property rights, the NIH indirectly offers prizes as well. He is right about that, too. But in the main, the breakthroughs and the prizes are for treatments that ameliorate diseases and not for discoveries that might eradicate them. We need to do better for the next generation.
Prizes for cures, in addition to the current funding systems, will help us get there.
Footnotes
(RE: Bernstein J. Not the Last Word: Prizes for cures. Clin Orthop Relat Res. 2019;477:1786-1789).
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