2023-12-21 23:37:00
Opinion
Photo: Diego Peña Pinilla
In the 19th century, the average life expectancy was about 40 years, while in the 21st century, it has increased to about 70 years. This increase is due to various factors. Among the most important are nutrition, improvements in hygiene and advances in medicine. However, this increase in longevity has brought with it the emergence of chronic conditions and quality of life problems that were not so common before. Although infectious diseases remain prevalent and cause mortality, we have antimicrobial therapies and vaccines to combat many of these. We have even managed to talk about measures such as the eradication, elimination and control of some infectious diseases. (Read: For the first time in the last ten years, births were reduced in Colombia)
In the search for a longer life, non-infectious chronic diseases have gained significant relevance, since they represent a high percentage of disability and mortality. These conditions include metabolic, cardiovascular, neurological and mental health problems. Given this evolution and increasing prevalence, going backwards in aspects related to primary care and public health measures should not even be a topic of debate. At the same time, it is crucial to adapt to new forms of therapies that, although they may carry a higher initial cost, have the potential to significantly prevent the implications and impact of some of these diseases.
This openness to the future generates fear among the population and tension among the actors in the health system. Prevention and health promotion must be clear objectives in any system, but we must also integrate innovation into this vision, since ignoring it could generate a large therapeutic gap in human care.
The first, crucial step towards this objective involves achieving the conviction of governments about the importance of the issue. It is vital to initiate the development and implementation of new forms of medical therapy with determination, avoiding postponements that could lead to greater social and economic costs.
The arrival in 1804 to what is now Venezuela of the expedition led by the Spanish doctor Francisco Javier de Balmis y Berenguer, who carried the miraculous threads of the human smallpox vaccine, which was received with joy by the population. This event even inspired the creation of an ode by the Venezuelan humanist and patriot Andrés Bello. At that time without much biomedical knowledge, there were no significant questions. (Read: Lead contamination continues to affect millions of people around the world)
However, in 1885, with greater scientific progress and even after the attenuation of the rabies virus for vaccine purposes by Louis Pasteur, there were questions. The “vaccine” against rabies, although it had been previously studied in animals, generated all kinds of controversy in the academic community when it was applied to a child bitten by a dog suspected of having said disease. It seems that as more knowledge is acquired and procedures are perfected, greater questions and debates arise, just as we have experienced with the vaccines for Covid-19.
New technologies not only bring advances, they also raise new doubts and suspicions. It is evident that adverse reactions and complications arise, but we currently have ethical protocols for clinical studies that guarantee greater safety in their application to humans.
Today we have various biological treatments, which use components made by living organisms to address diseases. Recombinant proteins are an example, as they help replace missing or altered molecules in the body, such as cytokines or clotting factors. In addition, monoclonal antibodies offer hope to patients with advanced tumors without other treatment options, other than the use of cellular, messenger RNA or genetic therapies that will be used to treat or prevent diseases.
Therefore, we cannot afford to wait another three or four decades to initiate the necessary developments in new forms of biological therapy, as happened with the production of vaccines and serums in our country in the recent past. Currently, the crucial discussion is not only limited to health reform, but how we can start now to adapt to the medicine of the future.
*MD, PhD. Full Professor – Universidad de los Andes
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