The Future Of Drugs

In an age in which so much of medical science is utterly incomprehensible--even to other scientists--it's comforting to remind ourselves from time to time that a lot of what passes for modern medicine is simply the refinement and repackaging of ancient remedies. Digitalis from foxglove. Opiates from poppies. Aspirin from the bark of willow trees. Even now, nearly 60% of the best-selling prescription drugs in America's pharmacies are based on compounds taken directly from Mother Nature's well-stocked armamentarium. It's as if there were a bright, healing thread running from the medicine bags of shamans and witch doctors to today's drugs for cancer, Alzheimer's and heart disease.

But that's about to change. With the mapping of the genome--the twisted double strand of DNA that carries the instructions for making every cell in the human body--the process by which new drugs are developed is being turned upside down. Trial and error, which is how medicines have been discovered for the past 100 years (and for millenniums before that), is yielding to drugs by design. Increasingly scientists, armed with blueprints for our genes, can identify the individual molecules that make us susceptible to a particular disease. With that information--and some high-speed silicon-age machinery--they can build new molecules that home in on their targets like well-aimed arrows.

How will this change our lives? The drugs we take? The pains we suffer? The diseases that finally do us in? The answers are as surprising as the science that is producing them. In the pages that follow we will try to give you a glimpse of the future by looking over the shoulders of the scientists who are searching--both genetically and the old-fashioned way--for tomorrow's miracle drugs. And in our first A to Z guide to the year in medicine, we will review the advances and setbacks--from aids cocktails to zinc supplements--that made 2000 such a remarkable year for patients and doctors alike.

--By Philip Elmer-DeWitt