The Meaning of Cities   /   Summer 2017   /    Notes And Comments

Big Promises, Unfulfilled Expectations

Joseph E. Davis

Illustration by merrycallie; flickr.

Rethinking the “future proof” promises of overhyped public health breakthroughs.

One Team’s Relentless Hunt for a Cure” runs the headline in UVA Today. The article that follows announces that “UVA researchers are on track to eradicate Type 1 diabetes,” while a piece of clever graphic art features the word diabetes with the letters, written in sugar crystals, being blown away.

University of Virginia researchers are “leading the way to a cure”? I had no idea. I read on expectantly. According to the article, an interdisciplinary team is working on early detection…that might be promising…they’re working on a smartphone app to regulate insulin delivery…and making some progress…and they’re embarking on a “journey” to “find a cure.” Hmm. What about eradicating diabetes? Not even close. The ability to generate beta cells—the insulin-producing cells in the pancreas that are destroyed or rendered dysfunctional in people with diabetes—is, we learn toward the end, still “largely uncharted territory.”

The UVA researchers’ journey, underwritten by a $17 million gift from the university’s Strategic Investment Fund, will presumably take them into stem cell and gene therapy investigations. These are considered the most promising approaches to beta cell regeneration. And they are the two areas of research that have, in recent decades, stoked the most powerful popular and professional expectations for a flood of new medical discoveries and treatments.

Indeed, it has become increasingly common for journal articles, university press releases, and scientists in the media to tout such work as “game changing,” “robust,” “amazing,” “novel,” and “unprecedented,” to name but a few of the favored adjectives. Last year, recognizing that things had gotten out of hand, the International Society for Stem Cell Research (ISSCR) issued some overdue anti-hype guidelines. “Potential benefits are sometimes exaggerated,” the society wrote, “and the challenges to clinical application and risks are often understated.” It called for researchers to be accurate, restrained, and circumspect in talking about their work, particularly in making “forward-looking statements on inherently uncertain developments.”

The ISSCR worries that the inflated rhetoric around stem cell research “can have tangible impacts on the expectations” of the general public, patients, physicians, and policymakers. There is plenty of evidence that it already has. Hundreds of stem cell clinics now market unapproved and unlicensed procedures. But the funding agencies themselves may be the greatest victims of the hype.

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