Dr. Elias Zerhouni, Director of The National Institutes of Health talks about preventive vs preemptive medicine and the genetic and environmental factors of disease.
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Dr. Elias Zerhouni: Preventive healthcare is when you apply solution to total population because you have statistical evidence that on an average people will do better. Preventive healthcare is little different. You really have an understanding of the disease process at the very fundamental level and you specifically target both, the biological mechanism as well as the individual who is likely to suffer from that mechanism. So prevention has the potential of being much more targeted to the right individual for the right disease process, but the science is not yet there for all of it, we are using genomic to advance that science, that is what is the difference. We know that we should stop smoking and we should not gain weight and so on. Those are very generic preventive strategies, but what I want to see the world go to just to become much, much more precise in terms of performing that. In cancer really, there is a combination of genetic factors, but also environmental factors. Actually, every disease process that you think of has two components, one is your individual susceptibility to the disease is your genetic makeup and environment, so that if you did not have an environment where excess food was available, excess sugar was available. If you walked to school and like the old days you wouldn't gain weight, so at that moment therefore it is important to realize that you need to understand both the environment and the biology of the disease process, not just one or the other.