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1、PERSPECTIVEWilltomorrow’smedicinesworkforeveryone?SarahKTate&DavidBGoldsteinThroughoutmuchoftheworld,’race’and‘ethnicity’arekeythanstudyingdiseasepredispostion6,9,atleastinthenearterm.determinantsofhealth.Forexample,AfricanAmericanshave,Pharmacogeneticsalsoseemspoisedtobecomeacommonc
2、ompo-bysomeestimates,atwofoldhigherincidenceoffatalheartnentofthedrug-developmentpipeline10,withproof-of-conceptstud-attacksanda10%higherincidenceofcancer1,2thanEuropeanieshavingdemonstrateditspotential11.Forthesereasons,wefocusAmericans,andSouthAsian–orCaribbean-bornBritisharethispe
3、rspectiveonpharmacogenetics.~3.5timesaslikelytodieasadirectresultofdiabetesthanareForconvenienceofpresentation,weshallnotattempttodefine‘race’BritishofEuropeanancestry3.Thehealthcarethatpeopleor‘ethnicity’here.Ourprimaryaimistodiscusstheevidencefordiffer-http://www.nature.com/natureg
4、eneticsreceivealsodependson‘race’and‘ethnicity’.Africanencesamonggroups,andsoweconsidermainlyhowpeoplearedistin-Americansarelesslikelytoreceivecancer-screeningservicesguishedinthecurrentmedicalliterature,forexample,inclinicaltrials;andmorelikelytohavelate-stagecancerwhendiagnosed2tha
5、ntherefore,werefertodifferentgroupsas‘racial’or‘ethnic’groups.WeEuropeanAmericans.Healthdisparitiessuchastheseareoneofdo,however,brieflyreviewdebatesabouttheextenttowhichhumanthegreatestsocialinjusticesinthedevelopedworldandoneofgeneticstructurecorrelateswithracialorethnicgroupings.t
6、hemostimportantscientificandpoliticalchallenges.Theinfluenceofraceorethnicityontheefficacyandsafetyofexist-ingmedicinesmayguideourexpectationsforthefuture.Therefore,Mostcurrenthealthdisparitieshavelittleorperhapsnothingtodowebeginwithareviewofevidenceconcerningwhetherspecificdrugswit
7、hgenetics,dependinginsteadonsocioeconomicandotherenvi-workdifferentlyindifferentracialorethnicgroups.Theconcernsronmentalfactors4,includinginequalitiesinthedeliveryofhealthabouthowgeneticsmightinfluencetheinclusivenessofmedicinescancare.Butthisfactshouldnotmakeusrejectthepossibilityt
8、hatbiolog-be
