The Development of Race-Specific MedicationsSarah Don 2009

As science advances and looks for new ways to branch and develop, the concept of race-specific medications has become an area for interest and investigation. However, scientists argue about what “race” actually is, how to define it, and whether different races are significantly genetically varying enough to be able to make medications targeted at a particular race group. The following is a summary of four articles on the topic of race-specific medication and how the authors think the drug development research process and trials should be altered in order to more accurately target a specific group of people with high disease frequency.

Race in a Bottle, an article published in the Scientific American in 2007 by Jonathan Kahn, discusses the viability of race-specific and genetically-targeted medications. In particular, Kahn used the drug BiDil as an example to address the viability of such medications and their trials. BiDil is a heart medication for the specific treatment of congestive heart failure in African-Americans. According to the article, studies done by Jay Cohn and NitroMed did not yield any results to prove that BiDil reduced the frequency of heart failure in black people more than in white people. Kahn concludes by suggesting that such race-specific medication is a result of racial injustice and greed, rather than an effort to reduce disease in a particular ethnic group that is affected more than other ethnic groups.

Race and Reification in Science by Troy Duster, published in Science in 2005, investigates the factors that influence racial identity. Duster also makes reference to BiDil, saying that under the pressure to build DNA databases to help identify genetic-racial connections, scientists have made “ethnic estimation[s]”, resulting in such occurrences as BiDil being labelled as a African-American drug only. Duster believes that more research should be conducted on BiDil and that the FDA should approve it as a drug for everyone with similar genetic markers as those in the original trials who responded well to the drug, and not just people with dark skin colour.

Conceptualizing Human Variation by S O Y Keita et al, an article published in the scientific journal Nature Genetics in 2004, discusses the similarity of the human genome across species and how geographical location and environmental factors may influence genetic differences between “races”. In the article, the concept of “race” is described as, “…people [of] a breeding population, based on a particular behavioral pattern of mate choice, as opposed to being defined by an anatomical trait complex.” (Keita et al, 2004) The article also states that, “Individuals with the same morphology do not necessarily cluster with each other by lineage, and a given lineage does not include only individuals with the same trait complex (or ‘racial type’).” (Keita et al, 2004) This means that genetic similarities are more likely to be found in people of the same ancestry rather than those of similar appearance or present geographical location. The authors explain that when there are questions without answers in regards to diseases, scientists look for connections in areas such as race, however they may find more by ignoring appearance and looking at ancestry.

In the article, How Social Status Shapes Race by Penner and Saperstein, incarceration, unemployment and poverty are identified as key factors that determine a person’s own racial identity. In the study carried out by Penner and Saperstein, approximately 13,000 individuals were interviewed every year for nineteen years. As part of the study, the individuals were asked to identify themselves with a particular race – black, white or other. The interviewers were also asked to classify the subjects as belonging to one of the three race groups. The results showed that “races are… created through social processes and subject to economic and political calculation.” (Penner, Saperstein, 2008) Over the course of the trial, an individual’s economic situation evidently caused a fluctuation in which racial group they identified themselves with.

In the case of race-targeted medications, if a person identifies themself as a black person and is prescribed with BiDil, but they don’t have the genetic markers to make the specific drug combination of BiDil work most efficiently, they may not be receiving the most effective form of treatment for their disease. Similarly, if a person identifies as being white and they do have the genetic markers to make BiDil (and other similar drugs) work most efficiently, they may be denied access to the very medication that may save their life. All the articles address this issue, either specifically or implied, and stress that physical appearance is a very shallow level to be conducting clinical trials at, and that ancestry may be a key in unlocking similar genetic markers across ethnic groups.