Headline, July24, 2013

'''THE DISSIDENT GENIUS OF

 EVOLUTIONARY BIOLOGY : 

SCIENTIST PAUL EWALD'''

As a society we have come to accept that most chronic diseases begin in our genes. It is  -thanks to the human genome project and much of the modern science  -the essence of the way we understand ourselves as evolved creatures. Our genome has come to be seen as the sum total of all our evolutionary being, and because it is subject to mutation and error, it carries through the generations the potential for diseases such as  -well you name it.

Dr Paul Ewald, though is of the belief that evolution brings creation towards ''something approaching perfection,'' so he wondered why natural selection did not do its job and weed out the genes for chronic disease, especially in the case of a disease like schizophrenia. ''Most schizophrenics don't reproduce,'' Ewald says,''so how can schizophrenia be a genetic disease?'' As is often the case with Ewald, he followed the implications of a question medicine seemed unable to answer.

He surveyed the medical literature and became perhaps the leading theorist for a movement of underfunded scientists who believe that infections answers the questions that genetics can't. He believes that you catch schizophrenia. Also autism. Also most cases of atherosclerosis that result in heart attack and stroke. Also Alzheimer's. Also a large percentage of cancers. Also multiple sclerosis. Also impotence.

He does not dismiss the possibility that genes are what makes us susceptible to infection; indeed, he published a paper that helped further the idea that people who are at a great risk of heart attack because they have the episilon 4 gene variant are at risk because epislon 4 makes them susceptible to infection by  a bug called  Chlamydia pneumoniae. This concession, however, only amplifies his conviction that medicine can best protect the episilon 4 population not by reengineering their genes but rather by protecting them from the primary infection.''No infection, no disease.''  says Ewald.

It is a simple notion, and the evolution itself, it gives rise to a series of fantastic and unsettling conclusions: that the promise of the human-genome project is, in Ewald's words, ''considerably overblown''; that ''the human health benefits from the study of genetics are tiny compared to the benefits of the study of infection''; that much of the data that will answer the biggest question in medicine were available at least as far back as 1940s, before the elucidation of the DNA molecule turned medicine away from answers that were staring in the face; and that medicine ''lacks the courage to pursue the causes of chronic diseases.''

Of course, ideas face their own competitive pressures and engage in their own competitive advantage. Ewald's ideas, in terms of his own preferred framework, have proven more virulent than transmissible, his is still distinctly minority position. ''When I wrote my first paper, I thought it would instantly transform medicine,'' he says.''But even now if you suggest to the Alzheimer's people that a pathogen causes Alzheimer's, they laugh. If you tell the flu community that they are wrong about the pandemic, they're dismissive, Then, if you ask them why they are dismissive, they get angry. Cancer researchers are the same way. They sneer at you, even though the three biggest breakthrough in cancer research ever, over the last thirty years have been in the vastly underfunded avenue of research.''

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