Troy Duster

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Position: Professor of sociology at New York University; Chancellor's Professor, University of California, Berkeley

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Issue: Are there scientific and medical justifications for targeting medicines at different ethnic and racial groups?

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Personal Point of Impact: Former chair of the Advisory Committee on Ethical, Legal, and Social Issues for the Human Genome Project; president-elect of the American Sociological Association; author of Backdoor to Eugenics

Technology Review: As researchers begin to better understand the genetic differences between populations, some are advocating using that information to develop and justify treatments and even particular medicines that target specific racial groups. Is this a good idea?
Troy Duster: There's not a quick and easy answer. I think under certain conditions, in certain contexts, race can be a proxy for looking at other factors. For example, we know that sickle cell anemia in this country is related to race because Americans of West African descent are at much higher risk. Where there are limited funds for a full-population screen, it would be legitimate to set up a screening program that is race related. But that is different than saying we're going to deliver a drug to a population defined by race. I think it is a mistake to begin with the assumption that race is a sufficiently precise category to deliver pharmaceuticals. Race is a huge and crude category with so much genetic variation that the idea of trying to come up with a drug specifically designed for such a population is counterintuitive and probably empirically wrong.

TR: And yet it is something being talked about by some drug companies.
Duster: Yes, I think it is because of profits and markets. Pharmaceutical companies don't sell drugs to individuals; they sell drugs to markets. So part of what is going on here is a market-driven biotechnology which is trying to find a population base for its product.

TR: But as you said, there are no easy answers. Are there potential benefits in looking at genetic-based medical differences between various population groups?
Duster: It is perfectly legitimate to ask why the rate of prostate cancer is more than double for group A than group B. And when that group A happens to be blacks in America and group B happens to be whites, then we come to the critical question of how to approach "whites" and "blacks." Given the genetic variation within any racial group, I think that the wrong approach is to assume a genetic basis as a first strategy to explain the difference. Rather, it is much more empirically valid to approach patterns of health disparities by focusing on external or environmental factors. To put it in plain language, it is fine to look at health disparities between any two groups-religious, gender, class, race, age, region of the country, et cetera-and ask why. But DNA should be the last place we look to try to explain those differences. Every molecular geneticist knows that there is far more genetic variation within what we call loosely African, European, and Asian continental ancestry than there is between these broad groupings.