The Power of the System
We know now what causes autoimmune diseases. We know to a certain level of detail what is MS and what causes it. Now that the technicalities of the diseases are known, we can work towards more effective therapies. But this requires change, change of the system.
Furthermore, this article that I find on the other thread makes quite compelling arguments why our system needs change. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140370/
on The Crisis of Capitalism and the Marketisation of Health Care: the Implications for Public Health Professionals
It is here that we run into problems. It is not the lack of medical technical understanding; it is the systemic issues that prevent change.
So many institutions and so many people from the health profession, science, commerce and government have so much invested in the current system, and therefore so much to loose by change. It is for this reason that we are not just dealing with problems of medical complexity but need to address political, economic and social issues.
It should be stressed of course that we are indebted to many of these institutions and individuals for so much progress over the last century. However, their very success, translated into power and influence, is now causing the problems.
As clinical medicine grew from strength to strength and its institutions became very grand and powerful, they have largely determined the shape of the whole health industry and how we think about health. They consolidated the power of the clinical medical profession.
But like the first antibiotics ended the grip of pneumonia and with that changed the course of history, the new insights in autoimmunity are set to change the course of history again, towards a whole new paradigm in medicine. This will not be a smooth transition or a gentle glide into the new world. Due to the inertia of the system, change will be disruptive and difficult, and resistance will be met everywhere. Powerful forces are opposing change, the scene is set for conflict.
Notwithstanding, with all current research e.g. into the role of the gut and the epigenetics and with patients becoming ever more vocal and networked (as here on TIMS) and sometimes even dictating new courses for clinical practice (e.g. on HSCT in Belgium), I am sure we are travelling in the right direction and change will happen. The big question for us now is how to accelerate the change, smooth its path and make sure that not too much damage is done on the way. In other words, how to make this transition as fast and comfortably as possible.
I think we need to stop having compartmentalized discussions in old vertical medical pillars and involve thousands of (young) people discovering the future for themselves as they help to create it. We need to do that in a more horizontal framework in layers as virology and immunology, the gut and epigenetics and microcellular biochemistry and oxidative stress whilst bringing together at the same time these interdependent layers.
I think it will need to be a process that I sometimes compare with the liberalization of the telecoms sector that was launched in Europe in 1987 (I was deeply involved). The 1987 Green Paper successfully defined a framework within which action could develop, leading to full liberalization of telecommunications in the European Union by 1998. At around more or less the same time, in the US the old AT&T was divested, the telecoms industry opened up and the Internet emerged. Under the rules of the WTO, the liberalisation process spilled over to many other part of the world. The subsequent decades saw an enormous expansion of services and entirely new industry dynamics. It is the medical world now that needs to be opened up in a similar way.
https://www.emeraldinsight.com/doi/abs/ ... 1311305399