Neil Schluger
Professor; Columbia Univ. Medical Center; Columbia Mailman School of Public Health

How is modern medicine changing the way humans evolve?

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What will we look like in 100 years?

Neil Schluger

Dr. Neil W. Schluger's  main area of academic interest has been in tuberculosis, including clinical trials, molecular epidemiology, development and evaluation of diagnostics, and human host immune responses. He is the principal investigator at Columbia University for the Tuberculosis Trials Consortium, a CDC-funded collaboration in clinical trials in which patients are enrolled in trials of treatment of latent tuberculosis infection and active tuberculosis disease. In addition, Dr. Schluger has led studies examining the transmission dynamics of tuberculosis in New York City, using tools of molecular epidemiology. He has a long standing interest in the development and evaluation of new tools for the diagnosis of tuberculosis.

 More recently, in addition to his studies in tuberculosis, he has led clinical trials for the use of retinoids in the treatment of emphysema and for the use of interferon gamma in the treatment of idiopathic pulmonary fibrosis.


Question:How is modern medicine changing the way humans evolve?

Neil Schluger: Well, that’s an interesting question. Evolution--  I would say modern medicine has probably affected it very little up until now and that’s because first of all evolution occurs very slowly and most of the things that modern medicine have- has accomplished really affect people’s lives when they’re finished reproducing. Right. So most people are having kids between the ages of let’s say 20 and 40 and that’s a very healthy population so most of those people don’t really get the benefit of modern medicine. You don’t start taking Lipitor and aspirin and having colonoscopies and all that stuff until you’re sort of 50 and you’re finished contributing to evolution at that point and you’re finished having kids so I don’t think now. The potential though is there because now we have tools where we can tinker around even before people are born and select babies who have certain genetic characteristics. We can diagnose things in utero and choose not to have those children so- but that’s just beginning but I think that’s where the impact of modern medicine on evolution is, and that’s a tricky thing.

Question: What might we look like in 100 years?


Neil Schluger: Well, I just read something the other day that predicted that in a relatively short time there’s going to be 9 billion people on earth, up from 6 billion, and I think that’s scheduled to happen something- within the next 25 years or so. So that’s an enormous increase in population and of course most of that is going to be in poorer countries. Birth rates in countries like the United States and other developed countries are pretty low so most of that increase is going to be in countries where there is a lot of TB and HIV infection and things like that, and so I think the population growth that’s predicted if health is not provided to those populations that population growth could actually consign those countries to poverty and disease for many, many years to come. It’ll just put more people in to situations where less things are treatable so to me again it’s one of the great motivations to try and increase the health of the planet.


Recorded on: 04/25/2008