No Gene Cures
I wish there was a cure for diabetes. The techno-utopians want me to believe that gene therapies are on their way, and that a cure for diabetes might not be far behind. But after listening to a Long Now podcast about engineering gene safety those hopes have been dashed. Presenter Renee Wegryzn enthusiastically talked about DARPA and about how genetic engineering was revolutionizing everything. She mentioned something horrifying: RNA therapies. In addition to gene therapies that target DNA molecules, researchers are targeting RNA molecules. RNA molecules are generated on the fly, and so RNA therapies (unlike DNA ones) would not be permanent in the body. Wegryzn was enthusiastic about such research because RNA therapies would be reversible, and therefore potentially safer than DNA ones.
Do you see where this is going? DNA gene therapies are cures. They would be applied once, and then (presumably) they would never been to be applied again. RNA gene therapies are treatments. In order to keep enjoying the effects of the therapy, the therapy would have to be administered again and again. If you were a company that had the choice of deploying a DNA therapy that would earn you a one-time fee vs an RNA therapy that would earn you fees every time the therapy was re-administered, which would you choose?
Individuals within those companies might be genuine in their beliefs that they are looking for cures. The companies themselves want nothing to do with cures. They want treatments. Very few cures will ever be developed, because RNA treatments would be reversible and therefore "safer". So there won't be a cure for diabetes, even if such a cure is technologically possible to develop. Instead there will likely be a bunch of treatments people can continue paying for for the rest of their lives, which is not so different than the situation we are in now.