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Web-only Exclusives
November 30, 2000

From Our Correspondent: Hirohito and the War
A conversation with biographer Herbert Bix

From Our Correspondent: A Rough Road Ahead
Bad news for the Philippines - and some others

From Our Correspondent: Making Enemies
Indonesia needs friends. So why is it picking fights?

Asiaweek Time Asia Now Asiaweek story

RE-ENGINEERING THE BODY OF THE FUTURE

Science will soon deliver miracle cures, designer babies and new dilemmas

By Choong Tet Sieu


asia in the new millennium
Mapping the Future The future wealth and size of Asian nations

The 21st Century By Arthur C. Clarke

Asia Trends 2000 The promises and perils of one wired world


The Microchip Silicon will get into everything
The Power As the region prospers, chances for conflict may become greater
Essay by Fidel Ramos Ending repression was easy; now we must defend freedom
The Dynasty It's here to stay
The Classes Many more Asians may escape poverty
The People Democracy in Asia will become increasingly deep-rooted
Essay by Bishop Carlos Ximenes Belo Shifts to new paradigms may include the "common good" and spirituality
The Mind Classrooms of the future will be virtually unrecognizable
Essay by Stan Shih The challenge of creating markets in a competitive world
The Body Science will soon deliver miracle cures, designer babies and new dilemmas
The Soul Asia seeks a new cultural identity
Essay by the Dalai Lama Balancing material progress with inner development to achieve true success
The Food Are the pushers of genetically modified edibles out to lunch?
The Vacation Inner and outer space are the destinations of the future
The Design Asia still has a place in the shape of things to come
The Metropolis Sweeping global changes are reshaping urban destinies
The Earth Environmental awareness is growing
The Jobs New and reinvented careers will fire the imagination
The Money The cashless society is on the way
The Investor Globalization and the Net will empower future shareholders and savers
The Sexes Democracy, capitalism and the Internet can lift women to the top
Essay by Marina Mahathir In Malaysia, we should change the way society looks at their roles
The Family The family promises to be much different than it is today
The Economy New ways of working call for new ways of thinking
Essay by Donald Tsang Financial well-being is a responsibility for each nation and the world
The Network The connection will go much deeper


The Asiaweek Round Table on ASEAN in 2020

Celebrations Asia is gearing up

Celebrities How some of the region's most visible personalities intend to welcome the New Year

Millenium Dictionary From pop anthems to dawn sites and midnight nuptials, a guide to 2000

YOU'RE BREAKING OUT IN a sweat and the old ticker is going bumpety-bump. What's going on? The medic sweeps a flashing gadget over your body and then holds it briefly against your skin. The diagnosis: hypoglycemia, abnormally low blood sugar. Most likely, the underlying cause is diabetes. She should be able to tell you in a minute.

Medical fiction? Not entirely. Portable devices that can monitor a variety of vital signs, if not provide instant diagnosis, are likely to be standard equipment in the next few decades. Simpler models may be available for personal use - an extension of home pregnancy tests, if you like. For physicians of the future, could biometric sensors be the new stethoscopes? Thanks to a marriage of computing, engineering and polymer science, devices may eventually be designed that will not only measure levels of metabolites in the body, but put the information together - and come to a correct conclusion each time.

Does that mean it will be easier to stay healthy? Many traditional enemies have been eliminated. Even among developing nations, epidemics of cholera and dysentry are largely nightmares of the past thanks to sanitation and immunization programs. Yet despite new drugs and therapies, medicine has not be able to bring many chronic ailments under control. Heart disease, for example. A joint study by the Harvard School of Public Health and the World Health Organization predicts that in 2020 we will fall prey mainly to non-communicable diseases such as cancer and stroke (see chart). But the top killer will remain coronary heart disease. This pattern extends to developing nations, too, where seven out of 10 deaths will be due to non-infectious causes.

But the bugs - bacterial and viral - will be here to plague us still. Time has blunted some of the initial panic over AIDS. All the same, experts reckon that about 11 persons worldwide are infected with the auto-immune virus every minute. And more than half of them are people between 15 and 24. Vaccines being developed now won't help the 7 million-plus infected people in Asia. But how many of those at risk can afford them anyway? HIV-driven vulnerability has helped an opportunist killer to stage a comeback: tuberculosis. Now the second most deadly infectious disease, it contributes to about 40% of AIDS death in the region.

As we approach the next century, the world is facing a dramatic increase in microbial threats. Scientists have identified at least 30 new disease-causing bugs over the past 20 years. And they seem deadlier than ever. Remember Ebola? This year, Malaysia experienced its own version of such terror. At its height, entire villages were deserted as residents fled the pig-borne nipah virus. Then there was H5N1, better known as bird flu, which struck Hong Kong. Just six people died, but officials around the world feared that avian viruses might swap genes with the human variety to form an extremely virulent hybrid.

The way we live - the factory-like nature of meat production, for instance - often creates conditions that help microbes proliferate. With half the world concentrated in urban centers, Hong Kong-based flu expert Kennedy Shortridge suggests that in the new millennium, "conditions will be ripe for respiratory infections to spread with even greater ease." In short, a flu pandemic is waiting to happen.

Meantime, defenses against bacteria are crumbling. Superstrains are emerging that prove resistant to even the most powerful antibiotics. The costs are enormous. Bacteria are responsible for illnesses ranging from cholera to meningitis. And we help build bacterial resistance by over-prescribing antibiotics and using them in animal feed and even household cleaning agents. But scientists in California may have found a new key to understanding bacterial diseases: a "master switch" which turns on infections.

One of the most profound impacts on medicine may come next year, when scientists expect to complete most of the human genome map. By identifying the genes that shape our physical character, researchers will be able to determine the mechanisms of disease. It will allow doctors to screen patients for risk of, say, cancer, and work out a course to minimize it. The promise is considerable. Gene-based drugs (permanent weight control is being mooted) will vastly extend the 21st-century pharmacopoeia. New therapies may also evolve from the Chinese medicine chest.

Health-conscious types of the future may prefer to take a precautionary bite of tomatoes modified to hold a vaccine. Want a complete physical just to be sure? You may not even have to see the doctor. Just as long as you have a wired home with the basics: electrocardio-meter, a gadget to monitor hormone levels and a toilet that will analyze the blood-sugar in urine. Matsushita Electric is ready to deliver this version of information infrastructure for the home by 2003. Of course, patients will want to keep their own medical records on a smart card (an idea some Hong Kong physicians are proposing), which can be made available to doctors they consult.

As organ engineering comes to the fore, autograft could be routine. Tissue rejection won't be a problem since replacements will be grown from patients' own cells. Specialists in body farms will coax undifferentiated stem cells into arteries, bone and even notoriously difficult cartilage (a boon for professional athletes). Bionic parts can enable the blind to see and the deaf to hear. Age - and stretch marks - will not deter having babies late in life. There will be artificial wombs, tanks circulating with artificial amniotic fluid, to nurture the baby until full term. Prof. Kuwabara Yoshinori of Juntendo University has had several goats born this way. In 10 years' time, he reckons he will be delivering babies. The discovery of telomerase, an enzyme that lengthens the life span of cells, may turn the clock back for aging body parts. Not only will we live longer (120 years, some say), we should be fitter too.

But as amazing as medical science may be, it is ultimately the means to an end - to ensure well-being. New advances herald new social and ethical dilemmas: genetic discrimination in the form of designer babies, for instance. There could be an unhealthy reliance on "lifestyle" drugs rather than exercising and eating properly. Insurance companies may use genetic screening to set higher premiums. Physicians worry about the consequences of increasingly remote relationships with their patients due to high-tech diagnostics. Communities as a whole must determine how well the new tools are used, and how the benefits are shared. India's Amartya Sen, a Nobel laureate for economics, argues that people should not see themselves merely as patients. We must also be "agents of change." The penalty of apathy, he says, is likely to be illness and death.


WHAT TO EXPECT

- Lifespans of up to 120 years
- Artificial wombs
- Cell transplants for Parkinson's disease
- Implanted biosensors
- Bionic eyes
- Designer babies
- Organs grown to order

THE TOP 10 CAUSES OF DEATH

1990
1. Heart disease
2. Cerebrovascular disease (stroke)
3. Lower respiratory infections (pneumonia)
4. Diarrhoeal diseases
5. Conditions of the perinatal period
6. Chronic obstructive pulmonary disease
7. Tuberculosis
8. Measles
9. Traffic accidents
Bronchus & lung diseases

2020
1. Heart disease
2. Cerebrovascular disease
3. Chronic obstructive pulmonary disease
(bronchitis, asthma and emphysema)
4. Lower respiratory infections
5. Bronchus & lung diseases (incl. cancer)
6. Traffic accidents
7. Tuberculosis
8. Stomach cancer
9. HIV
10. Self-inflicted injuries

Source: The Global Burden of Disease (WHO)

This edition's table of contents | Asiaweek home

AsiaNow



WASHINGTON
U.S. secretary of state says China should be 'tolerant'

MANILA
Philippine government denies Estrada's claim to presidency

ALLAHABAD
Faith, madness, magic mix at sacred Hindu festival

COLOMBO
Land mine explosion kills 11 Sri Lankan soldiers

TOKYO
Japan claims StarLink found in U.S. corn sample

BANGKOK
Thai party announces first coalition partner



TIME:

COVER: President Joseph Estrada gives in to the chanting crowds on the streets of Manila and agrees to make room for his Vice President

THAILAND: Twin teenage warriors turn themselves in to Bangkok officials

CHINA: Despite official vilification, hip Chinese dig Lamaist culture

PHOTO ESSAY: Estrada Calls Snap Election

WEB-ONLY INTERVIEW: Jimmy Lai on feeling lucky -- and why he's committed to the island state



ASIAWEEK:

COVER: The DoCoMo generation - Japan's leading mobile phone company goes global

Bandwidth Boom: Racing to wire - how underseas cable systems may yet fall short

TAIWAN: Party intrigues add to Chen Shui-bian's woes

JAPAN: Japan's ruling party crushes a rebel ì at a cost

SINGAPORE: Singaporeans need to have more babies. But success breeds selfishness


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