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Global health and precision medicine: Highlights from day two of Stanford’s Childx conference

"I do think it's possible to end preventable child death." Those were the powerful words spoken by Rajiv Shah, MD, the former administrator of USAID, during his keynote address at the start of the second day of Stanford's recent Childx conference. More than 6 million children die each year before age 5, mostly of easily preventible diseases, Shah told the audience.

Shah went on to describe some of the more daunting health and humanitarian crises he faced during his 5-year tenure at the helm of United States Agency for International Development, including the recent Ebola outbreak in West Africa, and the Somali famine that he helped to address with the U.S. government's Feed the Future program. Speaking about visiting a severely overcrowded Somali refugee camp, he said, "If you looked closely, you saw signs of hope and innovation." For instance, children were receiving the pentavalent vaccine that protects against five serious childhood diseases and that was, until quite recently, considered too expensive to distribute in this type of setting.

Shah also described how a rapid redesign of protective gear for health-care workers fighting Ebola was essential to helping get the highly contagious illness under control: The old gear was much too hot and cumbersome, as well as being difficult to remove safely, and may have been a factor in the high rates of infection among health care workers early in the Ebola outbreak. Several partners, including NASA, the Department of Defense, Kimberly-Clark and Motorola, worked together to make new protective equipment that was easier to use and better suited to intense heat.

Our capacity to innovate is essential for solving global health problems, Shah concluded. "...Saving children's lives in resource-poor settings is not just... great and morally important," he said. "It actually creates more stability in communities." Families have fewer children and invest more in the education of those kids, including the girls, and the surrounding society begins to look more stable and prosperous, he said. Innovation and technology in the arena of child health are important "not just for health purposes but for shaping the kind of world that keeps us safe, secure and prosperous over many decades."

Shah's talk was followed by a session on precision medicine, a priority for both President Obama, who called it out in his most recent State of the Union address, and for medical researchers across the country. (The School of Medicine's dean, Lloyd Minor, MD, opened the Childx conference by saying, in part, "Our vision at Stanford is to lead the biomedical revolution in precision health.")

Childx audience membersStanford's Euan Ashley, MRCP, DPhil, described how the new accessibility of personalized genome sequencing will change medicine. (He got a laugh from the crowd by telling us that if Ferraris had experienced a drop in cost that was proportionate to that of genome sequencing, the $400,000 sports cars would cost 10 cents, and we could each get one "and drive away from here very fast when we're done.")

He talked about a few early cases of genetic data being used to make medical-care decisions, including the case of a Wisconsin child named Nicholas Volker, likely the first child anywhere to have had his life saved by DNA sequencing. Nicholas had what appeared to be a very severe case of Crohn's disease, but standard treatments didn't help him. After sequencing his DNA, his doctors discovered that his illness could be explained by a gene mutation that was causing a rare lymphoproliferative disorder. He received a bone marrow transplant in 2010, at the age of 5, and has since been doing much better. "It's an absolutely remarkable story about the power of genome sequencing," Ashley said, noting that as part of the NIH's Undiagnosed Diseases Network, Stanford is expanding physicians' ability to use genomic data to make decisions for patients' medical care. "Genomic medicine is here, we're doing it, and it's changing the lives of our patients," he said.

Previously: Innovating for kids' health: More from the first day of Stanford's Childx, "What we're really talking about is changing the arc of children's lives:" Stanford's Childx kicks off, Countdown to Childx: Global health expert Gary Darmstadt on improving newborn survival, Countdown to Childx: Q&A with pediatric health expert Alan Guttmacher and Countdown to Childx: Stanford expert highlights future of stem cell and gene therapies
Photos by Saul Bromberger

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