Diokno, Laya Elena A.
February 20, 2009
Navarro, Lorina Ann M.
The Truth Behind the Race-Based Medicine
In the United States, African-Americans are shown to be 50% more likely to develop heart failure as compared
to other ethnic groups, and they are more likely to develop this early in life with symptoms more severe, leading to
hospitalization and deaths from this condition. Heart failure develops in African Americans more because of higher rate
of high blood pressure and diabetes, as well as, African Americans’ lower access to and use of health care services,
greater exposure to environmental pollutants, and greater tendencies to be overweight and to get less exercise (“BiDil”,
In 2004, the drug, BiDil which is composed of isosorbide dinitrate and hydralazine hydrochloride was
approved by the U.S. FDA (Food and Drug Administration). BiDil is a designed to treat heart failure in self identified
African Americans. It is the first Race-based medicine. Since the approval of the drug, there have been many questions
regarding the ethics and the biological aspect of what the drug entails, which is a medicine designed for a certain race,
as well as questions on the development of the drug, its trial and approval.
Its approval consequently fueled much discussion over the use of the term “race” in treating medical conditions
and the implications of having a drug that is restricted to one racial category. One of the most noted and controversial
articles the this debate is evolutionary biologist Armand Leroi's article, “A Family Tree in Every Gene,” in which he
argues that race is a “vital shorthand that enables people to speak sensibly about genetic rather than cultural or political
differences” and that its uses will reap benefits such as improved medical care and treatment, as different races are
prone to different illnesses from their specific characteristics (Leroi 2005). Inevitably, his article spawned backlash in
the scientific community, and he was criticized for his simplistic framing of race and also his disregard for the social
causes for disease.
The issue of BiDil and Dr. Leroi's article are both constituents of the greater issue that is the use of race in
medicine. While the consensus among anthropologists is that race is a social construct based on distinct physical
variation among people who belong in a certain population, and, more importantly, a non-biological entity and a
byproduct of historical and contemporary social, economic, educational, and political circumstances (AAA, 1998),
some scientists, however, the upsurge of genetic testing in the nineties and up to the present has given some scientists
the opinion that there is significant biological variation between different racial and ethnic groups in disease