Drug development in the 21^st century: Medicines, man and receptors

Drug development in the 20th century has increasingly focused on efforts to define molecular substratcs - receptors, enzymes, ion channels etc - that can serve as targets for drug design. The advent of genomics has permitted the definition of receptors even in the absence of definition of their ligands or function. Whilst in principle genomics should generate a large increase in the number of potential drug targets there may exist, in practice, significant limits because of the complexity of the cellular signaling networks. Genomics has, however, influenced drug discovery in ways additional to a simple expansion of targets. It has provided the tools of contemporary drug discovery, the pathways to personalized medicines and, of particular importance, it has reshaped the nature of synthetic chemistry through the imposition of the paradigm of molecular biology. Despite this scientific success the fruits of medicine and healthcare remain mal-distributed. The poor world receives little attention and its diseases and public health infrastructure receive too little attention and too few resources. This is unacceptable since science, as mankind's single greatest intellectual achievement, should be shared by all.