The 6.5 billion people in the Earth in the early 21st Century are split between social exclusion -poor quality of life and innumerable infectious and chronic diseases, among others- and social inclusion -that is, a substantial minority that enjoys high quality of life and is exposed to diseases that can be anticipated based on hereditary patterns, aging or their way or living.

A dramatic picture of such reality is the total failure in the plans made during the 1980's by the World Health Organization (WHO) concerning the "Strategies for Health for All by the Year 2000." Today, towards the end of the first decade of the 21st Century, there is prevalence of devastating diseases, including AIDS and tuberculosis as the icon of poverty; promiscuity; ignorance, hunger and death.

On the contrary, science, technology and innovation make headway, bolstered by a human force backed by cybernetics, satellites, systems and a wide range of management formats. Membership in the knowledge society provides the soundest assurance for the inclusion of human beings.

One of the most benefited sectors is the medical practice -including bio-analysis, pharmacy, dentistry, veterinarian medicine, among others- and multiple epidemiological, diagnostic and therapeutic approaches that forecast a new stage of prevention and cure of infections and chronic diseases. We could name it "genetically customized clinical medicine."

I am trying to match a brief explanation of the meaning of the new stage of clinic medicine with a sensible homage to El Universal in its 100th anniversary and to Venezuelan doctors overseas who are researches and institutional leaders in several medical fields of expertise. I am positive that their hearts are in great pain and deeply concerned about the country's plight under totalitarianism.

In order to attain this twofold goal, I will briefly elaborate on their opinions.

Let me start with my brother, Jesús Alberto Bianco C., a nuclear cardiologist and associate professor with Wisconsin University. "A comprehensive study of the high-tech generation of echocardiography, nuclear cardiology, resonance and positrons, together with powerful information software is needed. A preventive cardiologic map is being outlined, particularly for genetically sensitive patients."

Igor Espinoza-Delgado -the director of the program of immuno-modulators at the National Cancer Institute, Bethesda, Maryland- reminds us that the cancer biology is closely related to the genetic dossier of each person, turning it into an "individual disease." The development of biomarkers will help detect features in the tumor that will make it sensitive to therapies against specific targets. Such therapies will prevent continued renewal of the cancerous cell or the destruction of pancreatic islets in diabetes mellitus.

For his part, Guillermo Arreaza -the head of Clinical Immunology, National Health Institute, Bethesda- comments that this is the era of advanced genomics and proteomics, and epigenetics -which studies hereditable cell changes. This will lead us to a predictive, individual clinic medicine.

Immuno-dentist Natalia López -a researcher with McGill University in Montreal- reports that the exceeding function of regulating T cells put us in an immunodeficiency state and favors the outbreak of cancer. 

Rafael Marino, a bio-analyst and basic immunologist, also in McGill, dissects in mice genes and their products which make the bronchial asthma sensitive as he looks for new forms of gene therapy.

Epidemiologist Carmen Tamayo thoroughly investigates at the National Health Institute in Bethesda vegetal compounds in the context of supplementary alternative medicine. She agrees on the need to "customize" the genetic approach as the basis of the holistic -physical, psychological and social- protocol applied to the therapy of chronic diseases.

My good friend Joaquín Madrenas, a researcher with Western Ontario University, London, Canada, every inch a Catalonian, sums up this extraordinary development of medicine over the next decades. He anticipates therapeutic approaches, such as "genetic, molecular and cell intervention by using molecular and cell imagery, robotics, tele-presence, target-specific modulation and cell reengineering, based on the formidable union of cyber-science, biological systems and huge databases."

These contexts of clinic medicine in the early 21st Century, defined by Venezuelan and friendly voices, seriously worsen our medical present and, above all, the shabby skeleton of the national health sector. Ten years of outrage and a deeply anti-national campaign that comes from top government levels have tirelessly slandered the noble, abnegated group of Venezuelan doctors.

Venezuela has always had exceptionally valuable medical children. Its public universities, with Central University of Venezuela in the vanguard, have yielded Vargas and Razetti, Gabaldón and Oropeza, Baldó and De Venanzi, Agüero and Pérez Carreño, and finally, thousands of young doctors who render a high-quality service elsewhere.

The grandeur of human creation will continue being the best clue to hope. Today's generations and the students attending our university classrooms make sure that Venezuela will take the way of freedom and development. Every endeavor and hard work awaits them.

How fabulous would be taking part in this destiny!

Nicolás Bianco
Academic Vice-President and Doctor Honoris Causa, Central University of Venezuela

Translated by Conchita Delgado