Darth Ruinus wrote:Broomstick wrote:Something as simple, destructive, and beneficial as the sickle cell gene demonstrates why we should be cautious. Without question, elimination of the sickle cell trait would relieve great suffering and early death by eliminating sickle cell anemia. However, it would also increase the suffering and death created by malaria.
Wait hold, on. I'm not getting this. Malaria mainly occurs in the sub-saharan Africa, so unless you live in that area why would it be a bad thing to remove sickle cell trait?
Not true - malaria occurs in the entire Medditerrean area, India, south-east Asia, and the tropical Americas. It also used to be endemic in the US south - one reason the US Congress used to recess during the summer was to avoid the mosquito season in DC (now they do it largely from tradition). Anti-mosquito measures from pesticides to window screens significantly reduced the incidence in many parts of the world, even eradicated it in some areas, but the idea that only Africa needs to worry about it is in error. Europeans also have have blood mutations where 1 gene provides protection and 2 cause illness, but in that instance the disease is
thalassemia, not sickle cell anemia. Well, there are several types of thalessemia, one which has
four genes involved and babies that get all four die before or at birth, it's a fatal condition. The point being, I guess, that malaria has exerted so much selection pressure on the human race that
multiple defenses have evolved, all of which can cause increased infant/child death so the advantage conferred must be significant for them to be so widespread (thalessemia is also found as far east as Cambodia - strictly speaking, it's not a Caucasian disease, it's just that the Greeks and Italians have some of the highest rates of it). Clearly, if you live in St. Petersburg or Hudson Bay you don't need this trait at all, but a significant slice of humanity apparently still has need of it so despite the suffering caused eliminating it from the gene pool at this point is probably not a good idea. Given how people move around these days, such that people born on one continent may well move to another for their adult lives, there might be a rationale for, say, Caucasians bearing and raising children in, say, the north of Africa to bestow the trait on their children. Or for Africans moving to Siberia to have it removed from their children before birth. But wholesale elimination of the trait? No, not yet, not while we have
500 million cases of malaria a year world-wide. Without genetic protection the death rates would be even higher than they are now (that's a million or two people a year). Eradication is
theoretically possible (it has, after all, been eradicated from some locales, such as the US) but it takes money, effort, and a lot of work. Until we're ready to make the attempt giving up genetic protection against the disease is not wise.
Of course, if you live in an area where malaria is common then you would want the sickle cell trait, as it combats the malaria, but in any other situation you could remove it and not have to worry.
Unless, of course, you vacation or move to one of those areas or your children do or someone from one of those areas brings malaria to where you live.... Reintroduction to areas where malaria has been eliminated does keep some public health people up at night, it's unlikely, but if it occurs (and it can) it would be a major pain in the ass.