The enigma of drug discovery

Abstract

It is generally thought that we are on the eve of a new pharmaceutical revolution, and that the fundamental developments in molecular biology, genetics and biotechnology will soon bear fruit. In this sense it seems as though the “knowledge gap hypothesis” which attributed the decline in drug innovation in the 1960s and 1970s to a lack of fundamental knowledge may prove to be historically correct. The idea that complicated diseases can only be understood and treated at the bio-molecular level is becoming more widely accepted.¹ The quest for greater understanding in pathophysiology has led to increased molecular-level experimentation that should allow the drug designer and the biologist to make progress.² Considering the expansive growth in medical theory, the fundamental role played by medical-pharmaceutical practice in the drug discovery process might be regarded as in danger of becoming an anachronism. This view however is not only incorrect but also dangerous. It contradicts past events and misses the essence of the drug discovery process. It is also a threat to the development of new medical therapies. Because of the strong attractive power of this bio-molecular reductionist thought — in this respect there would seem to be a return of the classic view of drug discovery — it is worthwhile examining and clarifying anew the important role of medical-pharmaceutical practice.