IN 1958, British surgeon was in Uganda studying an obscure form of cancer that appeared to predominantly affect only . Further studies revealed a peculiar pattern of both geography and climate, suggesting it might be caused by a microbe. At the time, the view was that most cancers were caused by exposure to harmful environmental agents. But in 1964, with the discovery of the first human 鈥渙ncovirus鈥� in a tissue sample from an African individual. It soon became clear that this virus, now called Epstein-Barr virus, and other infectious agents are important causes of cancer, transforming our ideas about the disease.
Had Burkitt not worked with people in Africa, this might have taken longer to come to light. Studies of racially and ethnically diverse populations are the best way to reveal disproportionate disease risk and burden in specific groups, and they also benefit humanity as a whole.
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We in science and medicine aren鈥檛 immune to the biases and prejudices that lead to discrimination. To improve health for all, we must acknowledge how inequities continue to shape our professions and take concrete steps to put science on a fairer and more productive path.
The historical abuse of research in traditionally underrepresented populations 鈥� such as the unethical , in which Black men in the US were deliberately denied medical treatment 鈥� has understandably led to deep mistrust of medical research in these communities.
Yet history also teaches us that ethically broadening the diversity of research participants builds new knowledge that is widely applicable. An example is the story behind PCSK9 inhibitors, drugs that are extraordinarily effective at lowering the type of cholesterol associated with cardiovascular disease by targeting a protein called PCSK9. By ensuring African Americans were included in her studies, Helen Hobbs at UT Southwestern Medical Center in Texas that certain mutations in the gene that makes the protein 鈥� common in African Americans but rare in people of European descent in the US 鈥� are associated with a 40 per cent lower level of harmful low-density lipoprotein cholesterol. This led to the development of safe PCSK9-blocking drugs that are far more potent than statins.
Our own research, from to , provides similar examples of the need for diversity in research. Another recent found that, because cancer research employing the gene-editing tool CRISPR draws on 鈥渞eference genomes鈥� that are insufficiently diverse, it is prone to missing genes that, when mutated, promote the development of cancer among those of African descent. Only more inclusive research will improve these outcomes.
Studies that research by diverse teams has the greatest impact. This supports students from historically excluded communities to pursue careers in science. We must also encourage scientific inquiry that puts equitable practices at its heart and seeks to repair justified mistrust of the scientific community 鈥� for example, by partnering with historically Black medical colleges in the US.
Finally, we need continued support of large-scale initiatives that mandate more inclusive representation, like the US National Institutes of 91色情片鈥檚 programme, which is building huge databases of health data from more than 1 million people with varying backgrounds. It is past time for leaders across the scientific community to commit to a future of equal, open science that benefits everyone.
Michal Elovitz is at Icahn School of Medicine at Mount Sinai, Stephen Quake is at the Chan Zuckerberg Initiative and Hannah Valantine is at Stanford University.
