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The Next Revolution
Who's Ready? Who's Not?
by Juan Enríquez and Rodrigo Martínez
 Of course, there is no guarantee that the benefits of the life sciences revolution will be shared equally across the globe. Indeed, the incalculable opportunities this revolution opens up are matched only by the enormous challenges entailed in sharing its benefits equitably. Political, social and economic structures along with public policy choices determine the evolution of any technology and its applications. What will the life sciences revolution mean for the future of public health in the Americas? How can we make sure that Latin America and the Caribbean will participate in this revolution and enjoy its benefits?
Equally momentous revolutions of the past have shed some light on this question. The agricultural, industrial and information revolutions all showed the importance of understanding the rules of the game and developing a working knowledge of the "dominant language." Some people, countries and regions understood the transformation of an agriculturally based global economy into an industrial one (having 12 children and a lot of land suddenly mattered much less when one had access to a thousand horsepower). Countries that prepared their citizens to understand and adapt to the industrial revolution became the dominant global players. Thus England--a little island on Europe's periphery--was able to out-produce all and run the world's largest empire, while China's and India's relative importance simply collapsed.
Today, just as then, those who understand how technology is changing the rules and the dominant language and those who prepare their populations for these changes are the ones who will reap the benefits. All the others risk getting left further behind.
A new language
The life sciences revolution is based on the single most powerful language humans have ever tried to unravel, the language of life, in which every living thing on our planet is coded. This revolution actually started 49 years ago, in 1953, when James Watson and Francis Crick deciphered the structure of DNA. Their work introduced a new alphabet based on A's, T's, C's and G's (for Adenine, Thiamine, Cytosine and Guanin), the four nucleotides that form DNA.
Today the language of genomics is increasingly merging with the language of the digital revolution, which itself transformed the global economy over the last 50 years. The ability to transmit data through ones and zeroes (or light and no light) has shifted economic activity from commodities and manufacturing toward services and knowledge. In the 1960s, one-third of the global economy was agriculture, one-third was industry and one-third was services and knowledge. Today, services and knowledge account for two-thirds of the global economy, while agriculture represents less than 4 percent.
These shifts allowed some poor countries to reeducate their own populations and reinvent their economies, and today they are much better off. Examples include Singapore, Taiwan and South Korea all of which in 1965 were much poorer than Mexico.
A region short-changed
Unfortunately, most of Latin America and the Caribbean failed to make the required adjustments, and today we see some of the results. In every country of the Region, large numbers of people live in critical conditions. In rural areas of Argentina, Brazil, Bolivia, Chile and Mexico, more than three-quarters of the population has no access to clean drinking water, much less good health care.
While life expectancy has increased during the past half-century in most parts of the world, other regions have done better than Latin America and the Caribbean. In 1960, someone living in the Region could expect to live 58 years about four years longer than someone living in South Korea. In subsequent decades, South Korea which had few natural resources invested in human capital, and by 1999 the average South Korean could expect to live 73 years, two more than someone living in Latin America.
We see a similar pattern in infant mortality. For the last 40 years, Latin American and Caribbean countries have reduced infant mortality by 70 percent, while Singapore and South Korea have seen a 90 percent decrease. In the 1960s, an Argentine baby had about a one-third higher chance of survival than the average South Korean child. Today, an Argentine baby is twice as likely to die as a South Korean baby (and South Korea is not the richest country in Asia, nor is Argentina the poorest one in Latin America).
These gaps, unfortunately, could soon widen. According to World Bank data, health expenditures in Latin America increased from 5.8 percent of GDP to 6.4 percent during the first half of the 1990s. Yet this is less per capita than in Asia: in 1995, Latin American countries spent $192 per capita on health, while Singapore spent $926 and South Korea $551.
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