Modern medicine makes it possible for many people to live with multiple chronic diseases for decades, but this has enormous social, financial, and environmental consequences. Preclinical, epidemiological, and clinical trial data have shown that many of the most common chronic diseases are largely preventable with nutritional and lifestyle interventions that are targeting well-characterized signaling pathways and the symbiotic relationship with our microbiome. Most of the research priorities and spending for health are focused on finding new molecular targets for the development of biotech and pharmaceutical products. Very little is invested in mechanism-based preventive science, medicine, and education. We believe that overly enthusiastic expectations regarding the benefits of pharmacological research for disease treatment have the potential to impact and distort not only medical research and practice but also environmental health and sustainable economic growth. Transitioning from a primarily disease-centered medical system to a balanced preventive and personalized treatment healthcare system is key to reduce social disparities in health and achieve financially sustainable, universal health coverage for all. In this Perspective article, we discuss a range of science-based strategies, policies, and structural reforms to design an entire new disease prevention-centered science, educational, and healthcare system that maximizes both human and environmental health.

中文翻译：

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跨学科研究和临床优先事项以改善健康。

现代医学使许多人有可能在数十年内患有多种慢性疾病，但这会产生巨大的社会、经济和环境后果。临床前、流行病学和临床试验数据表明，许多最常见的慢性病在很大程度上可以通过营养和生活方式干预来预防，这些干预针对的是特征明确的信号通路以及与我们微生物组的共生关系。大多数研究重点和健康支出都集中在寻找新的分子靶点以开发生物技术和医药产品。在基于机制的预防科学、医学和教育方面投入很少。我们认为，对药物研究对疾病治疗的益处的过度热情期望不仅有可能影响和扭曲医学研究和实践，还可能影响和扭曲环境健康和可持续经济增长。从主要以疾病为中心的医疗系统过渡到平衡的预防和个性化治疗医疗保健系统是减少社会健康差距和实现经济上可持续的全民健康覆盖的关键。在这篇 Perspective 文章中，我们讨论了一系列基于科学的战略、政策和结构改革，以设计一个全新的以疾病预防为中心的科学、教育和医疗保健系统，最大限度地提高人类和环境健康。