Pioneers in medicine

Abstract

Sometimes revolutions begin in the most unlikely of places. Iceland is a piece of volcanic rock in the middle of the Atlantic Ocean, inhabited by less than 300,000 people. Estonia is now the easternmost outpost of the European Union, after an overwhelming majority of its people voted on 14 September to join the EU. The country only gained its independence from the former Soviet Union in 1991, and the consequences of Soviet rule are still reverberating. But both countries are leading the way in the next revolution in medicine by establishing DNA and health databases of their populations, something that most larger countries have not yet begun to consider. “Many people are talking about population genetics, but you in Estonia are doing it,” said John Norton, Director and CEO of the UK Biobank Project, at the Gene Forum 2003 conference in Tartu, Estonia, this September. In fact, it seems to be easier for smaller countries, such as Iceland and Estonia, to go ahead with such initiatives. “Establishing a database is of course easier in Estonia with its small population [of 1.4 million people],” agreed Arvo Tikk, chairman of the Ethics Committee of the Estonian Genome Project (EGP) Foundation, not only for logistical reasons but also because it is easier to convince the public, and to adapt the laws and regulations. As of mid‐September, deCODE, the private company that is operating the Icelandic genome and health databases, had collected genetic data for more than 100,000 Icelanders. The EGP finished its pilot phase in March this year and since then has collected biological samples and health data from more than 4,000 Estonians. The aim of both projects is the same, but the similarities end there. deCODE is a high‐tech company based in Iceland's capital, Reykjavik, with more then 600 employees and state‐of‐the‐art …