La Lettre de l'Académie des sciences n°37-38

350

YEARS

SCIENCE

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Cell and gene therapies, for which first results have been obtai-

ned (hereditary diseases, some forms of leukaemia), may even

enlarge the therapeutic arsenal.

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The development of medical devices – such as a sophisticated

implant in ergonomic engineering research – is another source

of progress, and so is minimally-invasive surgery, which draws

on “augmented reality” obtained through the use of new software

combined with robotics.

And the results are here to see: life expectancy is ever-growing. In

France, between 1990 and 2013, life expectancy in men thus passed

from 73 to 78 years old, and in women from 81 to 85 years old. Such

spectacular results are also due to social progress but medicine and

especially improvements in perinatal medicine, preventive measures

and policies – hygiene and vaccination – so as the effective treatment

of many diseases, have been influential. The implications of such progress are twofold: the life expectancy

in good health has increased (4 years gained for men and 3 years for women in France between 1990

and 2013) but, at the same

time, a growing fraction of

the population lives with one

or several chronic diseases.

Indeed, of the 60-69 years old

age group, more than 75 %

suffer from at least one disease

and close to half of them have

at least five. Combined with

the ageing of the population,

this situation is a health and

economic challenge for our

society.

The challenges of tomorrow’s medicine and health

Despite spectacular breakthroughs, some fields of medicine have less progressed, as the questions

they raise are more complex. Such is the case, in particular, with diseases that are neurodegenerative

or sensory (deafness, blindness) and with mental health conditions. Changes in the environment and

behavioural evolutions are at the source of some progressing conditions: obesity, diabetes, addiction,

allergic or autoimmune diseases, bacterial diseases triggered by antibiotic resistance. Medical research,

boosted by progress in fundamental research, should take this into account.