| New gene therapies hold extraordinary promise, but they might not be enough to overcome a medical system that marginalizes Black Americans.  Illustration by Ibrahim Rayintakath In 1904, a twenty-year-old Grenadian man named Walter Clement Noel arrived in New York with a painful sore on his ankle. In the coming months, he would develop a cough, struggle to breathe, and feel dizzy and feverish. When he finally stumbled into a hospital, doctors were shocked. His red blood cells, which are normally smooth and saucer-shaped, appeared in “thin, elongated, sickle-shaped and crescent-shaped forms.” This was the result of sickle-cell disease—an illness that we now know affects an estimated one in every three hundred and sixty-five Black babies. Those with severe cases live to about forty-five years, and the disease has long evaded a cure—until now. Dhruv Khullar writes, in a fascinating piece, about the hematologist Haydar Frangoul, who became the first clinician to try “a new twist” on a bone-marrow transplant technique, in 2019. Frangoul’s patient, a thirty-three-year-old woman, had suffered from debilitating fatigue and pain since childhood. Frangoul extracted bone-marrow cells from the patient’s blood, edited the cells’ DNA using CRISPR technology, and then reintroduced them. Incredibly, the patient felt as though she had been cured. But, as trials continue, scientists are cautious about calling gene therapy a cure just yet. The potential price of these therapies could be as high as one million to two million dollars per patient. “A treatment that exists is not the same as a treatment that helps people,” Khullar writes, and advocates are also asking not just how to address the illness, but how to provide access to gene therapies for those who need it the most. —Jessie Li, newsletter editor | 
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