So it might not be for you this morning if you're not in the mood to think big.

Professor John Bell.

There is this extraordinary thing that although everybody has this conversation about the future of the island, most people have not actually thought about the island.

We think of ourselves primarily as an agricultural economy, which is a good thing.

We think of ourselves as an industrial economy with tech that's linked in some way to the continent and all the rest.

But the idea that we're actually principally an island, leaving aside the political geography of the island, just in terms of our geography, that we are a large ocean state, which most Irish people wouldn't realise because the size of our seascape is somewhere between seven and ten times the size of our land.

And that means something now.

If they were to be applied, what would a place like Galway look like 30, 40 years from now if it was a successful bioeconomy hub? But it would have less

You know?

You know, just I, I looked at the, the list of people we have on this issue, and it's amazing.

I would say congratulations, Kristen, on organizing this because it's really fascinating spectrum of topics I think that people are really gonna enjoy.

I'm not, I'm not an aging specialist.

I'm a cancer guy like, uh, like Joe.

And, um, and what I found really fascinating about it was, you know, I trained as a virologist, immunologist.

I, I think you did as well, Joe.

[laughs]

So surely, unless we change how the clinical trial part of this works, we're only gonna see the very richest people able to really benefit from the revolutionary treatments.

Yeah.

So great question.

So one of the things we haven't talked about was this revolution in therapies for rare disease and ultra-rare disease and ultra, ultra-rare disease where only one person on the planet has the problem.

But because of genetics and the commoditization of genetics, we can now identify the exact mutations that cause those things.

And there are now ways to correct many of those using short strands of DNA that you-- called oligonucleotides that you can put in, which will actually change the way the gene operates.

So if you only have one person with the disease, it's hard to do a [chuckles] clinical trial.

But is there an issue here around the incentives on the firms involved to bring the prices down? We've got a little punchy question here from a listener called Adrian, who says: "Given the impact that this all has on equitable distribution of medicines, can we rely on Sir John to be fully impartial on the subject of intellectual property and the bias in favor of richer nations and their pharmaceutical giants?" Is there a fundamental conflict of interest here around getting these treatments out as cheaply and as broadly as possible, or are there incentives that will at least encourage companies to go slower on the cost reduction?

Can you talk us through what's happening behind the scenes there?

Yeah.

There are three or four major types of leukemia, and you're absolutely right.

30 years ago, they were mostly all a death sentence.

Very tragically, a couple of them occur in very s- young kids, which made it even worse 'cause these are kids who never really had a chance.

But then there are other forms that occur in later life and, um, and people in middle age.

Of those, there's only one left which has really not been tackled by novel therapies.

The, the fact that we're, we're talking here less about these general one-size-fits-all medicines and more tailored to the individual.