The potential benefits of targeting drugs to the groups in which they have the greatest efficacy seem too great to be ignored. But the use of racial categories in this way continues to provoke strong and opposing opinions, as highlighted by the recent approval in the United States of BiDil as the first drug for use by a specific ethnic group.

In this case, the group is black patients at risk of heart failure, and the FDA made its decision on the basis of evidence that the drug is particularly effective in these patients. This move has been praised by many, including the National Medical Association, an organization that promotes healthcare equality for patients of African descent.

But this news has not been greeted so warmly in other quarters. Some commentators are concerned about the suggestion that the differential effects of BiDil are based on genetic differences between ethnic groups. This, they say, could divert attention away from other health inequalities that might have socio-economic causes.

Similar issues are raised in the Review on page 623, which discusses mapping by admixture linkage disequilibrium (MALD), a method for identifying disease-susceptibility genes. MALD, like BiDil, has great potential for use in specific ethnic groups. However, the authors of this Review hope that the use of MALD will ultimately move the focus away from the use of racial categories and towards an understanding of the genetic variants in each individual that predispose to disease.

In a similar way, truly personalized medicine would look beyond superficial categories to treat individuals. The question now is whether these benefits can be delivered in a way that makes them economically viable and available to all.