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In considering the question of why diseases exist Dr Moalem proposes that most common diseases came into existence for very good reasons. Diabetes hemochromatosis cystic fibrosis and sickle cell anemia may all exist because at some time in our past they helped our ancestors survive some grand challenge to human existence. In turn he also discovers that genetic and cultural differences have led to each race having different and unique ways of reacting to their environment and subsequently how they become susceptible to certain diseases.