Ben Mack Hacking humanity
l o ok s at t h e New Zeal and c ompanies alt erin g l i f e as we know i t
A slew of New Zealand companies are helping us to l i ve l onger, healthier l i ves through biotechnology and are breaking new ground i n everything from gene editing, to organ transplanting, to bio- active paints. But what are the i mplications of editing humanity as we know i t? And where should we draw the l i ne?
Admit it: we all would like to live longer, if not forever. Likewise, we’d all like to change something about ourselves – be it our health, our body shape, eye colour, or even how smart we are. Call it our continued push for perfection. Call it “hacking humanity.” But no matter which label is affixed, it doesn’t hide the fact we’re continuing to use technology to modify ourselves in ways that not too long ago would’ve been thought impossible. And it’s something being done worldwide – including in Aotearoa.
Take, for example, what Kode Biotech is doing. “In the AUT Centre for Kode Technology Innovation we invented a range of bio-active paints that have the ability to stick to any living (e.g. cells) or non-living surface (e.g. plastic or metal) and then change the way that surface interacts with the environment,” explains Kode Biotech Group CEO – and AUT professor – Steve Henry.
But that, he says, is just the start of it. “These bio-paints can do many different things,” says Henry. “For example, one use of our bio-active paint is as a cancer immunotherapy. Injecting specific Kode molecules into a tumour to paint some of the cancer cells and teach the body how to recognise your own cancer as foreign, how to find it and kill it, wherever it is in your body.
“In theory, the technology could be as simple as injecting one tumour, and all your tumours will be killed wherever they are. Licensee trials scheduled for mid-year will show how effective the technology is in humans. Kode technology is also currently being used in a range of blood diagnostics and as a tool-box to enhance research.”
Translation: Kode is quite literally working on a cure for cancer – a cure that might very well one day be a reality. But that’s not all they’re doing. “Currently our R&D team at AUT is focused on developing Kode technology to prevent infections on surgical implants and to make bandages actively involved in healing wounds,” says Henry.
‘Smart bandages’ certainly sound exciting, and could save a large number of lives seeing as though infections kill millions of people around the world. “These are major global issues and as Kode technology has the ability to be applied to, and add a new layer of functionality to any existing product, it has the potential to improve the quality of life for millions of people,” says Henry.
While many biotech companies claim to be changing the world for the better, there is danger in taking companies at their word. Take Theranos CEO Elizabeth Holmes, who deceived the public about the viability of her ‘revolutionary’ blood testing technology. At its peak, the company achieved a valuation of about US$9 billion, but Holmes took investors’ money on the condition that she wouldn’t have to explain how the technology worked. It was then revealed that the technology wasn’t actually giving accurate results, putting a hole in her story about using tech to better humanity.
Then there’s the issue of abuse. Our own recent past – and present – is littered with examples, such as eugenics, the Nazis and the ever-present fear of terrorists or governments using ‘bioweapons’ against people that could inflict unspeakable horrors.
Henry claims that’s not a huge concern for what Kode is doing – but admits it could happen.
“There is little risk of Kode technology being abused as it is a temporary coating (i.e. not permanent like genetic engineering), but because it is a platform it is always possible someone may find an unethical use,” he says. “Society should always be concerned over the use of any new or existing technology and monitor its use and potential to be misused. In reality, once Pandora’s box has been opened only the conscience of a society is able to ensure ethical and moral use of that technology.”
Drawing a line in the ethical sand
Bioethicist Josephine Johnston is a New Zealand-trained lawyer with a master’s degree in bioethics and health law from the University of Otago, as well as the director of research at The Hastings Center in New York, the oldest independent, nonpartisan, interdisciplinary research institute of its kind in the world.
She says the ethical implications of what we can do to our bodies is an area being explored, and it will likely continue to grow as technology evolves and new technologies are developed.
“One of the biggest ones I’m working on, and a lot of people are working on, is genomic sequencing technology,” she explains.
According to Johnston, one of the main arguments involving genomic sequencing is that while some people see it as having the potential to cure diseases such as diabetes, cancer and a host of other illnesses that can be passed down from generation to generation, others view the individual genome as what constitutes one’s ‘individuality’ and their ‘essence’. In other words, your genes are what makes you, well, you.
Johnston also says that the US and a host of other nations (including New Zealand) forcibly sterilised large numbers of people, and some of the Nazis’ most horrific ‘experiments’ involved what they claimed was genetic research in their misguided quest to create superhumans and exterminate those they viewed as inferior.
“The history of eugenics is a massive shadow,” she says. “The eugenics movement was an early version of genetic research.”
There’s also the issue of differentiating what we call a ‘condition,’ and what simply makes us different. Johnston points out that sexual orientations other than heterosexuality, and gender identities not corresponding to the biological sex a person was assigned at birth, used to (falsely, as we know now) be considered ‘illnesses’ by mainstream science until our understanding increased.
Currently, there’s a large neurodiversity movement in which some people view such things as being on the autism spectrum not as a ‘defect,’ but a difference that helps make everyone unique.
“There’s enormous debate,” Johnston says, adding much of the debate boils down to whether these genetic traits should be removed or altered before a foetus is born. “It’s a really big issue in pre-natal genetics.
“Everything seems to be pointing in the direction that gene editing, things like the CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats, a DNA sequence) discovery, will be a fruit. But there will be debate about the misuse.”
And then there’s not just eliminating diseases like cancer and HIV, but augmenting ourselves to be smarter, stronger, look better, and anything else – and the industry that could spawn to cater to such desires.
“There will be companies that will market technologies or therapies to raise or lower IQ,” Johnston says. “There will be a market for it.”
Johnston doesn’t think a dystopic future is necessarily in the cards for humanity, or that we’ll have to deal with the machinations of malevolent genetically engineered superhumans. But they are still within the realms of possibility, she says.
Technology should ensure that l onger l i ves also mean better quality of l i fe. Dr Paul Tan NZeno director and CEO
The quality of life debate
One organisation exploring possibilities with genetics and what makes us human is NZeno Limited. The company is breeding gene-edited pigs with organs suitable for human transplantation.
“The New Zealand advantage is having pigs from the Auckland Islands that are free of common pig infections,” director and CEO Dr Paul Tan says. “The purpose of this technology is to have pig organs that can be better matched for human transplantation to relieve the worldwide shortage of human organs. The first focus is on kidney organs, but other tissues such as heart, lung or liver are potentially possible.”
Dr Tan says a focus for his company is not just using tech to help us live longer, but to live better.
“Technology should ensure that longer lives also mean better quality of life. For example, successful kidney organ transplants are widely accepted as being more cost-effective than dialysis (kidney machines) and offers a better quality of life.”
Kode Biotech’s Henry echoes the importance of quality of life. But that, too, he says, has risks.
“No doubt technology has the potential to enable us to have longer and better lives,” he says.
“However, living longer is only useful if it has quality, both for the individual and society as a whole. Unless solutions for mental health can catch up and then keep pace with extended lifespans, then living longer is not necessarily a good thing.
“There is also a potential risk that the removal of all bad and pain from society could be undesirable, as many of the greatest humans to have lived were not the healthiest or happiest.”
NZeno’s Dr Tan says no matter what innovative new technologies we develop, they need to be accessible.
“Health technology will solve some current health problems as it has in the past – correctable congenital malformations, cure of some cancers, infectious disease and the successful management of HIV/AIDs, the on-going challenges are in mental health and care of the aged,” he says.
“The impact depends on availability of beneficial technology to all who need it. For NZeno, it is important to us that safe and matched pig kidneys are made available at a price that governments can afford for all citizens who need it. We believe it can be made cost-effective for the national health budget.”
As with abuse of technology, the past is rife with examples of large numbers of people being denied access to medicines and procedures that could save or improve their lives.
Infamous CEO of Turing Pharmaceuticals Martin Shkreli, also known as ‘the most hated man in America’ jacked up the price of the lifesaving HIV/AIDS drug Daraprim by a factor of 56 from US$13.50 to US$750 per pill. That isn't unusual in the pharmacy industry. And while it was unrelated to the Daraprim saga, he is now in a US federal prison for securities fraud.
New Zealand’s unique approach
Johnston says the development of procedures that could make people smarter or stronger could very well create a society of ‘haves’ and ‘have nots.’ Or, at least, in some places. She says New Zealand currently has a model the rest of the world would do well to follow – one where new medical technologies aren’t usually introduced unless they are available to everyone.
“That’s kind of radical,” she says. “We try to make equally available the things we think are good.”
That approach will only become more important, Johnston adds, because of rising inequality in Aotearoa. “If you look at the last election, inequality was a political issue.”
There’s global precedence for making things that improve our lives freely available, Johnston adds. She says vaccines can be considered an example of using tech to extend our lives, pointing to how smallpox was eradicated in the 20th century thanks to a global vaccination campaign.
She says the continued efforts to eliminate polio – now only an endemic in parts of Afghanistan and Pakistan – through vaccination are another example. In both cases, the vaccines were given freely to everyone.
Dr Tan says that in addition for the need for new technology to be accessible, there is a very real danger of misuse. That includes NZeno’s technology.
“The gene editing technology is widely available,” he says. “The application of this technology to our herd of pigs means that we have control of the use of tissues from such pigs. The application of all new medical technologies have to be regulated.”
Regulation has long been a hot-button issue when it comes to medical technology – particularly new or potential new technologies. For instance, cloning an entire human is illegal in dozens of countries, but therapeutic cloning – cloning specific organs for the purpose of harvesting and transplantation – is legal in a number of nations.
Deep in conspiratorial fever swamps, there’s a fear of ‘human-animal hybrids’ that could result from implanting human DNA in animals. While such experiments have been conducted on a small scale, such as human brain cells implanted in mice, the idea of a human mind being trapped in the body of a mouse remains unlikely.
Regardless of the level of regulation, Kode Biotech’s Henry says the next 20 years will likely only see greater divisions between people who are able to access the latest healthcare technology and those who cannot, unless something radically changes.
“Society will be very different in 20 years – technology, in particular connectivity to technology (be that either access or desire), will almost certainly create divisions within society,” he says.
“By that, I mean those who want or are able to connect directly into technology will have significant advantages over those who don’t or can’t. This will create significant social issues.
“Within 20 years, from a healthcare perspective the biggest impact will be from integration of technology with the human body, which will range from connected devices that will be able to provide real-time monitoring and response through to structural devices such as artificial hearts, organs and exoskeletons directly controlled by the brain of the user. Equally important will be new understanding of disease mechanisms deciphered from genomic studies, which will allow for design of tailored approaches to treatment of diseases, and the importance of the microbiome.”
But, he says, those breakthroughs might not necessarily yield immediate results. “A lot will happen in 20 years, but the