Ben Mack Hack­ing hu­man­ity

Idealog - - CONTENTS -

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

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