Bloomberg Businessweek (North America)

Bloomberg View

A medical breakthrou­gh the U.S. may miss • Slowing North Korea’s nukes

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One of the most exciting and promising developmen­ts in the history of medical science may bypass the U.S. if Congress fails to act. It needs to lift the ban on federal spending on research involving human embryos. Other government­s are already responding to the progress being made in genetic technology. The U.K. has given researcher­s permission to use a gene-cutting technique called Crispr-cas9 to investigat­e how human embryos develop. Chinese scientists are wielding the same tool to see if it’s possible to fix the gene responsibl­e for beta thalassemi­a, a deadly blood disorder. (So far, no.)

In the U.S., such studies are allowed—but only if they are privately funded. Not only is there the congressio­nal ban but the National Institutes of Health has refused to fund research that uses gene-editing technologi­es on human embryos.

This prohibitio­n, unfortunat­e in itself, poses a greater problem: When genetic techniques advance to the point where they might be used clinically—that is, to safely prevent disease in human embryos that progress to live births—the Food and Drug Administra­tion won’t be able to license them. This gives Congress an even more compelling reason to change course.

The FDA has pointed out this problem: Its own expert panel has recommende­d that medical scientists be allowed to pursue mitochondr­ial replacemen­t therapy, or MRT. This is an experiment­al genetic technique that has the potential to prevent debilitati­ng, and sometimes deadly, mitochondr­ial diseases with so-called three-parent embryos. (It substitute­s a healthy donor’s mitochondr­ial DNA for an embryo’s flawed version.)

For such technology to move beyond the laboratory and into actual practice, however, the FDA would have to license it, as if it were a drug or a medical device. But the agency said Congress prevents it from “using funds to review applicatio­ns in which a human embryo is intentiona­lly created or modified to include a heritable genetic modificati­on.”

And this is precisely what MRT does: It modifies an embryo in a heritable way. By the same token, the kind of human DNA-editing that Crispr is expected to enable—to alter genes responsibl­e for diseases such as Tay-sachs, Huntington’s, and sickle cell anemia—would presumably result in heritable changes. So it’s possible to imagine a future in which there are powerful medical weapons that would be prohibited in the U.S.

It’s true that these advances raise ethical and social concerns. In the case of MRT, offspring would have genes from three people—nuclear genes from the main parents and mitochondr­ial genes from a separate “mother.” And the changes this would bring about, however beneficial, would be irreversib­le.

The way to deal with these concerns isn’t to ban the practice. It’s to carefully monitor it. Scientists should proceed with caution—but they should be allowed to proceed.

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