biotechnology dna science image from pixabayIn H.G. Wells book The Time Machine, a trip to the year 802,701 AD sees humanity split into two offshoot species: the subterranean Morlocks and the surface dwelling Eloi.  This change, in Wells’ work, was at its fundament an outgrowth of class inequality in Wells’ present, the late 19th century.  The concept may seem bizarre at first glance, but we already see biological distinctions based on economic means today.  Further, emergent biotechnology shows the capability to rewrite the function of our bodies at the genetic level – not in some speculative future, but today.  Wells suggests the split derived from a continually widening gap between the working class and upper class, a tension that at the time of writing in 1895 was becoming particularly acute in Europe.  While this dual-class division is not as well defined in our era, the implications of differing groups – between global regions, between nations, or between groups within various societies – raises similar questions.  Are we on a path that sees humanity divided not simply by access to resources, but at a fundamental biological level?  There are movements within public policy circles that are taking the concept seriously, with significant potential impact to how the health industry and biotechnology research are structured and function.

On its own, economic inequality probably would not get us to a “morlock situation”, even with 800,000 years of evolution.  After all, poverty has historically tended to shorten lifespans for a variety of reasons: starvation, disease, and violence in the past, and issues such as obesity or alcoholism in the last few centuries.  In the 200,000 year history of homo sapiens, at least 10,000 of which involved sedentary agriculture, we have not seen a speciation along economic lines.  Wells’ himself was not trying to accurately predict the future, of course; his take was a commentary on class division in his own era, a sardonic outlook that saw the wealthy transformed by their own opportunity into food for the working class. But science may be providing a shortcut to speciation that could (among other possibilities) shake out along economic lines.

New therapies are allowing the medical profession to “train” the body via biologics to identify and overcome chronic diseases, notably in fields such as oncology. Immunotherapy has begun to resonant in the popular consciousness, in part by high profile remissions of late stage cancers in people such as Jimmy Carter.  The current drug pipeline includes new immunotherapies and biologics based treatments for many age-related ailments, perhaps most notably Alzheimer’s; while a “cure” for aging is unlikely to arrive in the near future, there is reason to believe that two of the most common causes for death among the elderly, cancer and Alzheimer’s Disease, may soon be reduced in their impact on human mortality…at least for those with medical access.

Treatment of illness in old age is one thing, but biotechnology presents another alternative in (re) designing the bodies of the young to reduce or eliminate common problems.  Genetic editing, thought to be the next potential leap forward in personal medicine, has begun to come to the commercial viability.  Cystic Fibrosis, historically thought to be a death sentence by one’s mid-twenties, now has treatments to mitigate a gating mutation which aggravates the condition, offering the potential for the disease to become a manageable condition (links).  More radically, CRISPR research offers the potential for large scale genetic modification, both for adults and potentially the unborn.  Few would argue that genetic modification to eliminate these sorts of diseases is negative, but the possibilities expand beyond that, from unusual manners of conception to “designer babies”.  At present, likely possibilities for such treatments would be for simple aesthetic changes and removal of genetic defects during natal development; however, the potential exists to enhance physical or mental development via “optimized” genes.

So where does this leave us?  Will we see a speciation brought on by differing genetic modification?  Will those with greater access to cutting edge biomedicine diverge from those without?  And if we do see such a change, how will the lines be drawn?  Policy makers in the medical profession and at the national level are already considering the implications along the lines of economic inequality, and the “right to health” has generally been accepted (in theory) by the international communitySome thinkers have begun to argue that in practice, such a right to health will involve a rethinking of the business of medical development and healthcare, one that will not rely purely on capitalist pursuit of profit, but rather as a joint collaboration between governments and private entities to subsidize and ensure reasonable access across economic lines.  Some have argued for an even more extreme outcome, with individualized medicine leading to “health hackers” disrupting traditional institutional control over the rate of experimentation, operating via digitally mediated “crowd research”.

Such an analysis deals with one possible point of differing access, due to economic means.  But what if the difference emerges as one of geopolitical and cultural division?  The idea is not so strange when you considering the differing ethical standards and approaches towards biomedical research worldwide.  The aforementioned CRISPR, for example, is currently hotly debated in the West, with proposals ranging from a moratorium on human genomic modification to restricting it solely to correction of existing genetic disorders.  As the Wall Street Journal has reported this year, however, 86 individuals in China have already had CRISPR modification as part of biomedical treatments; the idea of genetic modification has less philosophical opposition and the stigma of genetic defect a greater concern, leading to a changing pace of applied genetic research in human testing.  With the possibility of more and varied modification to human ability, we may be reaching a point where cultural perspectives intersect with medical ethics and the national interest in determining geographically the acceptable limits of enhancement or change.  Jump forward Wells’ eight thousand centuries and the human race is divided not by economic inequality, but on the reification of cultural boundaries into the biological.

These are of course early thoughts at the dawn of a new era of medicine.  But they are issues that will become increasingly pressing as the biomedical industry moves from research into commercialization.  Genetic modification and treatments are no longer the realm of R&D proof of concept, but actualized medicines.  How society chooses to treat this new potential will have a profound effect on how the business of biotechnology is structured, and how it in turn will structure us.

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