The Genetics Epidemic

The revolution in genetic engineering that will make it possible for humans to actively manage our evolutionary process for the first time in our species’ history is already under way. In laboratories and clinics around the world, gene therapies are being successfully deployed to treat a range of diseases, including certain types of immune deficiency, retinal amaurosis, leukemia, myeloma, hemophilia, and Parkinson’s. This miraculous progress is only the beginning. The same already existing technologies that will soon eliminate many diseases that have victimized humans for thousands of years will almost certainly be used eventually to make our species smarter, stronger, and more robust.

The prospect of genetic engineering will be exciting to some, frightening to others, and challenging for all. If not adequately addressed, it will also likely lead to major conflict both within societies and globally. But although the science of human genetic engineering is charging forward at an exponential rate, the global policy framework for ensuring this scientific progress does not lead to destabilizing conflict barely exists at all. The time has come for a meaningful dialogue on the national security implications of the human genetic revolution that can lay the conceptual foundation for a future global policy structure seeking to prevent dangerous future conflict and abuse.

The rate of recent progress in human genetics has been astounding. It was only 61 short years ago that the DNA helix was uncovered and a mere 50 years later, in 2003, when the human genome was fully sequenced. The cost of sequencing a full human genome was roughly $100 million in 2001 and is under $10,000 today. If even a fraction of this rate of decrease is maintained, as is highly likely, the cost will approach negligibility in under a decade, ushering in a new era of personalized medicine where many treatments will be customized based on each person’s genetic predisposition. Processes like these will only widen and deepen in the future, just at an exponentially accelerated pace.

It is already possible, although not legal in all jurisdictions, to do a full genomic analysis of each of the fertilized eggs being considered for in vitro fertilization (IVF), before implantation into the mother, in order to select one with a specific gender or not carrying a given mutation. And we are learning more each day about what the massively, but not infinitely, complicated genome tells us. When it becomes clear that the genetic selection process can safely optimize the genetic inheritance of children, with far more informed parents choosing from among their “natural” embryos prior to implantation, more and more parents around the world will opt in. As this process becomes more affordable, governments and insurance companies will have strong incentives to promote its adoption as an alternative to paying the costs of what will then be seen as avoidable lifetime genetic disabilities.

And when embryonic stem cells are extracted and stored, or new processes for reprogramming mature cells into induced pluripotent stem (iPS) cells become mainstream, we will be able to transform any stem cell into an egg cell and finally into an egg. Because human eggs are a limited resource but stem cells (and eggs developed from them) are not, this will allow prospective parents to choose from among hundreds or thousands of their own embryos if they wish (and can afford to do so), instead of roughly five to 15 embryos as is currently the case. Some parents may opt out, but the offspring of those who opt in will likely have, on average, significant advantages over their peers not born through this process. It will then be only a matter of time until technology-assisted reproduction will become the method of choice for procreation among the world’s most advantaged, replacing what may then be seen as the relatively risky process of sex-for-procreation purposes, even if sex will, of course, live on for recreation, pair bonding, and other purposes.

In the medium term, it will likely be possible to go beyond genetic selection to genetic enhancement, designed to repair mutations, lengthen life spans, enhance brain function and senses, increase endurance, and protect ourselves from disease.

Recombinant DNA techniques, for example, which have already been used successfully in plants and animals, will be used to alter the genetics of human fetal cells. DNA fragments in a single cell could be spliced and replaced with genes from other humans, or from animals, or created synthetically. If, for example, two parents were carriers of harmful mutations that showed up in all of their preimplantation embryos, the gene for this mutation could be replaced by one taken from somebody else’s genome. It may then be only a matter of time before some people start adding extra capabilities to our genes from the animal world. Just as AquAdvantage salmon carry a small number of genetic constructs, transferred from other salmon breeds, that allow them to grow more quickly, some humans could acquire small genetic constructs that will give them extra capabilities. After that, synthetic, lab-generated gene constructs will accomplish the same purposes with greater predictability and scalability.

If the current debate around genetically modified (GM) crops is any indication, the idea of genetically modified people being cultured like salmon will send many among us to the barricades, even if the science eventually proves safe. Although, despite decades of testing, very little science suggests that genetically modified crops are any more dangerous than conventional crops, a massive global anti-GM movement has emerged (and made some important points on issues such as biodiversity and corporate ownership of seeds). Humans have been manipulating the genetics of crops for more than ten thousand years through domestication. But fast genetic manipulation through science is, at least on an emotional level, more unsettling for many people than the slow manipulation process that has created nearly all the fruits and vegetables we consume. And although GM crops have the ability to reduce pesticide use, introduce essential nutrients, protect the livelihoods of desperate, climate-stressed farmers, and make it possible to feed the estimated nine billion people expected to occupy our planet by 2050, the emotional charge of the anti-GM movement continues unabated.

In the far more complicated and higher-stakes debate on human genetic manipulation, opponents will raise critically important and very real issues of unintended consequences, eugenics, and societal divisions. Some will seek to maintain a distinction between acceptable somatic genetic manipulation for therapeutic reasons on the one hand and banned genetic enhancements or heritable, germ-line manipulations on the other. Others will call for measured restrictions. Still others, the so-called transhumanists among them, will see genetic engineering, including heritable mutations, as freeing humanity from the confines of our current biology and deserving to be free from any regulation. However this contentious debate evolves, the domain of what is socially acceptable and legally allowed will expand.

Despite our fetishization of Mother Nature, she has been a cruel mistress for our species. The moment humans started farming or began developing medicines, we were fighting back against the so-called natural processes that wanted us to have 40-year life spans spent foraging for food and hiding in caves. But if the application of human knowledge to improve our lot can be called natural -- because we ourselves are part of nature -- it’s hard to know where natural ends and unnatural begins. By the same token, as genetic technology develops, it will be increasingly difficult to determine where a treatment ends and an enhancement begins. As genetic therapies make it possible to address or eliminate genetic diseases, initially single-mutation ones like Down syndrome and Parkinson’s and then, over time, more polygenetic ones like multiple sclerosis and celiac disease, we will almost certainly not refuse. But what will be the difference between removing a genetic predisposition to diabetes, for example, and creating a stronger genetic disposition for more optimal insulin regulation?

Despite and because of differing views on questions such as these, competition within and among countries will drive this technology and its application forward. Within societies, parents will not want their children to be disadvantaged once the science is deemed safe. When a Colorado company, for example, announced that it could do a genetic test to determine which children had a special gene shared by top NFL quarterbacks, they were besieged by parents demanding the test for their children. Would parents line up, at least in some parts of the world, if genetic tests could loosely predict which of their preimplanted embryos would increase their chances of having a healthy and brilliant child, however defined? When asked if it was acceptable for scientists to change the makeup of human cells to prevent children from inheriting a genetic disease, a majority of Americans, Australians, Canadians, and Japanese polled said yes. Although the poll numbers are less favorable when people are asked about genetic modification to increase intelligence or foster other “special” attributes, even these numbers have shifted toward favorability over time and will likely continue to do so as gene therapies and other treatments become more mainstream.

The contentious debate on genetic enhancement within societies will be made all the more complicated by international differences. Even today, laws regarding human genetics vary greatly among countries. In Europe, Germany bans embryo selection, while the United Kingdom is moving toward allowing heritable genetic manipulation through mitochondrial transfer for some women undergoing IVF. India bans gender selection, but the United States allows it. The list goes on.

As the stakes increase, these types of differences will only be exacerbated. Although Christian-majority countries like the United States may join the Vatican and others in pushing for strong restrictions, and countries like Germany may have strong reservations for historical reasons, others, such as China and Korea, whose worldview is based less on the concept of a divine plan, will continue to be more comfortable moving forward with human genetic engineering, as polling data has shown.

To see an example of this global divergence today, one only has to visit China’s BGI Shenzhen, a company that has acquired the most genome sequencers in the world and is going full throttle on a cognitive genomics initiative. A recent article in Wired described efforts by BGI Shenzhen to map the genetic footprint of intelligence as a foundation for spawning a next generation of Chinese geniuses. According to the article, the team at BGI believes it can boost the IQ of children through the IVF/genetic selection approach by up to 20 points per generation. Intelligence is a highly complicated and polygenetic train, so this effort has produced a lot of skepticism. But when big data tools become more widely applied in a future world where most people’s genomes will have been sequenced, it seems only a matter of time until this type of genetic selection and manipulation will be possible. And it doesn’t take a gene-ius to realize that if China started enhancing its population and the United States did not, there could be serious competitive repercussions. That doesn’t mean that international competitive pressures would force societies to take up genetic enhancement against their will, just that those who don’t enhance, like those who do, will need to face the consequences.

And even if all countries opt out (which is unlikely based on current behavior), motivated individuals and nonstate actors will have full access to this technology. The Raelian cult, which believes that genetic manipulation can be used to bring back people’s spirits from the dead and created a global stir when it announced in 2002 that it had secretly cloned a human baby, will mark only the tip of the iceberg. Around the world today, do-it-yourself biology labs are proliferating, creating opportunities for hobbyist biohackers to get into the genetic manipulation game. As the science becomes more accessible, more people, with different backgrounds and inclinations, will begin to experiment whether others like it or not.

With whatever mix of catalysts and first movers, it is almost impossible to believe that our species, which has embraced every new technology -- from explosives to nuclear energy to anabolic steroids and plastic surgery and beyond -- promising to improve our lives but also carrying potential downsides, would forgo chasing advances in a technology that has the potential to eradicate terrible diseases, improve our health, and increase our life spans. The very idea of altering our genetics calls for an enormous dose of humility, but we would be a different species if humility, not hubristic aspiration, had been our guiding principle.

Given the emotional charge of this issue, and the fact that heritable genetic manipulations will have the potential to spread across populations through reproduction, some people and countries will likely become hostile if others elsewhere are changing the human genetic code in a manner that will impact them. If last year’s violent attacks on rice fields at the International Rice Research Institute in the Philippines are an expression of some people’s fears of genetically modified crops, imagine how some would react if they felt the human genome was being compromised. Would countries banning heritable genetic manipulations screen people for such mutations at their border or make it a crime for their citizens to procreate with them?

And what would the United States do if it learned that China had an effective human genetic enhancement initiative that would give China an insurmountable competitive advantage in a few decades? Would the United States do nothing and accept a potential loss of competitiveness, try to stop China by individual or collective means, or match China by enhancing its own population? What would the world do if nonstate actors like the Raelians were changing the genetic code of their followers outside of national jurisdictions, perhaps on the high seas? There are many scenarios to imagine how unfettered, unregulated enhancements to the human genome could lead to global instability or worse.

While this issue may seem far off to some and there are still serious scientific hurdles to be overcome, it is approaching far faster than most people think. Maybe we have five years to get serious, maybe ten. But given the velocity of scientific progress, we don’t have 20.

Although now should be the time to begin laying out principles to guide a global response to this complicated issue, the process for doing so has thus far gone nowhere. UNESCO, the Council of Europe, and the United Nations General Assembly have put forward preliminary resolutions on genomics and human rights, some of which try to ban reproductive cloning and genetic modifications for nontherapeutic reasons, with little impact. The 1997 UNESCO Universal Declaration on the Human Genome and Human Rights, for example, seeks to prohibit “practices which are contrary to human dignity,” without fully articulating what that might mean. The nonbinding United Nations Declaration on Human Cloning, adopted in March 2005, calls on member states to “protect adequately human life in the application of life sciences” and, among other resolutions, to “prohibit the application of genetic engineering techniques that may be contrary to human dignity.” Not least because the concept of “human dignity” is extremely difficult to define in a world of diverse perspectives where significant national differences remain, none of the states at the forefront of life sciences research, including South Korea, Singapore, the United Kingdom, and China, chose to sign the declaration.

It is hardly surprising that there is so little international consensus on what should be done, but it is more shocking that there is so little global attention to this critically important topic.

What is now needed is a far more robust global dialogue on the ethical and national security implications of the genetics revolution. The dialogue must foster the kind of evidence-based debate that has been so sorely lacking in the conversation about genetically modified crops. At the outset, this dialogue should not drive specifically toward a global treaty but instead seek to foster conversations within and among governments, universities, media and civic organizations, and populations. The UN could begin this process by authorizing a global committee of experts to formulate key questions and prepare background materials for structured conversations and forums to be held around the world. It could also collect and make publicly available the deliberations of these forums.

Because the science is moving forward more quickly than our consciousness, it is also necessary to start thinking about what a preliminary global regulatory framework might look like. Opponents of genetic engineering will call for an outright ban on genetic enhancement and heritable human genetic modification. Such a ban would cut short critically important research on eliminating some of the most deadly diseases that have ravaged our species and wouldn’t be respected even if established. In an important sense, the train has already left the station. Critics will have to accept that the best they may be able to do is to internationally define and stigmatize what can be commonly accepted as abuses, including grotesque human-animal chimeras and excesses of cloning.

On the other end of the spectrum, many transhumanists and others who believe this science must progress unfettered can be expected to oppose any restrictions, not least because they fear they will be used as a sword by their opponents. But even those on this permissive end of the spectrum will need to accept that stories of human genetic engineering that shock the public conscience in large parts of the world will make the utilization of this technology to improve health and lives all the more challenging.

The preliminary goal of a global framework must be to establish a regulatory regime that avoids both of these extremes by restricting some of the worst potential abuses while creating a permissive enough environment so that meaningful advances can continue. This Goldilocks approach may sound simple but will be anything but.

Although shorter-term issues such as terrorism and regional crises dominate today’s headlines, the ongoing revolution in human genetics will ultimately prove far more significant to our future. It deserves much more attention than we are affording it currently and a global process that can, over time, help us avoid dangerous conflict and guide us in a positive direction.