Pro Cards

Case – More regulations from public health sector

necessary.

Claim: Public funds used for private gains now  patents.

MIT NEWS OFFICE: http://news.mit.edu/2017/study-nih-funding-generates-large-numbers-
private-sector-patents-0330

In the US, the National Institute of Health (NIH) provides most

of the federal funding for biomedical research.
The paper, “The Applied Value of Public Investments in Biomedical Research,” is co-authored by Azoulay, who is

MIT Sloan; Danielle Li PhD ’12, an assistant professor at

the International Programs Professor of Management at

Harvard Business School; and Bhaven Sampat, an associate professor at Columbia University’s
Mailman School of Public Health.

Research grants issued by the National Institutes of Health (NIH) contribute to a significant number of private-sector patents in

study, published today in the journal Science,

biomedicine, according to a new study co-authored by an MIT professor. The

examines 27 years of data and finds that 31 percent of NIH grants,

which are publicly funded, produce articles that are later cited by patents in the biomedical sector.
(contribute to a significant number of private-sector patents in biomedicine)
After reviewing over 365,000 grants — making this a uniquely large study — the research also finds that over 8
percent of NIH grants generate a patent directly.

A 2015 working paper released by Azoulay, Li, Sampat, and Joshua Graff Zivin, a professor at the University of
California at San Diego, estimated that every $1 of public NIH funding yielded

between $1.5 and $2 in private-sector pharmaceutical drug sales. That

study is still undergoing peer review.

“Grants produce papers, and papers are cited by patents used by

pharmaceutical firms,” says Azoulay. “It's hard to think of an
innovation [in biomedicine] that doesn't have a patent.”

Impact: Patents used in order to exclude others from using innovation – and monopoly
produces more expensive products that public cannot access. Public funds now used to
generate PROFIT for PRIVATE sector.
 Case – UK Governance framework in biomedical research

Claim: In the UK, biomedical research does not center around profit, but
around the public good.

https://humgenomics.biomedcentral.com/articles/10.1186/s40246-017-0116-4

.
Consider an exemplar of this model: the UK Biobank. Its participants are not paid, and they receive few direct benefits

Research is not prioritised simply because it likely leads to profit, but

it must contribute to the public good. Half a million people voluntarily
and enthusiastically took part. Why? Perhaps they understood the purpose of the biobank to be about the advantages of

creating a sustainable public resource, and endorsed its intention to provide inclusive

access for the good of all. In the case of UK Biobank, the Ethics and Governance Council acts as a ‘steward’
of participants’ data and samples, and therefore takes a direct responsibility for their interests [ 30]. This role is

only possible because of a governance framework that incorporates

participants’ rights as conceived by the public interest and public
good, and creates a broad steering role for participants through a vision that is
informed by ethics rather than business. Even so, UK Biobank does recognise ‘reasonable’
patents, which refers to inventions that are ‘not used to restrict health-related research and/or access to healthcare anywhere in
the world.’8 Compare that to deCODE’s strategy to exploit the enthusiasm of the Icelandic people or Celera’s mission. Both had
begun with overt economic ideals to capture the public good.

https://www.ukbiobank.ac.uk/2017/07/uk-biobank-makes-available-vast-trove-of-genetics-
information/
“We believe that this is the single largest release of a genetic dataset in terms of number of individuals genotyped,” says
Mark Effingham, UK Biobank Chief Information Officer. “The dataset is vast, but we hope it will drive innovative and exciting
studies to transform research.”

There are lots of ways these exciting data can be used:

 Investigating the relationship between genes and diseases – are particular changes in inherited DNA associated
with particular diseases?
 More sophisticated analyses of our genes to help identify the causes of disease and the right ways to intervene to
improve health.
 Learn about shared biology – the same changes in our DNA may be involved in quite different diseases in interesting
ways.
 Research into how genetic & lifestyle measures influence health in thousands of people will be hugely important.
 Investigate how genetic risk factors interact with particular diets, lifestyles, environment and other aspects of our
health
 A2 - Eugenics
Claim: Public health sector expanding access will better regulate the
industry to prevent eugenics. We agree that there has been a dangerous legacy of oppression
and exploitation in the medical field. The logic of eugenics has existed since its founding by Francis
Galton in 1883. CRISPR is a symptom, not the root, of larger mentalities about race and disability. Those mindsets
should be challenged by public health services while they develop
technologies to reduce suffering and death.According to Dr. Sheila Jasanoff,
professor of Science and Technology Studies at Harvard, developments in gene editing
should take place through more inclusive engagement with “the poor, the marginal, and the socially
excluded.”1 This trust-building could ensure that CRISPR can benefit patients without perpetuating
unequal systems. Dr. Vivek Wadhwa, a professor at Carnegie
Mellon University, said
that there ought to be “ethical and legal guidelines to regulate in vitro genetic
editing” to avoid promoting “modern-day eugenics.”2 These guidelines are
consistent with our position on gene editing.

Impact: In the status quo, private sector abides by no strict guideline  entirely profit-
driven.

1
Shiela Jasanoff, J. Benjamin Hurlbut, and Krishanu Saha, “CRISPR Democracy: Gene Editing and the
Need for Inclusive Deliberation, ISSUES In Science and Technology XXXII, no. 1, Fall 2015.
2
Vivek Wadhwa, “If you could ‘design’ your own child, would you?” The Washington Post, July 27,
2017, https://www.washingtonpost.com/news/innovations/wp/2017/07/27/human-editing-has-just-
become-possible-are-we-ready-for-the-consequences/?utm_term=.6ce635b5afd7
 A2 – Germ-line Editing
Claim: Germ-line Editing Unfeasible in the first place because of
universal consensus against it.
http://time.com/4379503/crispr-scientists-edit-dna/

In January 2015 (International Summit on Human Gene Editing), she

encouraged other leaders in the field to gather in Napa Valley for a summit, the first of its kind, to discuss its place in science.
The idea was to discuss CRISPR's potential impact on society and debate the ethical issues involved to get ahead of some of the
anything-goes applications. They focused on what they felt was the most controversial use--editing human reproductive cells like
eggs, sperm and those in embryos, which would be able to pass on their changes to future generations.

the 13 scientists, ethicists and lawyers at the summit

By the end of the lively debate,

agreed that using CRISPR to modify human reproductive cells, so

called germ-line changes, that would result in pregnancy or treatments in people, should not
be attempted by scientists for the time being.
While Niakan plans to use CRISPR on human embryos, she will not allow them to develop beyond seven days--or about when

(U.K. law prohibits letting human

they've divided enough times to have 200 to 300 cells.

embryos in research to progress past 14 days.)

For now, the National Academy of Sciences has called for researchers to
voluntarily refrain from using CRISPR on human embryos that are meant to come to

term, calling such studies "irresponsible" at this point. Such guidelines, while not
binding in any legal or regulatory way, can still provide a crucial framework for shaping the way powerful technologies like
CRISPR are used. That's especially true in the U.S., where studies not funded by the government are not bound by any federal
laws overseeing human-embryo research.

Impact: Expanding access does not mean an immediate slippery slope to “designer babies”
or “playing God”; it creates more ethical and legal guidelines for the kind of research
conducted so that innovations are not merely profit-driven.
 A2 – Public Backlash
Sara Reardon, 2015 Reardon is a science journalist; “Global summit reveals divergent views
on human gene editing”Nature 528, 173 (10 December 2015) doi:10.1038/528173a
https://www.nature.com/news/global-summit-reveals-divergent-views-on-human-gene-
editing-1.18971

Held on 1–3 December, the International Summit on Human Gene Editing was
organized by the US national academies of sciences and medicine, the Royal Society in London and the Chinese Academy of
Sciences (CAS).

nearly everyone at the

Despite differences about how far to go in applying gene editing to the unborn,

meeting agreed that efforts to use gene editing after birth to correct
defects in non-reproductive cells should continue.
 A2 – Human Testing not Morally Justified
Claim: CRISPR generates better cell & animal models that reduce
the need and danger of human testing.
https://www.nature.com/articles/d41586-018-02477-1
Cell and animal models of human disease are crucial elements of drug development. The initial stages of testing candidate drugs

many of the disease

for efficacy and toxicity can rarely be done in people, for ethical reasons. However,

models that are available to researchers are far from perfect. The main problem has
been the complexity — and therefore the time and expense — of building superior
models for the huge variety of human diseases that exist. “In industry, speed and cost are as important as feasibility,” says
Fellmann. If it would take too long and cost too much to make a great model, a less perfect one might be preferred. Yet the
developers of drugs would like to avoid such a compromise.

CRISPR–Cas
Both Moore and Fellmann agree that the simpler and more reliable gene editing made possible by

has enabled researchers to create models of disease more quickly and

cheaply. “We can now, pretty much, change any gene in whatever way we want to mimic a disease,” says Fellmann. He
also emphasizes that the “surgical precision” of CRISPR–Cas gene editing means
that little or no trace remains of the editing process. With older genetic-engineering techniques, extra changes to the DNA
sequence can be left in or around the altered genes, similar to a surgeon leaving instruments inside a patient after an operation.

greatly reduces the chances of the gene-editing tool

The precision of CRISPR–Cas

having an undesired effect.

Con Cards
 A2 - Hunger and GMO
Claim: We have more than enough food already, the problem is
distribution.
(“A hungry world: Lots of food, in too few places,” CNBC, July 22, 2013,
https://www.cnbc.com/id/100893540)
"We have two or three times the amount of food right now that is needed to feed the number
of people in the world," said Joshua Muldavin, a geography professor at Sarah Lawrence
College who focuses on food and agricultural instruction. "A lot of people aren't analyzing the
situation correctly. We can deal with short-term food shortages after a disaster, but fixing
long term hunger gets ignored," he said. "We don't have food shortage problem," said Emelie
Peine, a professor of international politics and economy at the University of Puget Sound.
"What we have is a distribution problem and an income problem," Peine said. "People aren't
getting the food, ... and even if [they] did, they don't have enough money to buy it." If
there is enough food, a major problem causing scarcity is
what we do with it, said Roger Johnson, president of the National Farmers Union,
an advocacy group for U.S. farmers. "Something in the area of up to half of all
that's produced is wasted," said Johnson, who runs his own farm in North
Dakota. "In the undeveloped world, the waste happens before
the food gets to people, from lack of roads and proper
storage facilities, and the food rots," Johnson said. "In the developed
world, it's the staggering amount of food that's thrown out after it gets to
our plates."
Impact: GMO crops 治标不治本  does not address root issue  starvation
continues.
 A2 - Gene-editing for cancer

Claim: Gene-editing fails to address major root cause of cancer ->

addressing climate change and pollution does.
(2018 “Reduce your cancer risk with diet and lifestyle changes,”
https://www.cancercenter.com/community/newsletter/article/reduce-your-cancer-risk-
with-diet-and-lifestyle-changes/)

Many people mistakenly believe that cancer is largely a

hereditary disease, as if fate and the family gene pool alone dictate your chances of
getting sick. The truth, though, is that only about 5 to 10 percent of all
cancers develop from gene mutations passed down from one
generation to the next, according to the American Cancer Society.
That means that for the other 90 to 95 percent of cancers, the lifestyle choices you make, the
foods you eat and the amount of exercise you incorporate into your
daily life can
have an important impact on your overall risk. That’s why
prevention and awareness have become vital tools in the fight to
end cancer, and they start with knowing how to nourish your body and how to develop
healthy habits with lasting benefits.

Impact: Solving climate change and pollution directly improves one’s health,
prolongs one’s life, and improve their well-being.
 Case - Social Reform Tradeoff

Claim: Expanding access leads to overemphasis on improving individual

biology instead of complex social issues.
Nathaniel Comfort, Professor at the Institute of the History of Medicine at Johns
Hopkins University, 2015

(“Can We Cure Genetic Diseases Without Slipping Into Eugenics?,” The Nation, July
16, https://www.thenation.com/article/can-we-cure-genetic-diseases-without-slipping-
into-eugenics/)

Sci-fi genetic fantasies, whether hand-waving or hand-wringing, divert our attention from
other, more important determinants of health. Studies
by the World Health
Organization, the federal Office of Disease Prevention and
Health Promotion, the Centers for Disease Control and
Prevention, and academic researchers leave no doubt that the biggest
factors in determining health and quality of life are
overwhelmingly social. Genetics plays a role in disease, to be sure, but decent,
affordable housing; access to real food, education, and transportation; and reducing exposure
to crime and violence are far more important. In short, if we really wanted to engineer better,
happier, healthier humans, we would focus much more on nurture than
on nature.