Too much biotech too litle bioculture

 European Life Science is unique in the way it puts on the broad searchlight for how biotechnology can impact the future both in rich and poor countries with the whole spectrum of applications. Commitment to impact also the needs of the less privileged in the world compels us to look beyond the enthusiasm of our newfound insights and understanding of biotechnology and consider the future prospects of benefit for the many.

There are many reasons to be impressed by the recent huge leaps forward of life science and the new profound understanding of the mechanisms of life.  Research in biotechnological and genomics saw its biggest breakthrough so far with the completion of the Human Genome Project in 2001 and the sequencing of a host other genomes since then. We still have to admit, however,  that biotechnology has not yet met the huge expectations proclaimed a decade ago. The impact is still limited, especially for less privileged people in developing countries, but even for most end users in the more affluent part of the world like patients and food consumers. 

In this article I explore the current intellectual and real world political context of the biotech revolution to try to reconsider our direction of development and potential shift of focus areas for maximising cost effective impact for those who needs it most. 

Current contexts for biotechnology.

Biotechnology will potentially influence both the economic, ecological and political realities of the world, but is also itself dependent on these. Let us therefore first consider how the global economic, ecological and political backdrop for the biotechnological revolution shapes its possibilities to  impact   improvement of livelihood for people.  

Economic crisis

We are after the financial collapse in 2008, going through a global economical crisis. It is also a collapse of the recent economical paradigms and the ruling ideas of the economy as a scientific discipline. The crisis not only involve the financial segment of the economy where it was initiated, but also heavily impact the productive realms of the economy. It demonstrates a point that Michel Foucault described in his deliberations about “Gouvernmentalite”: The most dangerous of modern power structures are the power of the ruling ideas.  The economic crisis bore down the financial institutions in spite of the fact that the very same people and institutions should be the first to see the writing on the wall, understand its consequences and correct the course. Mindset and ideology in the dominating financial institutions, in the political communities and among the regulators was the main cause of the crisis. Ironically, those paying the price for the intellectual negligence of those on the top we had  reason to trust, where primarily people at the low end of the ladder being evicted from their homes and jobs and struggling to pay for daily necessities.  The lessons learnt have been  summed up by the economist Frank Ackerman : “… the market may be the engine of a socially directed economy, indispensable for forward motion. There are limits, however, for its capabilities: - it cannot change its own flat tyres, and if we let it steer, we are sure to hit the wall again.”

In addition to the obvious setbacks the financial crisis is for long-term investments in Biotechnology, it also illuminates the fact that market incentives will not necessarily serve the basic needs of the least privileged, but mostly the demand for profits by those controlling the capital. 

Ecological crisis

In parallel we have the rapidly escalating global ecological crisis produced by the extractive mindset of the productive segment of the economy:  The external costs  for emitting pollutants into the commons like air, water and landfills are not calculated as a cost to be covered by the polluter, but as a price to be paid or tolerated by the community. Climate change is now the dominating threat looming over the fragile ecological balance on our vulnerable planet. In this case we all are the victims, but again the less privileged are paying the highest price. Our understanding of biological systems large or small and their interconnectedness are obviously yet very limited, and we tend to approach them with an inappropriate and simplified technocratic mindset.

Equity and population crisis

Even more dramatic than the global financial and ecological conditions are the crisis of equity within countries and between countries. More than 1,3  people still live below the poverty line  .   On top of this we know that the world population may rise by an estimated 2,5 billion over the next generation before it hopefully culminates. This population increase will come mostly in the already under-privileged countries. These new world citizens will also need food, shelter, health care, education and employment. It is already a huge challenge to provide enough food and basic services to these countries and the broad potential benefits of biotechnology have not yet reached them.

These are the unprecedented and potentially disastrous challenges for the ecological system and livelihood of our planet, caused by the only species that also have the possibility to reverse them.  I believe these contextual conditions compel us also to reconsider how biotechnology can play a more productive role for the benefit of the least privileged.

The intellectual challenges of the current crisis’s. 

The intellectual paradigms driving the development in philosophy, science and economic growth since the renaissance has been that of reductionist analysis and a linear understanding of cause and effects. Core to this thinking is the idea that the whole can be studied and understood as the sum of its parts, and that cause and effect is a linear relationship.

Even though so far mostly studied by these methods, newer insights and concepts in biology, ecology and economics makes it clear to us that a system is more than the sum of its parts, and that system effects can be based on complex feedback processes influenced by a number of factors.  Systems needs broader concepts to be fully understood, and manipulating them to create specific results can be extremely complicated.

The paradigm of systems and systems analysis

Healthcare is probably one of the biggest such ventures of mankind, trying to influence both the health of individuals as well as that of whole populations. WHO is in a recent paper  accordingly promoting a systems paradigm for analysis and political understanding of health care systems . This approach emphasises that systems are dynamic, not static, they are a cause in themselves not only effects, and that they are self-organizing, nonlinear, constantly changing, history dependent and tightly linked, often counterintuitive, governed by feedback and resistant to change.

Using this paradigm of systems thinking, we can reconsider the context and future prospects for impact of biotechnology.  We then see that the four mentioned predicaments challenging the world today are closely interlinked: The economy impacts directly both the ecology and the equity of the world. Ecological change threatens to undermine many segments of the economy and deepen the equity crisis. Poor people that do not get health care and education has less to contribute to the economy. The explosive population growth exacerbates all these problems to a dramatic scale.

Considerations for biotechnology

Considering how technology and biotechnology specifically can contribute to the future prospects for a sustainable development of the world and livelihood for its population, we may also have to reconsider our current approaches to technology development, also in Biotechnology.  We may need to recognize that those that will be most in need will have the least resources available. Technology will have to be simple, cheap, quick and easy to distribute and apply on a large scale in difficult contexts.

The main paradigm of biotechnology have until now been very much based on a simplified technocratic Cartesian linear concept and mindset, from the simple to the complex, from genes and molecules to effects on the level of organisms and ecological systems.  We want to sequence and understand the individual genes and molecular pathways, to manipulate them and thereby create better health, food supply and ecological sustainability. This impact strategy not at all unreasonable and it needs to be pursued with persistent efforts. However, we have also seen that our simplified understanding of the impact of genes only 10 years ago, have been through several paradigm shifts since then: A substantial portion of what was considered un-functional “Junk Genes” turned out to be important regulatory genes. Short RNA sequences were also proved to have a multitude of independent regulatory functions. A deeper understanding of proteomics and epigenetics made the prospects for a straight forward way from identifications of genes to treatment of major disease much less realistic, but enhanced our understanding of organisms as complex feed-back systems. We have also finally understood that not always the competitive fitness of individual creatures, but rather the way they collaborate and care for the totality of a community have created the evolutionary success of many species from microbes to mammals, and for humans in particular.

This rapid sequence of what could be called minor scientific revolutions, gives us reason also to challenge our current mind-set in Biotechnology. My argument in this article is that it is not probable that the current approach for of data-mining for drug leads will be sufficient, affordable and quick enough and have sufficient impact to alter the grave consequences of the combined impact on the four main global challenges mentioned before, especially for those with the biggest needs. We need to add other paradigms and strategies as well, based on lower hanging fruits to tap the full potential of Biotechnology. Most global health challenges, whether in Health or other life science fields, are generic, not genetic in their nature. Therefore population strategies are more important than technocratic life Science approaches like the so called “personalized medicine”. This may be relevant for the treatment of a limited set of cancers, but not of big importance for other major disease burdens.

We should consider simpler and more straight forward strategies based on the understanding of balances of systems to push them in a more favourable direction. This can potentially have a bigger, more rapid and substantial impact than complex high-tech biotechnology products based on intensive and expensive, long term basic and applied research.

Among the criteria for an effective and appropriate application of biotechnology for health in low income countries should be the following:

• ¬ Realistic analysis regarding potential technology impact
• ¬ Technologies should be affordable, accessible, simple, effective, and easy to apply. 
• ¬ Programs should be based on broad systems considerations
• ¬ Upstream prevention should be preferred before cure for manifest crisis
• ¬ Population based interventions to be preferred before individual treatments 
• ¬ Technologies should create resilience and coping capabilities for people in their normal context , rather than increase need for industrial agriculture and health professionals

When looking at the wellbeing of the human organism as a whole from a systemic perspective, we would primarily focus on the relationship of the organism with its environment and its responses to various environmental factors. The most important relationship between and organism and its environment is mediated by the intake of various sources of energy and nutrients and the responses these invoke in the organism. This, I would argue, is a more productive and relevant approach to the concept systems biology. It will force us to focus more on our relationship to our biological context, environmental and nutritional factors, how food is produced and accessed, how it is processed in our gut and then our body, and the following consequences for our wellbeing.

We know that many of the major epidemics of the world like cardiovascular disease, cancers, diabetes/metabolic syndrome as well as infectious diseases although they apparently have complex genetic components, are mostly mediated through our intake of foods and nutrients as well as our exposure to physical, chemical or biological substances. Accordingly, our strategies to fight them should be searched for in the same domains, also by those trained in biotechnology.

We should focus more on broad scale public health issues related to the interplay of ecological and biological systems like the human organism as well as the benign and harmful effects of the human micro-biome. This means that we should focus more on the whole of living organisms, and their functions in contexts. We should as biologists be more concerned about Bio-Culture(s) like farmers and practicing doctors, and less on genes and biotechnologies as if we were physicists or engineers.

Let me briefly exemplify and substantiate such a claim illuminate with a couple of promising examples from my own field of knowledge, medicine.

Vitamin D,  an evolutionary protective substance.

 Vitamin D is a substance that can be found in number of biological organisms and contexts. It has been with us for a long period of evolution, and has apparently defended its ground as an important and useful substance for survival. It has long been recognized as an important micronutrient with well documented effects on both juvenile and post menopausal bone disease. What is less well known, is that a rapidly growing body of research indicates strong associations between Vit D status and a number of other pandemic diseases like diabetes, multiple sclerosis, some infective diseases and possibly cancers  ^,. Given that big segments of the world population both in temperate and more sunny tropical zones seem to have suboptimal physiological levels of Vit D, it is estimated that a simple program for improving the Vit D status of the population could have huge medical as economic benefits , with minimal risks and moderate costs. Our current need is to be able to further understand the functions of Vit D in the organisms, and to reveal the possible biological mechanisms behind its apparent substantial preventive effects for a number of pandemic diseases. With further specific knowledge and documentation of these effects, simple and cheap preventive programs with potentially huge impact on the health and wellbeing of both rich and poor 

Omega 3 fatty acids and their biological impacts; - fit from food?

Another example is the Omega 3 fatty acids and their well documented effects on eye and brain development of infants, as well as potential benefits for the immune system as well as a multitude of diseases like cancers, cardiovascular disease, Rheumatoid arthritis , psychiatric disease etc.

This kind of biotechnology based on the understanding of evolutionary selected beneficial substances and their function in biological systems, may therefore be much more relevant and have a potentially much bigger impact on global health challenges than sophisticated biotechnology and personalized medicine. We should prioritize our research agenda accordingly. 

Preventive programs for Vitamin D and Omega 3 deficiency can be as simple as advising more moderate sun exposure, eating more fatty fish, simple fortification of staple foods or individual supplementation, for example by simple and well tried substances like cod liver or plant oils. Biotechnology does not have to be complicated to be effective, and the simpler the technologies are the higher the probability of an effective implementation of programs and broad and substantial effect on people’s health.

However, to be able to promote this mode of biotechnology based on comprehensive systems analysis and understanding we need to develop a different research and public health agenda. We may need to change research paradigms, and expand analysis and research methodology into another kind of collaborative research, where basic biology, epidemiology, social sciences and developmental economy is integrated on a much higher level than today. Whole cellular or complex organisms and their ecological communities have developed amazing capabilities that we must learn to understand and cultivate to serve our needs. And we need to inform policy makers not only about the future potential of sophisticated biotechnology, but draw their attention to the low hanging fruits of simple biotechnologies, based on a deeper understanding of the interrelationships of complex systems. 

Presented by Dr. Werner Christie, Public Advice international

Former Norwegian Minister of Health.