A slew of New Zealand companies are helping us to live longer, healthier lives through biotechnology and are breaking new ground in everything from gene editing, to organ transplanting, to bio-active paints. But what are the implications editing humanity as we know it? And where should we draw the line on how much of ourselves we are ‘hacking’?
Admit it: we all would like to live longer, if not forever.
Likewise, we’d all like to change something about ourselves – be it our health, our body shape, eye colour, or even how smart we are. Call it our continued push for perfection. Call it “hacking humanity.” But no matter which label is affixed, it doesn’t hide the fact we’re continuing to use technology to modify ourselves in ways that not too long ago would’ve been thought impossible. And it’s something being done worldwide – including in Aotearoa.
Take, for example, what Kode Biotech is doing. “In the AUT Centre for Kode Technology Innovation we invented a range of bio-active paints that have the ability to stick to any living (e.g. cells) or non-living surface (e.g. plastic or metal) and then change the way that surface interacts with the environment,” explains Kode Biotech Group CEO – and AUT professor – Steve Henry.
But that, he says, is just the start of it. “These bio-paints can do many different things,” says Henry. “For example, one use of our bio-active paint is as a cancer immunotherapy. Injecting specific Kode molecules into a tumour to paint some of the cancer cells and teach the body how to recognise your own cancer as foreign, how to find it and kill it, wherever it is in your body.
“In theory, the technology could be as simple as injecting one tumour, and all your tumours will be killed wherever they are. Licensee trials scheduled for mid-year will show how effective the technology is in humans. Kode technology is also currently being used in a range of blood diagnostics and as a tool-box to enhance research.”
Translation: Kode is quite literally working on a cure for cancer – a cure that might very well one day be a reality. But that’s not all they’re doing. “Currently our R&D team at AUT is focused on developing Kode technology to prevent infections on surgical implants and to make bandages actively involved in healing wounds,” says Henry.
‘Smart bandages’ certainly sound exciting, and could save a large number of lives seeing as though infections kill millions of people around the world. “These are major global issues and as Kode technology has the ability to be applied to, and add a new layer of functionality to any existing product, it has the potential to improve the quality of life for millions of people,” says Henry.
The risks of innovation
While many biotech companies claim to be changing the world for the better, there is danger in taking companies at their word. Take Theranos CEO Elizabeth Holmes, who deceived the public about the viability of her ‘revolutionary’ blood testing technology. At its peak, the company achieved a valuation of about US$9 billion, but Holmes took investors’ money on the condition that she wouldn’t have to explain how the technology worked. It was then revealed that the technology wasn’t actually giving accurate results, putting a hole in her story about using tech to better humanity.
Then there’s the issue of abuse. Our own recent past – and present – is littered with examples, such as eugenics, the Nazis and the ever-present fear of terrorists or governments using ‘bio-weapons’ against people that could inflict unspeakable horrors.
Henry claims that’s not a huge concern for what Kode is doing – but admits it could happen.
“There is little risk of Kode technology being abused as it is a temporary coating (i.e. not permanent like genetic engineering), but because it is a platform it is always possible someone may find an unethical use,” he says. “Society should always be concerned over the use of any new or existing technology and monitor its use and potential to be misused. In reality, once Pandora’s box has been opened only the conscience of a society is able to ensure ethical and moral use of that technology.”
Drawing a line in the ethical sand
Bioethicist Josephine Johnston is a New Zealand-trained lawyer with a master’s degree in bioethics and health law from the University of Otago, as well as the director of research at The Hastings Center in New York, the oldest independent, nonpartisan, interdisciplinary research institute of its kind in the world.
She says the ethical implications of what we can do to our bodies are something says is an area being explored, and it will likely continue to grow as technology evolves and new technologies are developed.
“One of the biggest ones I’m working on, and a lot of people are working on, is genomic sequencing technology,” she explains.
According to Johnston, one of the main arguments involving genomic sequencing is that while some people see it as having the potential to cure diseases such as diabetes, cancer and a host of other illnesses that can be passed down from generation to generation, while others view the individual genome as what constitutes one’s ‘individuality’ and their ‘essence’. In other words, your genes are what makes you, well, you.
Johnston also says that the US and a host of other nations (including New Zealand) forcibly sterilised large numbers of people, and some of the Nazis’ most horrific ‘experiments’ involved what they claimed was genetic research in their misguided quest to create superhumans and exterminate those they viewed as inferior.
“The history of eugenics is a massive shadow,” she says. “The eugenics movement was an early version of genetic research.”
There’s also the issue of differentiating what we call a ‘condition,’ and what simply makes us different. Johnston points out that sexual orientations other than heterosexuality, and gender identities not corresponding to the biological sex a person was assigned at birth, used to (falsely, as we know now) be considered ‘illnesses’ by mainstream science until our understanding increased.
Currently, there’s a large neurodiversity movement in which some people view such things as being on the autism spectrum not as a ‘defect,’ but a difference that helps make everyone unique.
“There’s enormous debate,” Johnston says, adding much of the debate boils down to whether these genetic traits should be removed or altered before a foetus is born. “It’s a really big issue in pre-natal genetics.
“Everything seems to be pointing in the direction that gene editing, things like the CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats, a DNA sequence) discovery, will be a fruit. But there will be debate about the misuse.”
And then there’s not just eliminating diseases like cancer and HIV, but augmenting ourselves to be smarter, stronger, look better, and anything else – and the industry that could spawn to cater to such desires.
“There will be companies that will market technologies or therapies to raise or lower IQ,” Johnston says. “There will be a market for it.”
Johnston doesn’t think a dystopic future is necessarily in the cards for humanity, or that we’ll have to deal with the machinations of malevolent genetically engineered superhumans. But they are still within the realms of possibility, she says.
The quality of life debate
One organisation exploring possibilities with genetics and what makes us human is NZeno Limited. The company is breeding gene-edited pigs with organs suitable for human transplantation.
“The New Zealand advantage is having pigs from the Auckland Islands that are free of common pig infections,” director and CEO Dr Paul Tan says. “The purpose of this technology is to have pig organs that can be better matched for human transplantation to relieve the worldwide shortage of human organs. The first focus is on kidney organs, but other tissues such as heart, lung or liver are potentially possible.”
Dr Tan says a focus for his company is not just using tech to help us live longer, but to live better.
Technology should ensure that longer lives also mean better quality of life.For example, successful kidney organ transplants are widely accepted as being more cost-effective than dialysis (kidney machines) and offers a better quality of life.”
Kode Biotech’s Henry echoes the importance of quality of life. But that, too, he says, has risks.
“No doubt technology has the potential to enable us to have longer and better lives,” he says.
“However, living longer is only useful if it has quality, both for the individual and society as a whole. Unless solutions for mental health can catch up and then keep pace with extended lifespans, then living longer is not necessarily a good thing.
“There is also a potential risk that the removal of all bad and pain from society could be undesirable, as many of the greatest humans to have lived were not the healthiest or happiest.”
NZeno’s Dr Tan says no matter what innovative new technologies we develop, they need to be accessible.
“Health technology will solve some current health problems as it has in the past – correctable congenital malformations, cure of some cancers, infectious disease and the successful management of HIV/AIDs, the on-going challenges are in mental health and care of the aged,” he says.
“The impact depends on availability of beneficial technology to all who need it. For NZeno, it is important to us that safe and matched pig kidneys are made available at a price that governments can afford for all citizens who need it. We believe it can be made cost-effective for the national health budget.”
As with abuse of technology, the past is rife with examples of large numbers of people being denied access to medicines and procedures that could save or improve their lives.
Infamous CEO of Turing Pharmaceuticals Martin Shkreli, also known as ‘the most hated man in America’ jacked up the price of the lifesaving HIV/AIDS drug Daraprim by a factor of 56 from US$13.50 to US$750 per pill. He is now in a US federal prison.
New Zealand’s unique approach
Johnston says the development of procedures that could make people smarter or stronger could very well create a society of ‘haves’ and ‘have nots.’ Or, at least, in some places. She says New Zealand currently has a model the rest of the world would do well to follow – one where new medical technologies aren’t usually introduced unless they are available to everyone.
“That’s kind of radical,” she says. “We try to make equally available the things we think are good.”
That approach will only become more important, Johnston adds, because of rising inequality in Aotearoa. “If you look at the last election, inequality was a political issue.”
There’s global precedence for making things that improve our lives freely available, Johnston adds. She says vaccines can be considered an example of using tech to extend our lives, pointing to how smallpox was eradicated in the 20th century thanks to a global vaccination campaign.
She says the continued efforts to eliminate polio – now only an endemic in parts of Afghanistan and Pakistan – through vaccination are another example. In both cases, the vaccines were given freely to everyone.
The need for regulation
Dr Tan says that in addition for the need for new technology to be accessible, there is a very real danger of misuse. That includes NZeno’s technology.
“The gene editing technology is widely available,” he says. “The application of this technology to our herd of pigs means that we have control of the use of tissues from such pigs. The application of all new medical technologies have to be regulated.”
Regulation has long been a hot-button issue when it comes to medical technology – particularly new or potential new technologies. For instance, cloning an entire human is illegal in dozens of countries, but therapeutic cloning – cloning specific organs for the purpose of harvesting and transplantation – is legal in a number of nations.
Deep in conspiratorial fever swamps, there’s a fear of ‘human-animal hybrids’ that could result from implanting human DNA in animals. While such experiments have been conducted on a small scale, such as human brain cells implanted in mice, the idea of a human mind being trapped in the body of a mouse remains unlikely.
Then there’s the case of controversial surgeons Sergio Canavero and Xiaoping Ren. The pair have been working on a procedure – to much controversy and morbid curiosity – to remove a human head and attach it to another body, effectively performing the world’s first “head transplant” (or, to be more scientifically accurate, full-body transplant).
Canavero has said successfully performing the procedure would be an achievement for humanity akin to reaching the moon, since it would potentially free people from a host of crippling and life-threatening diseases.
While some in the medical community have expressed horror at the possibility of the procedure due to the extreme ethical concerns, others have written that we’re rapidly nearing the stage where such a procedure is at least technologically a possibility – and Canavero and Ren have already (at least allegedly, as they have offered little proof for their claims) performed the procedure on at least two different sets of cadavers.
The experiments that have been performed so far – and the possible future attempt to attach a living person’s head to a new body – have taken place in China, because other nations have refused to allow such experiments.
Regardless of the level of regulation, Kode Biotech’s Henry says the next 20 years will likely only see greater divisions between people who are able to access the latest healthcare technology and those who cannot, unless something radically changes.
“Society will be very different in 20 years – technology, in particular connectivity to technology (be that either access or desire), will almost certainly create divisions within society,” he says.
“By that, I mean those who want or are able to connect directly into technology will have significant advantages over those who don’t or can’t. This will create significant social issues.
“Within 20 years, from a healthcare perspective the biggest impact will be from integration of technology with the human body, which will range from connected devices that will be able to provide real-time monitoring and response through to structural devices such as artificial hearts, organs and exoskeletons directly controlled by the brain of the user. Equally important will be new understanding of disease mechanisms deciphered from genomic studies, which will allow for design of tailored approaches to treatment of diseases, and the importance of the microbiome.”
But, he says, those breakthroughs might not necessarily yield immediate results. “A lot will happen in 20 years, but the real impacts will probably take 50 years to be realised.”
Johnston says part of the reason it could take a while is because of our innate desire to want to enhance ourselves, rather than simply make ourselves healthier. In other words: our own vanity.
“Treatments make you less sick, enhancements make you better than well,” she explains. “I think most people would like an enhancement of some kind.”
Johnston describes the differences like this: while wearing glasses or contact lenses to correct your vision would be an example of a treatment, because they would help you see normally, correcting your vision by wearing glasses that also gave you infrared vision would be an enhancement, because humans don’t naturally have infrared vision.
Cosmetic surgery – such as breast augmentation, rhinoplasty (nose jobs), dyeing one’s eyes, buttock lifts and more – could also loosely be considered a form of enhancement, Johnston explains, especially if they give the person something (such as a larger cup size) that they would not otherwise have naturally. Unlike infrared vision, for the people who want these procedures and can afford them, these surgeries are within their fingertips.
It's life, Jim, but not as we know it
In the 40 years since Louise Brown became the world’s first IVF baby, in vitro fertilisation –a process where an egg is fertilised by sperm in a test tube or elsewhere outside the body – has become a very normal part of New Zealand society. As many as 2,000 IVF treatment cycles are done in New Zealand each year, with about 650 babies born through the process. It’s a long way from the first IVF clinic opening in New Zealand in 1983. But what’s next? The next 40 years of fertility research are set to create new treatments that will one day be considered ‘normal’.
With the process of in vitro maturation (IVM), scientists are now able to replicate the process where egg cells mature in the ovaries outside of the body. Differing to IVF, where women’s eggs are matured with hormonal injections before they are collected and fused with sperm, IVM allows the maturation of eggs to take place in the lab. Using this same process, scientists have recently been able to grow human eggs in a laboratory by using strips of ovarian tissue removed in a biopsy. The breakthrough could allow women who suffered childhood cancers (that is, before puberty when matured eggs can be frozen) to have the option to conceive. If these eggs are proven to be normal and can form embryos, there are many possibilities for the technology to be utilised in as-yet unimagined future fertility treatments.
The emerging technology of IVG is opening up the possibility of converting any adult human cells (not necessarily reproductive cells) into artificial gametes, lab-made sperm and egg that could be combined to create an embryo and implanted in a womb. The process could allow same-sex couples to both be biological parents, or even produce children with a single biological parent because individuals could provide the cells to make both eggs and sperm. Using IVG in collaboration with gene-editing could eliminate the need for the difficult process of ‘three-parent IVF’ to remove any genetic diseases from the embryo. IVG, a process researched by Japanese scientists, could be as little as 20 years away from being safe enough to be used in a clinic.
The quest to live forever
With all the advancements of these advancements in mind, and research into other areas such as cryogenic preservation and mind uploading, the question arises: could we one day live forever?
The questions has dogged philosophers and ethicists almost since the dawn of humanity. And for good reason: our mortality, some argue, is what makes us human. We’re born, we live, and no matter what – regardless of who we are or how much or how little of a difference we make or what our life is like – we die.
Kode’s Henry, for one, doesn’t think living forever is a possibility, regardless of our technological progress.
“Living forever in the human-form including an advanced human-form is not likely,” he says.
So what’s more likely? “Humankind will almost certainly be superseded by machines, potentially biological machines based on humans (homo borg, a play on the artificial-biological villains from Star Trek bent on galactic domination), and in that form immortality is certainly possible. But I am sure it won’t take long for in-silico evolution to have discarded the human form for a much more efficient and functional form. But by then humanity will have long since ceased to exist.”
In other words, a Borg invasion – or a Terminator-like scenario where machines decide humans are not needed – of a kind is at least a possibility, if we don’t destroy ourselves first.
Our history is littered with stories of attempts to live forever by changing ourselves – often with disastrous results. For example, according to an ancient Greek myth, the titaness Eos asked Zeus to make her human lover Tithonus immortal. But, she forgot to ask that he also be granted eternal youth. As the years went by, Tithonus slowly became shrunken and shrivelled, eventually turning into what we know today as a grasshopper. One can reasonably assume his quality of life was not exactly ideal.
NZeno’s Dr Tan also cites myth and literature in his belief as to why pursuing immortality might not be the best idea.
“In the foreseeable future, it is unlikely that we can live forever,” he says.
“Many of us would not want to. Someone may write a contemporary version of Faust (Johann Wolfgang von Goethe/Charles Gounod), The Picture of Dorian Gray (Oscar Wilde), The Makropulos Affair (Karel Čapek/Leoš Janáček) or Back to Methuselah (George Bernard Shaw).”
Immortality aside, Dr Tan says it’s important not to “mess up” technology – and, again, stresses that we need to use it for the right reasons. “Our intention [with NZeno] is to use limited gene editing on pigs – excessive gene editing will likely disrupt their genome,” he says.
“Others are gene editing the human genome. For selected diseases this would be appropriate – while this may be hacking the genome it need not ‘hack humanity.’ Historically, humanity can be and has been messed up with the technology of the day or without technology (by just looking away).”
The Hastings Centre bioethicist Johnston also stresses the importance to understand what it is we’re doing to avoid catastrophe.
“We can sequence a genome and edit it, but it would be a mistake to say we fully understand genomics,” she explains.
Johnston points to nuclear as an example of a technology that can have positive and negative uses, but also was not entirely understood when it was first developed. While it can have positive uses – such as X-rays and energy – it can also have negative uses, such as being used as a weapon of war. Plus, at least in the beginning, the grave health dangers posed by radiation weren’t well-known. “That happens a lot with technologies – we don’t always understand it.”
But living forever, even with technology? Johnston is quick to answer – and her answer isn’t exactly the kind of thing that would get futurists’ imaginations fluttering. “I don’t think we’ll be living forever.”
Johnston also says no matter how great our technology becomes, there are other more basic commodities responsible for helping us live longer now than how much we are able to modify ourselves – things which humans would do well not to lose sight of.
“People are living longer not just because of technology, but because of basic sanitation and medical care.”
Idealog has been covering the most interesting people, businesses and issues from the fields of innovation, design, technology and urban development for over 12 years. And we're asking for your support so we can keep telling those stories, inspire more entrepreneurs to start their own businesses and keep pushing New Zealand forward. Give over $5 a month and you will not only be supporting New Zealand innovation, but you’ll also receive a print subscription and a copy of the new book by David Downs and Dr. Michelle Dickinson, No. 8 Recharged (while stocks last).
Idealog is part of ICG. We work with clients like Woolworths New Zealand, All Good, Huffer, Liquorland, Resene, Citta Design, TVNZ, Spark and FCB on their event activations, in-store, in-office or out-of-home signage, content creation and vehicle wraps.