This week it emerged that the first human test of the controversial gene-editing technique CRISPR had taken place at West China Hospital in Chengdu, where oncologists used it to treat a man with an aggressive lung cancer.
Similar trials are expected to start in early 2017 in the US, sparking speculation that the two countries are . But is this a responsible way to frame the development of a technology that is so fraught with possible risk?
The Chinese trial involved collecting the man鈥檚 immune cells, editing them using CRISPR to create a much more aggressive version and reinjecting them to fight the cancer cells 鈥� this last step took place on 28 October.
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This and a handful of other pioneering human trials using different gene-editing techniques 鈥� including the successful treatment of a 1-year-old girl with leukaemia 鈥� are comparatively uncontroversial because the alterations had no bearing on the reproductive system, so the interventions can鈥檛 be inherited.
However, scientists also have a wish list of medical applications, such as the eradication of rare genetic diseases, that would survive down the generations. The endgame with these is more radical.
Disease eradication
Take the Human Genome Project-Write, which aims to build an artificial human genome. At its launch earlier this year, one of its founders, , described a future in which we could eradicate diseases and better adapt our species to the modern environment. 鈥淲e are not well-suited to 60-mile commutes, a superabundance of food and certainly not for being astronauts,鈥� he said.
But we don鈥檛 know yet how we would go about making a person resistant to diabetes, HIV or cancer. If we want to find out, we need to start tinkering, and that鈥檚 where ethicists come in. China has already performed CRISPR edits on embryos four times. Here, the US lags behind.
Which brings us back to that space race comment: speaking to Nature, which first revealed the trial, Carl June at the University of Pennsylvania, described a coming 鈥渂iomedical duel on progress between China and the United States鈥�.
Which nation wins may be determined by how successful domestic proponents are at convincing regulators to relax gene-editing rules. CRISPR is already being used in the US and elsewhere to create pigs that are immune to many diseases, cattle that don鈥檛 get TB and chickens that are resistant to bird flu. But the US Food and Drug Administration isn鈥檛 on board yet, keeping these innovations strictly in the lab for now.
If it鈥檚 tough to get the FDA on side, it will be even harder to get the backing of those who approve human clinical trials. Although the US has no official ban on the technique, it prohibits federal funding for research involving human embryos, and regulatory approval is needed for human gene editing.
Metaphorical failure
And that鈥檚 where some ethicists have a concern. 鈥淭he space race is a terrible metaphor,鈥� says , who directs Stanford University鈥檚 Center for Law and the Biosciences. 鈥淔ighting disease has no national boundaries. If groups in China 鈥� or Mexico, or Indonesia, or Russia 鈥� find cures, we all benefit.鈥�
He sees darker implications in the metaphor. 鈥淚t seems to me a crude effort to create excitement, hype, more funding,鈥� he says, 鈥渁nd perhaps laxer controls.鈥�
In the West, it鈥檚 widely assumed that China鈥檚 regulations benefit from a more-relaxed view of ethical obligations, particularly in gene-editing research. It鈥檚 less clear whether this .
鈥淎s far as I can tell, its structure for regulating clinical research doesn鈥檛 look that different from those in the US or the West generally,鈥� says Greely. 鈥淭he extent of enforcement is unclear but that鈥檚 true here also to some extent.鈥�
Greely doubts the differences are substantial, but it鈥檚 an argument that cynical people in the US could use to convince regulators to loosen rules.
鈥淥ne might dismiss the space-race talk as hyperbole business as usual,鈥� says Greely, 鈥渂ut its aim at China makes it a bit more dangerous than that, in an era when there are people in the US who want to demonise China.鈥�
