The politics of cloning

On a recent visit to South Africa I was fortunate enough to be given access to interview a number of high-level academics, journal editors, and science journalists on questions concerning the social and ethical implications of genomic technology in Southern Africa.  What I found surprised me.

Africa is discussing the same issues as everyone else.  Everyone, the world over, seems fascinated by the bio-safety, health, and commercial implications of genetically modified food.  And, (almost) everyone in the higher echelons of academia, the world over complains that the ‘general public’ remains misinformed, polarised, and altogether unable to grasp the science behind genetic modification.  Although these interviews could not prove it, it would appear that (nearly) everyone, the world over, is fascinated by the potential for genomic engineering to provide vaccines, diagnostics, and cures for the diseases that they are most burdened with.  The difference between these discussions, and those elsewhere, are the diseases with highest prevalence in the population and the numbers (absolute and relative) of people affected by such diseases. 

In South Africa, the main focus of discussion regarding disease and genetic engineering is upon HIV/AIDS and TB.  In Europe and the US, the focus is upon cures for cancers, diseases ‘of age’, and – more topically – the genetic basis (and subsequent) cure for the burden of obesity and associated diabetes.  Some would argue that in future Africa might be burdened with both a high level of communicable disease and chronic disease as the population demographic changes.

So what is the point of studying the ethical, legal, and social implications (collectively known as ELSI) of biotechnology and genomics in sub-Saharan Africa; and what is the point in trying to stimulate a multi-disciplinary debate of such issues?  The reason is simple.  The ELSI debate over genomics and biotechnology determines - not the presence or absence of technology in a country - but, instead determines the manner in which such technology is made to work for the populations of a country or continent.  Increasing knowledge flows – stimulating communication – within academia (between traditionally separate disciplines), between academia and the general public, through education, and through newspapers, radio, and TV – increases the chances that such technology will work for the population of South Africa (and similarly for any countries or populations able to discuss these issues).  Politicians and policy makers also need to become involved!

In Africa – or at least as far as I can deduce from my interviews – there was awareness - within academia and science journalism – that knowledge about science is not being shared either between academic disciplines, or with journalists, or directly with the general public (I’ll be pleased to hear from individuals and institutions which challenge this perception).  On this limited sample basis, I would feel confident to state that more (on a relative scale) of the African population lacks basic knowledge of genomics and biotechnology than the European and US populations.  The ability to have an ELSI debate is therefore more limited and, by implication, a smaller percentage of the population will have the tools available to make genomics and biotechnology work for them.  ELSI debates about biotechnology and genomics can – if started early enough – integrate the process of developing new genomic technology – with frameworks for distribution of such technology.  Without such an integrative framework – an ‘innovative’ or ‘embedded’ approach – access for the poorest people and poorest countries in Africa will be an afterthought - technology and technologists will appear distant from the needs of the public, and the genomics revolution will sweep through Africa as technology developed (primarily) by and specifically for a non-African social context.

So in answering the title question – the ELSI debate in South Africa is roughly the same as anywhere in the world.  A surprise – to me at least!  There is no fundamental distinction as to what people might discuss or why they might discuss it.  What is different - as compared to a hypothetically generalised level of debate in the US and Europe - might be the scale of exclusion from the debate.  And, although this picture of a major knowledge gap is not unique to Africa, it is nonetheless indicative of the need to begin an open dialogue as quickly as possible.  So, if the answer to the title question is a qualified “nothing fundamental”, in part II, I’ll ask the same question – but find reasons why the African ELSI debate regarding genomics is fundamentally different (and why the answer may be found in James Watson’s recent comments).