Life-Sciences Evolves Amidst Controversy Era.

Fasten your seat belts for a century that promises to be anything but dull

Life sciences, rapidly gaining momentum, will begin to dominate U.S. economic activity by 2100, then predominate well into the following century. (See Chart 1, "Life Sciences and Genetics: Dominant by 2100.") Up to 90 percent of all genetic discoveries occurred within the last 30 years, and the pace is increasing. Massive advances will follow as the 140,000 genes and 3 billion molecular units (base pairs) comprising the human genome are plotted in rough draft before 2001, and definitively charted by 2003. Genetic patterns provide the means to govern many of the 75 trillion parts in every human.

Creation's schematics for life-forms--translated by biotechnology and applied through genetic engineering--open up almost unimaginable opportunities to control the evolution of plants, animals, and--eventually--human beings. Cloning a sheep, Dolly, from an adult cell in 1997 proves that duplication of genetic successors is possible and shakes the meaning of life to its very roots.

Associations take center stage

The impact of the life-sciences era on associations, while perhaps not immediately apparent, will span a vast spectrum. The ethical issues it will raise potentially may affect virtually every association given that associations, even those that represent trades and professions, ultimately serve and influence the lives of individual human beings.

Associations with missions that encompass management and human relations issues are certain to feel the impact of this contentious yet miraculous biotechnological era now beginning to unfold. Scientific research groups will be the first to become fully immersed in the coming era. Associations representing producers (and their suppliers) acquire new responsibilities as research and development concepts are brought to market. Next, organizations representing end-of-chain distributors and users acquire new roles.

For some organizations, staying in the forefront of developments and trends will engender newfound responsibilities and continuing leadership. For others, the era may mean lost opportunities, decline, and eventual demise. Association executives can prepare themselves and their organizations for the life-sciences era by staying current on biotechnology developments and evaluating how such advances might affect their particular field.

A time of rigorous debate

As early as 2020, new powers to create or to take a life will unleash the most divisive moral and ethical dilemmas of all time. Eugenics (humans taking conscious control of their evolution) is certain to become the most controversial center of these debates. Threats of genocide and the creation of a super race, coupled with the gargantuan geriatric problems of an expressed longevity of 125-160 years, will alter reality as we now know it.

Organizations focused on ethics, morals, philosophy, and religion -- medical societies, research institutions, universities, religious organizations, and public interest groups -- will focus on new dimensions of age-old problems. Bioethics, a term that everyone will be hearing a great deal more about, emerged in 1970. By 1978, a four-volume Encyclopedia of Bioethics emerged, which is just one indication of where things are headed.

Attempts by various groups or interests to encumber advances in biotechnologies, genetics, and life sciences will be overcome by the sheer force of necessity. Advances will prove far too important to be stifled, such as

* eradicating genetic diseases;

* extending life expectancy;

* generating new fuel and energy sources;

* increasing food production;

* creating life-saving pharmaceuticals;

* enhancing resource recovery;

* providing synthetic lumber;

* generating industrial enzymes;

* producing biodegradable plastics; and

* creating computer biochips.

Nearly every major advance in bioscience has met with resistance. Not so many years ago, church leaders denounced as blasphemous Luther Burbank's hybridizing of plant life. Centuries earlier, human dissection was blocked on grounds it was sacrilegious, cruel, immoral, and obscene. Medical and public health measures as well as the introduction of antiseptics, immunizations, and nutrition therapies all have encountered similar opposition. Religious groups, to this day, oppose female-egg donation and artificial conception.

As it eventually turned out, each one of these advances saved countless lives and eliminated untold suffering. Science-oriented associations, including the Biotechnology Institute for Medical and Biological Engineering, Washington, D.C., and the Biomedical Research Institute, Rockville, Maryland, represent overall biotechnology interests and stand in the vanguard for keeping progress on track.

Body shops will flourish

Body shops stand to acquire new meaning as an aging population seeks such body tune-ups as

* resetting molecular clocks governing aging;

* cloning or replacing body parts;

* jump-starting senescent brains;

* gassing up with genetically-engineered hormones;

* regenerating new cells and molecules; and

* reaming out tube-clogging plaque.

Health care related associations, rehabilitation groups, and specialized clinics will dominate this field. New opportunities could emerge for other organizations, such as diet and nutrition health centers, and retirement communities, depending on how they respond to trends.

Cloning and organ transplants could usher in immortality of a sort for persons choosing that path. Cloning body-part replacements using one's own pluripotent (stem) cells is imminent. From this perspective, the fabled fountain of youth has resided within each of us all along.

Another approach to potentially longer lives is already provided by morticians who provide sampling and cryogenic storage of genetic material until the time when cloning technologies will be able to resurrect life. Organs from other animals also will become widely available for transplant in humans.

These developments may bring an end to organ transplant shortages (and the inherent controversy in deciding which patients merit priority), halt incentives for illicit harvesting of organs, squelch black-market sales, and resolve immune-system rejection. Replacing body parts began more than 5,000 years ago; turning back is not a realistic option.

The fine line between therapeutic and cosmetic reconstruction poses questions of one sort. More difficult questions arise when facing the issue of limiting health care funding to worthy cases. For example, should one genetically impaired patient costing millions of dollars to cure and sustain prevail when funds could otherwise be devoted to help or save a far greater number of afflicted whose health problems could more easily and inexpensively be treated? Balancing socially beneficial outcomes will not be simple; associations undoubtedly will play a pivotal role in disseminating information about the many divisive issues posed by the life-sciences era.

Designer babies multiply

Until recent times, women passively accepted the number of children "willed by God." The situation changed as contraceptives were begrudgingly introduced after being outlawed for centuries. Amniocentesis, available since 1952, and enhanced visualization techniques are among the existing procedures that can detect developmental and genetic problems and allow for early identification of the sex of the fetus. Abortion also became a somewhat limited right that still remains in contention.

Lab-assisted fertility and genetic screening open up new opportunities for ensuring sound stock. Surgically removed ova and sperm can be carefully screened for gene-based defects, and then combined in the laboratory to create perfect zygotes. Selected blastocysts (multicelled developing embryos) can be implanted in the biological parent or a third-party female surrogate.

Since the first test-tube baby, Louise Brown, was born in 1978, females receiving fertility assistance soared to 64,000 during 1996. In-vitro clinics increased from one in 1986 to more than 300 in the United States by 1999. Egg-donor use jumped from 2,500 in 1995 to 5,000 in 1996. By 1998, 5,000-10,000 donor-egg babies had been born. During 1999, more than 5,000 donor-eggs were implanted.

On another front, in utero surgery (first reported in 1981), creates other opportunities for dealing with fetal abnormalities. Genetic therapies also can repair certain problems--both in utero and at later stages of human development (first successfully accomplished in 1990).

Fertility therapies are not cheap. Start-to-finish costs for in vivo fertilization easily cost $9,900. Egg donor fees, which initially cost less than $1,000, soon rose to about $3,000 and then to about $6,000; one anonymous party reportedly offered as much as $50,000. Consider further that multiple procedures may be necessary before bringing a baby to term. Who, then, pays for this costly treatment? Private insurance rarely covers such procedures. Given the high costs, social-insurance programs eventually may be broadened to include some procedures.

Eventually, it might be possible for would-be parents to select from a menu of traits. Given the option to control genetic defects, parents most likely will do everything possible both to prevent their children from having to cope with genetic defects and to ensure that they have the most advantageous genetic predispositions possible. A Bahamas-based company, a forum or venue of least resistance, reportedly offers human-cloning services for $200,000. Apparently money can, literally, buy anything. Genetic technologies denied in one jurisdiction, simply will be established elsewhere.

Given these trends, sexual activity eventually will become more for recreation than for procreation. Birth control, contraceptive technologies, fertility controls, and surgical sterilization will help ensure this turnabout. Normal sexual reproduction without genetic profiling or engineering will come to be deemed as foolhardy as foregoing prenatal care is today.

Medical professions, such as the American Society for Reproductive Medicine, Birmingham, Alabama, and activist organizations of all stripes dominate public discussion of these developments and will continue to do so as the era of life sciences evolves. Egg or sperm donor anonymity may cause emotional problems for persons with unknown biological origins, thereby drawing organizations like the American Psychological Association, Washington, D.C., into the loop.

Health care undergoes cataclysmic shift

Thumbnail-sized diagnostic probes with one million micro-tubules have been designed to assay genetic indicators of disease and profile DNA. Biochip slides and films coupled to portable labs can identify limited numbers of genes within minutes or hours. At least 400 different genetic tests had been devised by 1999, with a torrent more imminent. Such mini-lab sales are expected to skyrocket from $1 billion to $40 billion between 1999 and 2009. Associations representing diagnostic and computer manufacturers, along with their suppliers, stand to benefit. On-the-spot diagnosis poses a different fate for associations representing the 170,000 central medical-testing laboratories.

Detecting genetic abnormalities affords new opportunities to correct defects. Gene therapies can be used prior to or at early stages of conception, during gestation in utero, or after birth and later on during life. The cataclysmic shift from a corrective to a preventive approach to health care cannot be underemphasized.

At the same time, discovery of genetic defects poses risks involving discrimination, invasion of privacy, health care rationing, abortion, and euthanasia. Great wisdom will be required, lest a false move terminate a potential Lou Gehrig, Babe Ruth, or Stephen Hawking. On the other hand, spending millions to treat genetic impediments that might have been avoided if irresponsible parents and health care givers had taken proper screening measures could become too burdensome for limited taxpayer-funded health care. Sky-high health care costs could reach the point that social consensus clamors for a halt.

Lawsuits involving children injured by genetic procedures or therapies gone wrong, fertility clinics that allegedly passed along genetically flawed sperm or ova, medical practitioners who failed to detect genetic defects or omitted mentioning availability of genetic screening (that might have prevented the birth of an afflicted baby), already have been lodged. Not only medical professions, fertility clinics, and insurers have important stakes in litigious aspects of the genetic revolution, but also such organizations as the American Bar Association, Chicago. From a different vantage point, the Health Insurance Association of America, Washington, D.C., grapples against efforts to bar disclosure of family history, physical exams, or medical records in hiring or insuring practices.

Weight, height, life span will increase

People will be living longer--as long as 100 years or maybe even forever. They will grow taller--to an average of six feet, two inches by 3000. And they will weigh more--180-210 pounds by 3000. (See Chart 2, "Human Growth.") These changes, accelerated by biotechnological advances, will result in more biomass to care for, feed, and clothe. In short: more business for everyone.

How will individuals who live 100 years or longer sustain themselves in retirement? From another slant, think of what 30-100 year increases in life expectancy hold for golf, leisure-time activities, health care services, pharmaceuticals, and assisted living, among other fields. It also stands to reason that greater life expectancy would impact the normal retirement age. Changes here have obvious implications for a great number of organizations, AARP (formerly known as American Association of Retired Persons), Washington, D.C., being the first to come to mind.

Assumptions that population will stabilize are merely hopeful musings. Boosted by life sciences, U.S. population may reach 900 million, and the worldwide population 30 billion, by 3000. This is equivalent to five times Earth's population today--an almost unimaginable market growth.

Growth will also register on an individual level. Ever wonder why those airplane seats feel too small? Increased girth and hip spread already have dictated altered seating standards for stadium chairs; the previous width of 18 inches has given way to 21-24 inches. Mattress loft and chair padding, along with their supporting frames, have become heftier, comfier. Little-noticed though these changes may he, they highlight how associations seemingly far removed from life sciences--such as the Independent Office Products and Furniture Dealers Association, Alexandria, Virginia, the Business and Institutional Furniture Manufacturer's Association International, Grand Rapids, Michigan, and manufacturers of stadium seating or church pews, can be impacted by these trends.

Genetic tinkering defies disease

More than 5,000 genes are linked to hereditary medical problems. Researchers already have discovered and tested genetic markers for such diseases as Alzheimer's, Huntington's, cystic fibrosis, and Down's syndrome. By mid-1999, more than 100 bioengineered drugs were on the market and more than 450 more were in clinical trials.

Genetic tinkering to eradicate cystic fibrosis, Tay-Sachs disease, or sickle cell disease deserve support without the hassle and heated debate that accompanied the discovery of drugs and vaccines that obliterated smallpox, tuberculosis, and polio. Still, careful evaluation of whether to proceed is essential before making the leap, and tradeoffs will not always be clear-cut.

Pharmacogenomics, a science that compares an individual's gene profile with optimal genetic makeup, enables person-specific designer drugs to be created. Individually tailored prescription drugs and lesser quantities of them will help to reduce rising health care and insurance costs.

Genetically engineered potatoes provide vaccines against cholera and hepatitis B. So-called pharm-foods are a godsend in countries where unsterile conditions, lack of refrigeration to store vaccines, cultural opposition, and prohibitive costs discourage life-saving vaccinations. Animals have become biofactories, selectively producing drugs recovered and purified from their milk, urine, blood, or other organs.

Representation of these developments falls upon the shoulders of such organizations as the Pharmaceutical Research and Manufacturers of America, Washington, D.C., and the Biotechnology Industry Organization, Washington, D.C.

In other developments, gene researchers have succeeded in reactivating dormant hair follicles and successfully restoring hair--a potential boon to baldness or hair loss following chemotherapy. Other researchers are seeking genes controlling hair color. Some observers fear that genetic control of hair eventually may lead to masking racial origins by changing skin color.

Associations interested in genetics because of prospects for restoring or coloring hair range from the Cosmetic, Toiletry, and Fragrance Association, Washington, D.C., and the Consumer Healthcare Products Association, Washington, D.C., to groups representing cosmetic surgeons, barbers, hair-dressers, and toupee manufacturers.

Genetic modification gets mixed reviews

Genetic technologies will boost crop yields far beyond those made possible by the Green Revolution. Bioengineered crops not only will boost yields, but create new varieties that thrive in hostile environments--surviving without irrigation, withstanding frost, tolerating herbicides, reducing agrichemical needs, and much more. More than 4,500 genetically modified crops have been developed and tested. Worldwide revenues generated by plant biotechnology are projected to reach $6.6 billion by 2005.

Turf grasses genetically engineered not to grow beyond a fixed height will revolutionize lawn care. Widespread acceptance of these varieties will radically alter missions of the Outdoor Power Equipment Institute, Alexandria, Virginia, Professional Lawn Care Association of America, Marietta, Georgia, and Turfgrass Producers International, Rolling Meadows, Illinois. Also affected will be associations representing varieties of grasses as well as sports-related organizations including country clubs and golf courses, lawn tennis, and lawn bowling groups.

Bioreactors are taking over where open-field agriculture leaves off. These reactors may either be natural, involving life-forms engineered to produce specific substances, or mechanical, typically fermenters or replications used to grow biological materials in labs or factories. Conceivably, genetically modified crops may be redesigned to yield only the most useful and valuable component desired: for example, orange juice sacs without roots, trunk, branches, leaves, rind, or seeds.

Enormous controversies swirl around these foods. Derisively referred to as Frankenfoods or mutant crops, World Trade Organization proposals seek to curb them. European Union policies have required label disclosure for genetically modified foods containing modified components in excess of 1 percent since 1997. The EU suspended regulatory approval of such crops on June 26, 1999.

Implications of these developments for U.S. farmers are huge. The United States supplies approximately 50 percent of the world's corn and soybean exports. U.S. soybean exports to EU countries plummeted from 398 million bushels (1997-1998) to 221 million bushels (1999-2000). Export sale losses attributable to genetically modified foods in 1999 exceeded $200 million. Because there is little difference between hybridized and genetically modified crops, prohibitions and restrictions essentially amount to non-tariff barriers to trade or veiled protectionism.

Adverse impacts curtailed farmer planting, devastated gene-spliced seeds, increased grain-storage costs (by necessitating segregated stock), and caused major biotechnology-based company stocks to decline. The twisted irony of all this is that genetic modification has been under way for at least 10,000 years. Around 8000 B.C., when natural crops became domesticated, selective breeding commenced. This was followed by cross-breeding and eventually hybridization (early 1900s), that contributed to accentuating and altering desired properties. Genetic modification simply involves a more conscious and directed refinement of previous hit-or-miss approaches at more precise molecular and cellular levels. Today, as much as 60-70 percent of all U.S. processed foods contain genetically altered components.

The gene modification debate has put center stage such associations as the Grocery Manufacturers of America, Washington, D.C., and Food Distributors International, Falls Church, Virginia. National Food Processors Association, Washington, D.C., gene modification representatives designate gene modification-related issues as their top issue. The America Corn Growers Association, Washington, D.C., anticipates a 20-25 percent reduction in acreage for gene modified corn, primarily due to reduced exports. A huge range of suppliers including The Fertilizer Institute, Washington, D.C., American Chemical Society, Washington, D.C., and American Crop Protection Association, Washington, D.C., have large interests at stake. The world's largest business federation--the U.S. Chamber of Commerce--has waded into the controversy, stridently opposing export restrictions on enormous amounts of U.S. food exports, while endorsing tax credits for research and experimentation. Their major reason? Every $1 billion in exports creates 20,000 U.S. jobs.

Boon for livestock industry

Cloning prize livestock will be a welcome boost to animal husbandry, for zoos interested in perpetuating scarce species, and for environmentalists concerned about preserving biological diversity. Livestock groups, including the American Meat Institute, Arlington, Virginia, represent vital industry segments such as beef with sales that totaled $30-35 billion in 1998. AMI, for example, is taking a keen interest in the work of Japanese scientists who recently cloned cows so prized that their meat was valued at $100 per pound. The National Pork Producers Council, Des Moines, Iowa, has championed the development and promotion of leaner and faster growing strains--to the great benefit of growers and consumers alike.

The jump to genetic-based animal husbandry and cloning is a small one, considering that 60 percent of all calves born on U.S. farms currently are conceived by artificial insemination. This procedure has also played a key role in boosting bovine milk output. Milk production per cow rose from 4,622 pounds yearly (8,600 pounds on well-managed U.S. dairy farms) in 1940 to 16,915 pounds in 1997. The world's record annual output for a single cow of 55,691 pounds indicates that there's plenty of room for further increases. Genetic inputs are certain to result in further increases. Cows that produce greater quantities of higher quality milk are of special interest to dairy associations, including the International Dairy Foods Association, Washington, D.C., Milk Industry Foundation, Washington, D.C., and related groups.

In concluding this discussion, consider this: The first biotechnology company startup, Genetech, established in 1976, had been joined by at least 1,300 others by 1999. One prominent company among them--Amgen--was valued at $30 billion in 1999, ranking it among the major pharmaceutical companies in the world.

More recently, biotechnology patent applications in fiscal year 1997 numbered 10,500, second only to those for computer sciences. However counted and whatever the numbers may be, this field is but one of many signs indicating that the life-sciences era is poised to dominate the U.S. economy in coming years.

Graham T. T. Molitor is vice president and legal counsel, World Future Society, Bethesda, Maryland, and president, Public Policy Forecasting, Potomac, Maryland.

Editor's note: The third millennium may have just begun, but it's never too soon to find out what role associations will play in our ever-changing world. This article, the third in a six-part series that began with the December 1999 issue of ASSOCIATION MANAGEMENT, explores the biotechnological advances that will shape the life-sciences era. Series author Graham T. T. Molitor, vice president and legal counsel, World Future Society, Bethesda, Maryland, and president, Public Policy Forecasting, Potomac, Maryland, describes the coming waves of economic activity he forecasts will dominate the United States and how these eras will impact associations. The remaining articles in the series will explore megamaterials, a new atomic age, and a new space age. Molitor's new books, The Next 1,000 Years and a multiple-volume Chronology of Civilization, comprehensively describing patterns of change, are scheduled for release in 2002.

As portrayed by Molitor, the life-sciences era will "unleash the most divisive moral and ethical dilemmas of all time," as biotechnological advances make it possible to control the evolution of plants, animals, and eventually human beings. Care to debate any of Molitor's observations or assumptions? We'd love to share your perspective with other readers, so please e-mail us at [e-mail].

                               Human Growth
                              U.S. POPULATION
                                (millions)
1610 350 Initial Settlers High-low projections
1790         3.9
1821          10
1853          26
1880          50
1915         101
1998         270
2000         275
2010         298
2050         394                  295
2100         291                  308
3000         900
                             WORLD POPULATION
                                (billions)
10000 BC .004
4000 BC  .007
1000 BC  .050
500 BC   .100
1000     .265
1340     .380
1600     .545
1750     .730
1900      1.7
1970      3.7
1999        6
2100       15
3000       30
WEIGHT (adult male,
pounds)
60-120                    3,500,000 BC
135-190                   1990s
180-210                   3000
BRAIN (cubic centimeters)
450-750                   3,500,000 BC
775                       2,900,000 BC
710-1200                  1,500,000 BC
1035-1255                 200,000 BC
950-1200                  1980s
1200-1500                 2000
1800-2000                 3000
HEIGHT (feet, inches)
4'6"-5'0"                 3,500,000 BC
5'4"                      1,600,000 BC
5'7"                      1200
5'7"                      1776
5'8"                      1916
5'9"                      1958
5'10"                     2000
6'0"                      2050
6'2"                      3000
                              LIFE EXPECTANCY
1 BC   18
AD 200 22
C 1400 35
1900   47.3
1960   69.7
1997   76.5
2050   83
3000   130-160