Protecting The World From Pandemics

Paul Hoffman: What about world cooperation? We had another guest at Big Think, Laurie Garret, who’s the global health analyst at the Council for Foreign Relations, and she observed that Indonesia has not been releasing certain avian flu samples for a few years now, on the grounds that they believe that their own people, or poor people around the world, won’t benefit if any vaccine is created. How do we address problems like this so we can have greater global cooperation, Barry?

 

Barry Bloom: It’s a big problem, and it has to do with the law of intellectual property. The perception that I have is that the rich countries are scientifically advanced. They invest in technology and they control most of the intellectual property and patents for things. And I think the cry from Indonesia, which is burst forth more quietly from other places, is that they want some share in any rights and royalties for discoveries made with materials, diseases, or viruses discovered in their countries.

That’s a radical change from the passivity of saying it’s the rich countries’ responsibility to take care of the poor countries. But it’s not putting tremendous, and I think appropriate demands, for just what you’ve said, is how do we share intellectual property? How do we make expensive vaccines available at low cost? As we are for AIDS drugs to people in Africa.

I would point out, when this played out with antiretroviral drugs; there was much screaming, particularly in countries in Africa, about intellectual property being monopolized by the rich countries. Turns out that the twenty-five sub-Saharan African countries with AIDS only one of them is a signatory to the intellectual property agreements at WIPO [World Intellectual Property Organization], and consequently, the rest of them were free to manufacture anything they wanted, because they were not bound by that. They simply didn’t have the technical capacity to do that.

I think the world has evolved. A lawsuit in South Africa was withdrawn. The companies have decided to reduce the price and say, we will share the technology that we have to help prevent death and save lives, when the case is really serious. And I would hope that Indonesia and other countries that are providing viruses for study, that get turned into vaccines, will be similarly cooperative.

Some countries have withheld information about viruses, others have accused developed countries of monopolistic tendencies. In this video, Barry Bloom surveys vaccine intellectual property disputes related to Indonesia, Sub-Saharan African and South Africa.

Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
Surprising Science
  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

Dubai to build the world’s largest concentrated solar power plant

Can you make solar power work when the sun goes down? You can, and Dubai is about to run a city that way.

Photo credit: MARWAN NAAMANI / AFP / Getty Images
Technology & Innovation
  • A new concentrated solar plant is under construction in Dubai.
  • When it opens next year, it will be the largest plant of its kind on Earth.
  • Concentrated solar power solves the problem of how to store electricity in ways that solar pannels cannot.
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19th-century medicine: Milk was used as a blood substitute for transfusions

Believe it or not, for a few decades, giving people "milk transfusions" was all the rage.

Photo credit: Robert Bye on Unsplash
Surprising Science
  • Prior to the discovery of blood types in 1901, giving people blood transfusions was a risky procedure.
  • In order to get around the need to transfuse others with blood, some doctors resorted to using a blood substitute: Milk.
  • It went pretty much how you would expect it to.
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