The myth of the biotech revolution

“How could you let yourself get like that?”: Stories of the origins of obesity in accounts of weight loss surgery

In the context of the contemporary rhetoric of the "obesity epidemic", the fat body is easily labelled as lazy, self-indulgent and lacking in discipline. Those who become fat often find themselves needing to account for their size in order to refute the suggestion of moral failure that attaches itself easily to the fat body. Drawing on a series of interviews with 35 weight loss surgery patients in England and Scotland, this paper explores the discursive resources and strategies available to those who are, or who have been, very overweight in accounting for their size. The paper argues that the participants drew on three core discourses in order to resist the construction of their fatness as an individual moral failure: (1) the fat-prone body; (2) childhood weight gain; and (3) life events disrupting weight management efforts.

Upstream ethics in nanomedicine: a call for research

Insufficient attention has been given to ethical and social issues integral to nanomedicine. Part of this deficiency arises from some mistaken assumptions about ethics. I consider five of these: that ethics is only important when a technology is mature (reactionary ethics); that there are no new ethical issues in nanomedicine; that ethics involves a kind of risk assessment that is already being conducted; that ethics is a hindrance to science; and that ethics is a luxury for an ideal world. After critically assessing these assumptions, I consider two types of nanomedicine and the kinds of ethical issues they raise. Type 1 nanomedicine is of an incremental kind, and proper ethical assessment of the issues must involve a fine grained study of the specific application. Type 2 nanomedicine is of a more foundational, programmatic kind. Ethical issues raised by these more programmatic developments include challenges integral to formation of interdisciplinary teams; issues related to intellectual property, authorship and publication; development of informed consent and confidentiality protections associated with new data sets; future challenges to the clinician–patient relation and personalized medicine. Ethical analysis should also consider some of the reductionistic implications of engineering models and metaphors integral to nanomedicine, as well as uses of nanomedicine for non-medical purposes, such as human enhancement. Many of these challenges concern rate-limiting steps in nanomedical research, and they should be prominently featured in developing nanomedicine initiatives.

Russia through the prism of the world biopharmaceutical market

Trends in the Russian pharmaceutical biotechnology and related fields representing the major sector of domestic biotech are reviewed through the prism of the world biopharmaceuticals market. A special emphasis is placed on biogenerics and follow-on biologics. The revival of national pharmbiotech is seen in close cooperation between private companies and the state, academia and industry. One of the first positive steps toward promoting development of domestic biopharmaceuticals is the Federal Program of subsidized supply of expensive pharmaceuticals (Dopolnitel'- noe Lekarstvennoe Obespechenie). The program allows the Russian government to purchases expensive drugs to be provided free of cost to certain preferential categories of individuals. As an example, production of recombinant human insulin by the largest Russian fundamental biotechnological institute, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry under the trademark Insuran (Insulin produced by the Russian Academy of Science) is reviewed. Some prospects and problems of Russian biotech research related to medical area are briefly discussed.

INNOVATION MODELS IN THE BIOPHARMACEUTICAL SECTOR

The innovation process in the biopharmaceutical sector is influenced by long business cycles, multiple stakeholders and complex interactions. Early models of the innovation process are inadequate to capture the complexity of innovation in the life sciences sector. In particular, narrow classifications which describe innovations as "radical" or "incremental" are not particularly useful when considered in the context of the complex patterns of interrelated innovations observed in practice.

Many partial models of the innovation process which equate innovation to inventive research, patenting and product development fail to recognise that innovation is a cyclical and business-driven process and underscore the final phase of the innovation process, namely, achieving timely market diffusion and adoption of innovations to benefit patients and innovators. Innovation is sustained if it is appropriately rewarded. Investment in the science base alone without appropriate reward system for innovations is unlikely to promote renewed competitiveness in the European biopharmaceutical industry.

The intersection of biotechnology and pharmacogenomics: health policy implications

Increasing knowledge of the genetic basis of disease is changing the landscape of health care. Two critical aspects are growth in biotechnology and growth in personalized health care, particularly targeting medicines based on genetic information (pharmacogenomics). This paper provides an overview of the health policy implications of the integration of biotechnology and pharmacogenomics. I examine four factors that determine whether relevant technologies will be successfully adopted, using case studies for illustration. Key policy challenges include determining the appropriate role of policy in (1) providing incentives to develop socially beneficial interventions and (2) facilitating development of the evidence base.

From hype to mothballs in four years: troubles in the development of large-scale DNA biobanks in Europe

This paper analyses the difficulties experienced by three large European DNA biobanks. The first, Icelandic-based deCode, generated immense commercial interest and intense ethical controversy. As a biotechnology company, deCode succeeded, but the Icelandic Health Sector Data Base failed. The second firm, Swedish UmanGenomics, marketed itself as the 'ethical' biotech company. Management problems including the inadequate recognition of intellectual property issues led to the company failing to secure adequate investment. The third and largest, UK Biobank, has, as a non-profit organization, not experienced these problems. But when the product - bio information--is marketed, the issue of ethically acceptable purchasers could well become contentious.

Shifting emphasis from pharmacogenomics to theragnostics

What will be the role of theragnostic patents in upstream and downstream biomarker research?

States of uncertainty: governing the empire of biotechnology

The biotechnological revolution presents states and governments with a set of challenges that they have difficulty meeting. Part of the problem is associated with common perceptions of the speed, volume and the radical uncertainty of the new developments. Globalisation is also implicated, especially in relation to the development of the knowledge economy and the role of multinational actors. This in turn contributes to the apparent decline in the confidence of the public that national governments will be effective in addressing mounting concern about the dangers inherent in new techniques and products. Under these circumstances, 'normal' governance begins to look more like 'failure' governance. This article asks whether the effects of the biotechnological revolution on governance can adequately be explained by the critique of imperialism proposed by Michael Hardt and Antonio Negri, and whether the state is in danger of becoming implicated in sponsorship of modernist schemes to improve the human condition of the kind analysed by James E Scott. Biotechnology does appear to have imperial qualities, while there are strong reasons for states to see biotechnology as a feasible and desirable set of developments. For some critics of biotechnology, like Francis Fukuyama, this is a lethal combination, and the powers of the state should be used to stop biotechnological development. Others, by contrast and more pragmatically, propose a check on what the state will support by the application of precautionary principles. The article concludes that the association between the biotechnology empire and the state, combined with the inescapable duty of the state to be the risk manager of last resort, alerts us to the complexities of uncertainty at the same time as it renders a merely restrictive precautionary approach impracticable.

Rescuing drug discovery: in vivo systems pathology and systems pharmacology

The pharmaceutical industry is currently beleaguered by close scrutiny from the financial community, regulators and the general public. Productivity, in terms of new drug approvals, has generally been falling for almost a decade and the safety of a number of highly successful drugs has recently been brought into question. Here, we discuss whether taking an in vivo systems approach to drug discovery and development could be the paradigm shift that rescues the industry.

The contract research organization and the commercialization of scientific research

The early 1980s constituted a watershed in science, mainly concerning the extent and nature of globalization and commercialization of scientific research, and its impact upon the university. Considerable debate has arisen about the sources of this transition, but aside from a few lone voices, the scholarly literature has neglected the concurrent rise of the contract research organization (CRO) and its role int he commercialization of scientific research. The CRO warrants wider attention as a modern paradigm of privatized science in the biopharmaceutical sector. In discussing the CRO's technologies, the purposes they pursue, and the legal and policy initiatives that have fostered their rapid rise, we confront the wider implications of the modern regime of commercialized science for the future conduct of scientific research. We identify five areas of innovation: treatment of human subjects, control of disclosure, subjection of research tools to commercialization, redefinition of authorship, and re-engineering the goals of research.