The genetic revolution

with Jamie Metzl

Jamie Metzl, a technology futurist and member of the WHO expert advisory committee on human genome editing.

About Jamie Metzl
Jamie is a technology futurist, keynote speaker, entrepreneur, media commentator, author, geopolitical expert, Senior Fellow at the Atlantic Council, former White House Fellow and a member of the WHO expert advisory committee on human genome editing. He earned his Ph.D. in Asian history from Oxford and has a law degree from Harvard. He is an accomplished athlete with 30 marathons, 15 ultramarathons and 13 Ironman triathlons completed. Jamie Metzl is a self-taught expert in genetics and his latest book is called Hacking Darwin – Genetic Engineering and the Future of Humanity.

How did you become an expert in genetics?
– 20 years ago I started thinking about what the big issues in the world were that nobody was paying attention to, and I kept seeing little bits of information telling me that genetics and biotech revolutions were going to change our lives. I hadn’t taken a science class since high school so I threw myself into studying, reading everything I could get my hands on and interviewed scientists. When I felt ready, I started writing articles, and after a while they started to get noticed. I testified before congress, did a lot of public speaking and wrote policy articles about genetics. But to reach more people I started writing sci-fi thriller novels, Genesis Code and Eternal Sonata. When I explained the science about genetics and biotech to people, like a storyteller, I could see their eyes widening and their minds changing. I realized that I needed to write this book, Hacking Darwin, which is the story of the past, present and future of the genetics revolution, and it’s written in a way that anybody can absorb.

The natural first choice to read for anyone interested in the genetic revolution.

You see three areas where we as humans are taking control over the manipulation, and it is healthcare, our bodies and baby making?
– We are transitioning from generalized healthcare based on population averages, to precision healthcare based on each person’s individual biology. For precision healthcare to work we have to know who each person is, and the most important information will be everybody’s sequenced genome. It will be standard practice to have the genome sequenced before a newborn leaves the hospital. Having all this data will help us move way beyond the simple understanding of single mutation genetics that we have now, to understand much more about genetically complex disorders and diseases. This will quickly move us from precision medicine to predictive health.

“Not only is our genetics an incredibly complex ecosystem, but it’s also in a complex interaction with our broader system’s biology”

– The second application is direct-to-consumer genetics. People are now sending in their mouth swabs and get back a little bit of accurate information, but a lot of it is just parlor tricks. But as we get this greater understanding of genetics it will not always be baloney. We will be able to get a lot of really important, actionable information from the direct-to-consumer companies. What we have to do is think about how people will process that and how to turn that into something that influences your decision-making processes in life. What we don’t want is either total ignorance or for people to feel genetically determined.

– The third is baby making. Northern Europe has already moved toward an increased use of IVF and embryo screening when making babies. About 2% of people have children via IVF in the United States, but it’s about 10% in Norway and Denmark. When we take conception outside of the human body, we have the ability to apply science to it in new ways. The first round of science will be embryo selection, which we are already doing, but it will be informed by a much greater understanding of genetics. Then we will be able to produce more human egg cells by using stem cell technology; taking adult cells, like skin cells, and turn them into stem cells and then eggs. If you have ten thousand fertilized eggs, pre-implanted and early-staged embryos, your selection will be much more powerful than if you just have 10 or 15 as in current IVF. On top of that we’re going to use precision editing tools, like CRISPR but much better, to make a relatively small number of discrete edits, either to prevent harm or to provide some type of enhancement.

One gene does not simply correspond to one trait, right? So is it not a great risk to start editing the genes to add or remove traits?
– For these single gene mutation diseases, disorders and traits, that is actually the case. But that’s a tiny portion of who and what we are and most of our traits and conditions are genetically complex and dynamic. Not only is our genetics an incredibly complex ecosystem, but it’s also in a complex interaction with our broader system’s biology. That is why I believe embryo selection will be the key application, because we don’t need a complete understanding for it to work. For genetic engineering in baby making, we will be able to predict increasingly – but never perfectly – the genetic component of a lot of traits with the help of machine learning algorithms plus these big data sets of genotypic and phenotypic information. But it will not be, as many people think, like the build-a-bear showrooms where you design your own teddy bear by picking what buttons you want, the color of the fur and so on. That’s not at all how it’s going to work.

Last year in China, researcher He Jiankui gene edited two girls and the international scientific community reacted with a strong condemnation. How should we manage to regulate this area of technology?
– In my view, what happened in China was extremely unethical, dishonest and dangerous. There’s now a Russian scientist who wants to do the same, but in a more transparent and accountable manner. This is still very premature. We need far greater humility. Caution and humility. Even though I believe that this is where we are heading, that doesn’t mean we should just race there. This is really serious stuff and we need to be extremely cautious and deliberate. We need an inclusive process so it’s not just the scientists doing this to humanity, but instead an engaged conversation about how we should use these very powerful technologies. This has to happen on both the governmental level and on the popular level.

“…when this becomes a crisis in the future, the big decisions will already have been made!”

– If we wait ten years, this is going to be the biggest issue that everybody will be talking about and the concept of genetically modified humans is going to terrify people. There could even be violence. Now we have an opportunity where we can actually have an inclusive conversation. When I say inclusive I mean everybody, including the religious conservatives on one side and the bio-hacking transhumanists on the other. We need to develop some kind of processes that can lead to norms and then national and international regulations. One norm might just be saying that here’s a line beyond which nobody should go. I’m trying to get people to see the importance of this now and to be part of the process, because when this becomes a crisis in the future, the big decisions will already have been made!

– One thing we need is for every country to have a robust national regulatory infrastructure. There are some countries, like the UK, that have really good systems. Some are average, like the United States. Some countries, like China, have decent laws in the books but they are not enforced, and then some countries don’t have anything. We need to make sure every country has something that aligns both with international best practices and the local traditions and values. We need a global process that can begin to develop norms that can underpin standards and regulations. It’s too difficult to go straight to regulations, because there’s not enough consensus right now.

What do you see as the best case and worst case scenarios?
– In the worst case scenario we race forward, without having this broad conversation about how the technologies should be used. Different countries see strategic advantages which cause an arms race structure. A lot of people get hurt and we probably do damage to ourselves. Maybe we bifurcate our species, if the wealthy and powerful will have access to technologies that the poor do not.

“This is our future and we can’t be ignorant about it”

– In the best case scenario, we recognize that these incredibly powerful technologies have a tremendous upside that can help us to live healthier and longer, and that we want to do it in a responsible, respectful framework. We realize that this is about values, human rights and investing in our diversity as a species.

What can normal people do, who read this and feel worried and want to engage?
– First, it’s great if you read my book or any book on the subject. As a first step everybody must be informed! This is our future and we can’t be ignorant about it. Once you’re educated there is a responsibility to engage the people around you – family, friends, colleagues, anybody! I have a blog post about how to hold a genetic engineering dinner party, with a recipe to each course, some background information and questions to discuss. Then you need to ask your elected representatives what they’re doing on these issues. Our government leaders have to engage and begin building effective regulatory infrastructures in our countries that represent, include and respect everyone. Then we all must engage internationally. If we don’t move forward together we have the potential to tear our species apart. I’m optimistic that we can use these powerful technologies wisely but this won’t happen on its own. We all must work to build the type of world we would want our children to live in.

Thank you Jamie Metzl, for sharing your knowledge of the genetic revolution!