The Great Stem Cell Race
  By Robert L. Paarlberg
  foreignpolicy.com | May/June 2005
  http://www.foreignpolicy.com/story/cms.php?story_id=2831&print=1
 
Scientists around the world are scrambling to unlock the potential 
of stem cells. Governments trying to balance research and ethics 
have quickly learned that they have little control. Competition for 
top researchers and private capital is pushing the pace�and 
punishing those who stumble. 





By the time U.S. President George W. Bush's administration announced 
its policy on stem cell research in the summer of 2001, Roger 
Pedersen was already fed up. A top embryo scientist celebrated for 
deriving many of the human stem cell lines then available to 
researchers around the world, Pedersen had been struggling with 
inadequate federal funding for five years. Finally, he decided to 
abandon his post at the University of California, San Francisco, for 
the chance to head up a new institute at the University of Cambridge 
in England. The British government was ready to offer funding and a 
better regulatory environment. Said Pedersen, "I chose to move to a 
country that was willing to provide support, broad support, for this 
research." 

He was not alone in fearing that federal restrictions would cripple 
U.S. labs in the race to tap the enormous potential of stem cell 
research. For a while, the United States had advanced quickly. In 
November 1998, two separate American research teams, one at Johns 
Hopkins University and the other at the University of Wisconsin, 
were the first to isolate and culture human embryonic stem cells in 
vitro. This medical revolution allows scientists to understand how a 
single undifferentiated cell�the fertilized egg�can develop into all 
the different tissues and organs of the human body. Embryos created 
through a process called "therapeutic cloning" might eventually 
yield stem cells to grow tissues and organs genetically identical to 
those of a patient, making possible a rejection-free therapy for 
spinal cord injuries, diabetes, Parkinson's disease, Alzheimer's, or 
heart disease. Unlike reproductive cloning, which creates a new 
human being, therapeutic cloning is used only to replace certain 
human tissues. 

The 1998 breakthroughs were immediately controversial, however, 
because the isolated stem cells were derived from aborted fetuses in 
one instance and viable embryos left over from an in vitro 
fertilization (IVF) clinic in the other. Stem cells are harvested 
from microscopic embryos just several days old in a procedure that 
destroys the embryo itself. It is a practice many religious and 
conservative organizations do not want supported with public money. 
In August 2001, Bush decided to restrict federal money to only the 
few stem cell lines already in existence at that time. 

Events following that announcement seemed to justify Pedersen's 
move. U.S. researchers learned that fewer stem cell lines were 
available for federal government funding than the president claimed. 
In theory, more than 60 stem cell lines were to be eligible, but 
intellectual property restrictions and problems with viability left 
only 15�18 lines available. Frustrated U.S. researchers then 
learned, in February 2004, that a team in South Korea had 
successfully harvested and cultured stem cells from a human embryo 
cloned using nuclear-transfer technology (the method first used in 
Scotland in 1996 to clone Dolly the sheep). Dr. Michael West, the 
president of Massachusetts-based Advanced Cell Technology, a company 
that had earlier attempted this experiment using private money, 
complained, "The [Korean] work should have been done in the U.S." 
Another top researcher, Dr. Irving Weissman of Stanford University, 
warned, "You are going to start picking up Nature and Science and 
all the great [scientific research] journals, and you are going to 
read about how South Koreans and Chinese and Singaporeans are making 
advances that the rest of us can't even study."

Now it appears that, even hobbled by federal funding restrictions, 
the United States is still leading the world in the stem cell 
research race. America's Christian right garners a tremendous amount 
of attention at home for its opposition to stem cell research, yet 
major portions of Europe have adopted policies far more restrictive 
than those in the United States. And, despite some impressive 
breakthroughs in Asia, limited access to private funds and global 
research networks keeps that region from sprinting ahead of the 
field. The United States may be the leader in this biomedical 
research race, but for that it has the rest of the world to thank.


Continental Drift
There has been no great exodus of U.S. stem cell scientists to 
Europe�and for good reason. The political and regulatory climate for 
embryo research is far worse there than in the United States. Not 
content with funding bans, several major European governments have 
criminalized stem cell harvesting and human cloning, even if done 
with private money and for therapeutic purposes. Germany's 1990 
Embryo Protection Act effectively bans all harvesting of cell lines 
from human embryos, and, in January 2002, a new law was enacted to 
prohibit imports of all stem cell lines not in existence at that 
time. The German Federal Ministry of Education and Research recently 
confirmed that a German scientist would be committing a criminal act 
if he so much as advised a colleague in another country engaged in 
the harvesting of new stem cells. 

Opposition in Germany�and in much of Europe�comes not just from 
religious and conservative groups but also from some members of the 
Socialist and Green parties. Germans in particular consciously 
separate themselves from what they call the "Anglo-American" 
approach to bioethics, which they consider to be dangerously 
utilitarian, and perhaps even a slippery slope toward a 
reintroduction of fascism. Antiabortion religious groups, anti-
science Greens, and many women's groups have joined forces to label 
embryo research as "continuations of Nazi eugenics." According to 
one Green Party statement, "We Germans, in light of experiences 
during the years 1933 through 1945, should be sensitive, even 
supersensitive [to the possible abuse of embryo research]." Even 
some advocates for the sick and disabled oppose stem cell research 
in Germany, contending that the pain of disease ought to be reduced 
through improved social conditions and greater tolerance rather than 
through expensive new medical research. 

In some cases, Europe's lockdown on laboratory research has come on 
suddenly, more as a result of recent political shifts than long-
standing concerns. New restrictions in Italy, for example, altered 
an earlier policy of loosely regulated research. An Italian 
scientist working at the University of Bologna created the first 
human embryos through IVF in 1961, a full 17 years before the birth 
of the world's first "test-tube baby." Unrestricted reproduction 
science continued in Italy and led to the birth of a healthy baby 
(using a donated egg and artificial hormones) to a 63-year-old woman 
in 1994. Severino Antinori, the embryologist who performed the 
treatment, later stated he planned to clone a human.

Then came the backlash. The 2001 election of Italian Prime Minister 
Silvio Berlusconi and a more conservative parliament ushered in a 
more restrictive regulatory environment. In February 2004, the 
Italian parliament voted to ban almost every form of assisted 
reproduction, including artificial insemination using donated sperm, 
embryo freezing, egg donation, surrogate motherhood, pre-
implantation genetic diagnosis, and fertility treatments for women 
beyond childbearing age. The law effectively blocked stem cell 
research as well. Paul Devroey, clinical director of the Center for 
Reproductive Medicine in Belgium, commented, "The Italian law is the 
end of any progress. It is the world's worst law ever seen, except 
for Costa Rica, where the constitution forbids IVF."

Even European states that liberalize their rules have had trouble 
creating a conducive environment for cutting-edge stem cell 
research. In France, prior to the enactment of a revised bioethics 
law in July 2004, scientists found it difficult to import stem cell 
lines. One research team in Montpellier hoped to collaborate with an 
American lab but had to wait two years for permission from the 
French government to import cells. The team was on the verge of 
relocating its activities to the United States when the new measure 
passed. This law allows wider options for conducting stem cell 
research legally, but nonetheless bans all human cloning, for both 
therapeutic and reproductive purposes. The new Socialist government 
in Spain has also loosened its stem cell research restrictions, but 
the revised rules remain strict: IVF human embryos can only be used 
if frozen for more than five years, and only if the couple involved 
explicitly authorizes their use for research purposes. In November 
2004, voters in Switzerland backed a new law allowing the harvesting 
of stem cells, yet antiabortion groups and the Green Party insisted 
that the new law ban all forms of human cloning. There is currently 
only one team of embryonic stem cell researchers at work in 
Switzerland, and they depend on cell lines imported from the United 
States.

Britain, and to a lesser extent Sweden and Belgium, has departed 
from the continental trend by actively encouraging stem cell 
research. The British government not only encourages advanced 
research into human biology but since 2001 has explicitly permitted�
and funded�cell harvesting from IVF embryos and therapeutic cloning. 
Britain's Human Fertilisation and Embryology Authority issued its 
first cloning license in August 2004. Public funds support this work 
through the Research Councils UK, the main public investor for 
scientific research in Britain. In the spring of 2004, the Research 
Councils announced a new stem cell initiative that totaled $30 
million for a research center at Cambridge (to be headed by Roger 
Pedersen) and the opening of a stem cell bank to share lines. 

These efforts have succeeded in attracting some researchers from 
continental Europe. Britain's first cloning license in 2004 went to 
a team that included a Yugoslav-born scientist who abandoned his 
career in Germany because of research restrictions. Yet, it has been 
reported that since Pedersen's 2001 departure, no leading U.S. stem 
cell scientist has moved to Britain. This is partly because 
Britain's public-sector model for promoting stem cell research has 
its own drawbacks, including uncertain public licensing, slow-moving 
funding cycles, and bureaucratic delays. When the Medical Research 
Council and the Biotechnology and Biological Sciences Research 
Council attempted to jointly fund state-of-the-art facilities for a 
British stem cell bank, red tape held up the first deposits for six 
months. Equally important, there is nothing in Britain or 
continental Europe to rival the U.S. system for mobilizing resources 
through partnerships between private universities, companies, 
venture capitalists, and philanthropic foundations. 

Without a more dynamic private sector, biomedical scientists in both 
continental Europe and Britain will continue to see their job 
options shrink and their research output suffer. A 2002 European 
Commission study concluded that biotechnology companies in Europe 
were falling behind their peers in the United States: "[T]he U.S. 
biotechnology industry started earlier, produces more than three 
times the revenues of the European industry, employs many more 
people (162,000 against around 60,000), is much more strongly 
capitalised and, in particular, has many more products in the 
pipeline." Europe still trains large numbers of highly skilled 
scientists, yet thousands come to the United States every year to 
seek advanced study or employment, and more than 70 percent never 
return. Indeed, about 40 percent of scientists now working in the 
United States were born in Europe. 

As a remedy, the European Commission called for special measures to 
encourage participation in genomics and biotechnology by small- and 
medium-sized enterprises. These inducements include complementary 
financing from the European Investment Bank and grants to business 
incubators through the European Investment Fund. Yet, when this 
strategy was officially reviewed in April 2004, progress was found 
to be slow. The European Association for Bioindustries 
commented, "Sadly, this year's progress report is not reporting much 
progress." 

Europe's problem is lagging private investment in the sector�a 
condition that has worsened. As recently as 1990, global 
pharmaceutical companies spent 50 percent more on research in Europe 
than in the United States. By 2001, those same companies were 
spending 40 percent more on research in the United States. The 
European Commission attributes this state of affairs in part to the 
failure of eight member governments in Europe to implement a 1998 
patent law directive, but many private companies view the problem as 
the commission itself, which they call "the dead hand of Brussels." 
Investors in Europe would like to see fewer slow-moving Eurocrats 
and more clear-thinking research scientists involved in funding 
decisions, plus a deregulated market environment; in other words, 
something closer to the U.S. system. Tim Wells, senior executive 
vice president for research at the Swiss biotechnology firm Serono, 
observes, "The European research system is much too fragmented, the 
regulatory system is too cumbersome, and often the incentives for 
setting up a company are not as well developed as they are in the 
U.S."


The American Bypass Operation
In October 2003, a leading British team announced the creation of 
three new stem cell lines, derived from a total of 58 embryos. This 
was an important step forward�but one quickly upstaged by events in 
the United States. Privately funded U.S. researchers were moving 
ahead even faster. 

In March 2004, a new collaborative research project, the Harvard 
Stem Cell Institute at Harvard University, announced it had 
developed 17 new embryonic stem cell lines that it was ready to 
share with other privately funded researchers. Then, in June 2004, 
scientists at a private U.S. fertility clinic in Chicago produced an 
additional 12 cell lines, including the first cell lines ever to be 
derived from embryos with specific genetic diseases, such as 
muscular dystrophy. In December 2004, the California-based Geron 
Corporation, which has invested more than $90 million in stem cell 
research since 1996, patented a new stem cell therapy for 
Parkinson's and began preparing to test a stem cell-based therapy 
for acute spinal cord injury. 

State governments are now getting into the act as well. When the 
Bush administration blocked federal funding for work on new cell 
lines, a coalition of disease foundations, science advocates, and 
Hollywood celebrities turned to the voters of California, who in 
November 2004 gave 59 percent approval to Proposition 71, a bond 
issue that allows the state to make available as much as $3 billion 
in grants for embryonic stem cell research over the next decade. 
There will be plenty of qualified takers for this new research money 
in California, which is already home to 2,600 biomedical companies 
and 87 university and private research institutions with $32.3 
billion in worldwide revenue and $15.5 billion in annual research 
outlays. Following the California vote, the governor of Wisconsin 
proposed spending $750 million through a public-private partnership 
in stem cell research and biotechnology to keep labs in his state 
nationally and internationally competitive. The governor of New 
Jersey also signed legislation last year to establish a stem cell 
research facility based at Rutgers University that will receive an 
initial $6.5 million in state funding, to be matched by $3.5 million 
in private funding. Illinois, Maryland, Massachusetts, and Texas are 
now also promising to put research money on the table in a bid to 
prevent their stem cell scientists from moving�not to Britain, but 
to California. 

Asia's Cellular Bid
If a strong challenger to the United States emerges in the stem cell 
race, it will come not from Europe but from Asia. The Korean cloning 
breakthrough of 2004 that unnerved many U.S. scientists is part of a 
larger pattern of aggressive stem cell science in East Asia. One of 
the region's biggest advantages is the much lower cost of employing 
research talent. Biotechnology research scientists in China are 
employable at one fifth to one tenth the cost of comparable American 
talent, and China now has a growing pool of capable researchers, 
many with U.S. training. Asia's scientists also benefit from strong 
state support. Even free-market oriented Singapore has spent $500 
million on its "Biopolis Asia," a 2 million-square foot biomedical 
campus that opened in 2003. Singapore has also adopted a British-
style regulatory system, hoping to attract international companies 
and encourage local start-ups. In South Korea, stem cell research 
has received significant state funding�$27 million from 2002 to 2004�
in part because of the strong personal interest of President Roh Moo 
Hyun. 

Nor do Asian scientists face as much cultural resistance to their 
work as their colleagues in the West. In Confucian and Buddhist 
societies, there are fewer religious inhibitions to the destruction 
of microscopic embryos. Throughout Roman Catholic Europe and in much 
of Christian America, religious authorities teach that a fertilized 
egg is already a person. In Confucian tradition, the defining moment 
of life is birth, not conception, and Buddhists view life not as 
beginning with conception but as a cycle of reincarnations. The 
South Korean scientist who led the 2004 cloning team said at the 
time, "Cloning is a different way of thinking about the recycling of 
life.� It's a Buddhist way of thinking." 

Stem cell researchers in Asia remain disadvantaged, however, by 
their limited connections to global research networks. The 
International Society for Stem Cell Research has 654 members in the 
United States and 56 in Britain, but only 34 in South Korea, 29 in 
Japan, 16 in Singapore, and 5 in China. Private investment has also 
lagged. Singapore's Biopolis notwithstanding, the city-state 
currently has only one company researching embryonic stem cells, and 
none engaged in therapeutic cloning. In China, private investors 
remain nervous about weak protections for intellectual property, 
insufficient exit options for venture capital, second-rate 
managerial skills, and a muddled regulatory environment. Although 
legalized in 2004, stem cell work had already been under way for 
several years without central government authorization, leaving 
individual institutes essentially free to operate according to their 
own (sometimes bizarre) preferences. In 2003, a Chinese team at 
Shanghai Second Medical University reported using human skin cells 
with rabbit eggs to produce early-stage embryos, which in turn 
yielded stem cells. This kind of "cowboy science" attracts newspaper 
headlines�as did Italy's IVF pioneers several decades ago�but 
private investors know it is not the best foundation for developing 
reliable clinical applications. This step requires networked access 
to top scientists from a wide variety of disciplines (from 
molecular, cellular, and developmental biology, to immunology and 
genetics, transplantation biology, and clinical medicine), something 
easier to arrange in San Francisco than in Shanghai.

Indeed, South Korea's 2004 research breakthrough was based as much 
on persistence as precision. The Korean cloning and harvesting team 
succeeded in part because it had 10 times as many researchers and 
unregulated access to 12 times as many eggs as the U.S. team that 
was attempting the same experiment. As the Korean scientists neared 
success, international scrutiny obliged Seoul to put in place a 
tighter set of restrictions on future embryo science, including a 
series of laws passed in January 2004 that banned human cloning for 
reproductive purposes, required scientists to receive prior approval 
for their projects, and prevented women from selling their eggs. One 
health ministry official commented, "We're getting to the point 
where I think Korea might be more restrictive about this kind of 
research than the United States." It was an exaggeration. Still, 
South Korea's recent experience suggests that even Asia may not be 
immune to an eventual regulatory backlash. 


Growth Industries 
Winning the stem cell research race has significance beyond national 
pride. In today's economy, scientific leadership means more of the 
best and highest paying jobs. The world-leading biomedical industry 
in California pays out $14 billion in wages and salaries every year, 
and the 230,000 Californians employed in the sector earn nearly 60 
percent more than the average salary in other sectors. The value of 
biomedical exports from California alone grew to $7.1 billion in 
2003. With such social and commercial benefits on the line, and 
having earlier lost the information technology race to the United 
States, it is understandable that Europe does not want the same 
thing to happen now in biotechnology. But it may be too late.

In the 2004 U.S. presidential campaign, Democratic challenger John 
Kerry warned repeatedly that the future of American stem cell 
research would be at risk if the restrictive policies of the Bush 
administration were not changed. This view underestimated the 
capacity of U.S. scientists to work around a simple federal funding 
ban. The ban has slowed the pace of some research, and it has forced 
scientists to segregate their labs according to funding sources, but 
it has not prevented companies and labs with private funds from 
going where the science leads. Indeed, conservatives might 
eventually come to regret Bush's decision to push American stem cell 
and cloning science so completely into the arms of the private 
sector and the states. Whereas governments in Europe have gone to 
the extreme of blocking all research with tight controls, the United 
States allows research that is not federally funded to race ahead 
with little or no federal control. As cloning and stem cell research 
move closer to clinical applications in the United States, 
commercial demand and private funding will strengthen, further 
weakening Washington's ability to shape the future of the field.

Divergent national policies on stem cell research are unlikely to 
converge any time soon. In 2004, the Bush administration tried and 
failed to promote a comprehensive global ban on human cloning at the 
United Nations. The measure failed internationally for the same 
reason it had earlier fallen short in the U.S. Senate: Support for 
therapeutic cloning is strong enough to make a comprehensive cloning 
ban unacceptable. The formal harmonization of national policy has 
been impossible even within the European Union, where the commission 
has recognized that regulations on ethical matters are best left to 
each country. 

Nonetheless, political and market forces may eventually drive some 
countries to a common point on regulating future research. As the 
clinical promise of stem cells emerges, more European states may 
decide to liberalize their policies, as recently occurred in Spain, 
France, and Switzerland. At the same time, the underregulated states 
in Asia may begin to follow the path of Singapore, and now South 
Korea, in accepting tighter regulation to preserve their 
international respectability. The United States, at least until the 
next presidential election, will likely continue to chart its own 
curious course, restricting federal money but imposing little 
federal control. Most other countries will reject this approach and 
converge instead around the regulatory standards of Britain�where 
generous public support for research is coupled with government 
monitoring and licensing. Although it may be unable to prevail in 
the research race, Britain may at least show the world the best way 
to run it.




Robert L. Paarlberg is professor of political science at Wellesley 
College and author of The Politics of Precaution: Genetically 
Modified Crops in Developing Countries (Baltimore: Johns Hopkins 
University Press, 2001).







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