Iwish to comment on the planned establishment of an umbilical cord blood stem cell bank in Zambia by Cryobank International of India.
Essentially, a “stem cell” is a ductile type of cell that can either naturally develop into most of the 220 types of cells of the human body—such as blood cells, heart cells, brain cells, and kidney cells—or be developed into most of such cells through manipulation. The fungibility or non-specialized nature of stem cells provides considerable therapeutic potential in that the cells can be “doctored” and used to replace damaged, infected or dead cells in a person’s body and restore his or her health.
In the ensuing paragraphs, let us consider the ethical debate associated with stem cell research, a useful caveat for Zambian law makers and researchers who are involved in contentious research projects, and the need for an effective mechanism for assessing the benefits and costs of such research projects.
The Ethical Debate:
While advances in human stem cell research have generated a great deal of excitement among researchers and optimistic predictions about revolutionary advances in biomedicine, they have also sparked a highly contentious ethical debate. Among potential benefits of the research are new treatments and possible cures for debilitating diseases and injuries—including Parkinson’s and Alzheimer’s diseases, diabetes, heart disease, multiple sclerosis, stroke, burns, spinal cord injuries, and some types of cancer.
Ethical challenges associated with the research generally pertain to the source of the most promising categories of stem cells used—that is, “embryonic stem cells” derived from embryos that are between 5 and 7 days old, and “embryonic gem cells” derived from immature aborted foetuses. Basically, the extraction of stem cells from an embryo kills the embryo involved.
According to McDonald, the ethical debate concerning the use of such stem cells boils down to three disparate arguments as follows:
(a) The embryos are genetically human and are potential human beings deserving of society’s full respect and protection;
(b) The embryos are neither conscious nor self-aware, and are mere clusters of human cells with no independent ethical status; and
(c) The embryos are a part of the human life-cycle, part of the human story, and should, as such, be treated with respect in the same manner as a human corpse is treated.
Human stem cells can also be derived from the tissue of an adult, in which case the subject is generally left unharmed. Unfortunately, stem cells from an adult tissue are difficult to extract; moreover, they are limited in quantity, and appear to be less useful in facilitating revolutionary advances in biomedicine.
In recent years, the multi-potent-stem-cell-rich blood found in the umbilical cords of infants has proven useful in treating the same types of health problems as those treated using bone marrow stem cells and peripheral blood stem cells (PBSCs). Since the umbilical cords are generally and traditionally discarded as a by-product of the birth process, umbilical cord blood stem cell transplants raise less ethical questions.
Besides, they are less prone to rejection by recipients than either bone marrow or peripheral blood stem cells perhaps because the cells have not yet developed the features that can be recognized and attacked by the recipient’s immune system. And since umbilical cord blood lacks well-developed immune cells, there is less chance that the transplanted cells will attack the recipient’s body. Both the versatility and availability of umbilical cord blood stem cells, therefore, makes them a potent resource for transplant therapies.
But where will the Indian company be obtaining the umbilical cord blood stem cells, and what if the sources of umbilical cord blood stem cells will eventually turn out to be aborted and/or miscarried human foetuses? And how are we going to ensure that some morally corrupt or deficient women in the country or across national borders will not use this as a “cash cow” by getting pregnant and later selling their foetuses to the envisaged stem cell bank for the extraction of umbilical cord blood stem cells?
I do not believe a blood disorder known as “Thallasemic condition” is common in Zambia to warrant the setting up of a “cord blood cell bank” in the country. I would, therefore, advise the government not to allow the setting up of such a facility in our beloved country, especially if there are no definite answers to the questions I have raised above.
While I see the potential for umbilical cord blood stem cells to provide a lasting cure to life-threatening genetic blood disorders, we should be wary of research endeavors which many Zambians would find morally repugnant—research which has the potential to promote abortions for the purpose of selling foetuses. We must, of course, advance the promise and cause of science and research, but we must do so in a way that honors and respects life.
We need to protect the dignity and integrity of human life! And we must guard against creating a market for human parts like umbilical cords in our country!
A Useful Caveat:
McDonald has provided a useful caveat for biotechnology companies and researchers facing vexing challenges and dilemmas arising from contentious research endeavors like stem cell research; it may be paraphrased as follows: The opinions of people in the host nation or community should be seriously discerned, publicly discussed, and ultimately used as important inputs in the generation of a “definition of corporate ‘best practice’ or clinical ‘standard of care’.”
An Assessment Mechanism:
It is essential for transnational companies which are engaged in contentious scientific and/or technological research projects to embrace measures which their host countries may institute to evaluate the technical and economic viability of such projects, and “the societal dimension of [the] impacts” of the projects. In other words, they need to participate actively in “technology assessments” which their host governments may introduce. Such assessments are important because they can be used by national governments in many beneficial ways. For example, they can be used as:
(a) Sources of vital information needed in isolating envisaged scientific and technological research projects that need to be promoted, and those which need to be discouraged or prohibited altogether;
(b) Means of assessing and minimizing the potential negative impacts that may be associated with scientific and technological research projects; and
(c) Vehicles for resolving the contentious moral and ethical issues and dilemmas that may be evoked by scientific discoveries and technological breakthroughs.
To be useful, technology assessments need to generate and provide sufficient and reliable information about a given scientific and/or technological project on such matters as the following: (a) the technical and economic feasibility of the project; (b) its potential economic, social, and environmental effects; and (c) the potential risks and safety concerns associated with it.
Moreover, the assessments need to be administered by an agency that is akin to what Alvin Toffler has referred to as a “technological ombudsman,” which can be created and charged with the responsibility for receiving, investigating and, among a host of other things, acting on complaints pertaining to the irresponsible application of new scientific discoveries and technological breakthroughs.
If it is prudently managed, such an agency can enable a country to create a positive and viable interface between society and scientific and technological research endeavors.
Henry Kyambalesa The guest author is the Founder and President of the Agenda for Change (AfC) party. (The Zambian Economist encourages guest contributions from leading Zambian thinkers on matters relevant to national development. The purpose of these notes is to stimulate discussion and ensure logic and impartial critique plays a leading role in shaping public debate. See thespecial guests page for more information).
 A definition adapted from Religious Tolerance, “Stem Cell Research: All Sides to the Dispute,” www.religioustolerance.org/; and National Institute of Health (NIH), U.S. Department of Health and Human Services, “Stem Cells: A Primer,” www.nih.gov, May 2000.
 See Hetman, F., “From Technology Assessment to an Integrated Perspective on Technology,” in Srinivasan, M., editor, Technology Assessment and Development (New York: Praeger Publishers, 1982), p. 37.
 See Kyambalesa, H., Business Innovation and Competitiveness in the Developing World (Brookfield, USA: Ashgate Publishing Company, 1993), p. 72.
 See Toffler, A., Future Shock (New York: Random House, Inc., 1970), p. 442.