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Category Archives: Transhuman News

Supporters of a big PFD are starting to back a constitutional convention. Alaska’s conservatives and libertarians see an opportunity. – Anchorage…

Posted: September 6, 2021 at 2:49 pm

The Alaska State Capitol in Juneau. (James Brooks / ADN)

JUNEAU In five hours of public testimony late last month, a line of Alaskans criticized members of the Alaska Legislature for failing to come up with a reliable formula for Alaskas annual Permanent Fund dividend.

Legislators have heard similar testimony since 2017, but this years comments brought a new wrinkle: A growing number of Alaskans, dissatisfied with a lack of change, are calling for a constitutional convention to address the issue.

Voters are asked once every decade whether they want to call for a convention, and the next vote is in November 2022.

Because conventions arent limited to one subject, conservatives and libertarians are embracing the trend, saying it could allow them to pursue long-held goals like a ban on abortion, public funding for private schools, or changes to the way judges are picked.

Michael Chambers is a libertarian who is urging Alaskans to vote yes on the convention next year. He has a list of items hed like to see addressed and said the PFD issue is 100% helping the cause.

I dont mean this in a negative way, but for the low-information voter, it absolutely makes a difference, he said. The more the PFD festers out there and sits there, the more ... the low-information voters are the ones that say, Hey, wait a minute, this is enough!

Legislators say theyre not certain that a constitutional convention will bring conservative nirvana. Alaskas political divides could mean a convention split between conservatives and progressives, just as the Legislature is today.

What may start out looking like a solution on the PFD could turn into a social battleground like weve never seen in this state, said Senate President Peter Micciche, R-Soldotna.

I think there is a potential for unintended consequences beyond the scope of anything we can currently imagine, he said.

In a convention, uncertainty abounds

Alaska hasnt had a constitutional convention since its first, which took place in late 1955 and early 1956, but voters are asked every 10 years if they want to hold one.

In 1970, 1972, 1982, 1992, 2002 and 2012 they said no, mostly by wide margins. (The 1970 vote passed by about 500 votes but was overturned by the Alaska Supreme Court, which said the wording of the question was too leading. A re-vote in 1972 changed the result.)

Sen. Bill Wielechowski, D-Anchorage, said things could be different this time around.

I think theres a real chance that people could vote for a constitutional convention, he said, adding that any convention would be unpredictable.

If you go to a constitutional convention, you just dont know where it goes. You dont know whos going to be the delegates, you dont know how the decisions will be made. And you just dont know whats going to happen, he said.

Unless the Legislature passes a different guiding law, a convention would generally follow the rules in place in 1955.

Delegates to the Alaska Constitutional Convention at work, Fairbanks, winter 1955-56.

That means voters would likely be asked to vote for delegates during the 2024 election, and might be asked to approve a resulting draft in 2026.

Bob Bird, chairman of the Alaskan Independence Party, has been trying for years to convince Alaskans to vote for a convention, most recently in columns published by the Watchman, an Alaska-based Christian website.

He said hes been talking to groups he considers Ron Paul constitutionalist and said concerns about the Permanent Fund dividend unite them, but so does a desire to change the states judicial system.

The Alaska Supreme Court has repeatedly ruled in favor of abortion rights, and there has been a steady conservative push to change Alaskas judicial selection laws in order to overturn those rulings.

I cant tell you which is the most energizing in regards to the call for a con-con, he said, using shorthand for the constitutional convention.

Chambers said that while it might seem ironic, hes seeing libertarian interest in a PFD amendment.

We libertarians believe in less government, and the best way for you to have less government is if they dont have money. And the easiest way in Alaska for them not to have money is to give it directly to the people, he said.

Opponents and proponents see momentum

Bird said hes seeing growing interest in a convention, regardless of the issue.

I think its a small snowball thats picking up momentum, he said.

Those concerned about a convention are also seeing that momentum.

A group called the Permanent Fund Defenders has been urging lawmakers to guarantee Permanent Fund dividend payments in the state constitution. For at least two years, members have been warning legislators that unless they act, voters might seek a convention.

Juanita Cassellius, a spokesperson for the group, said the prospect of a convention is worrying because it could turn into a can of worms. Despite that prospect, many Alaskans might be willing to risk it in order to end perennial debates over the dividend.

There is a very vocal group that will get attention because its a simple message, she said. I think it would be very catchy. And now, the people in our group are very afraid of that.

Sen. David Wilson, R-Wasilla, represents one of the most conservative legislative districts in the state. He said that when the topic comes up in small groups, he reminds people that a convention of delegates is likely to resemble the mix of views present in the Alaska House of Representatives.

There, a coalition of independents, Democrats and moderate Republicans holds a narrow majority.

I think thats part of the issue: Theres a lot of unknowns, he said.

The Alaska Senate is taking the prospect of a convention seriously enough that some state senators have begun researching the potential costs and how a convention might operate.

Chambers and others said that if the Alaska Legislature fails to settle the dividend issue by the end of the 2022 regular legislative session, it will become a significant issue in next years races for governor and Legislature.

He speculated that the push will begin ramping up around February, because thats where campaigns start coming out and people start taking positions.

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Supporters of a big PFD are starting to back a constitutional convention. Alaska's conservatives and libertarians see an opportunity. - Anchorage...

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Responding to DNA is a Program, and Programs Demand a Programmer – Patheos

Posted: September 4, 2021 at 6:14 am

One popular science-y argument for God is that DNA is information. In fact, its not only information, its a software program. Programs require programmers, and for DNA, this programmer must be God.

For example, Scott Minnich, an associate professor of microbiology and a fellow at the Discovery Institute, said during the 2005 Kitzmiller v. Dover trial, The sophistication of the information storage system in nucleic acids of RNA and DNA [have] been likened to digital code that surpasses anything that a software engineer at Microsoft at this point can produce. Stephen Meyer, also of the Discovery Institute, said, DNA functions like a software program. We know from experience that software comes from programmers.

But how does DNA brings anything new to the conversation? The idea that the human body is like a designed machine has been in vogue ever since modern machines. The heart is like a pump, nerves are like wires, arteries are like pipes, the digestive system is like a chemical factory, eyes and ears are like cameras and microphones, and so on. We dont hear, Animals arteries and veins are like the water and drain pipes in a house, so there must be a celestial Plumber!

I dont find the celestial Programmer claim much more compelling, but lets push on and respond to the apologists claim that programs (in the form of DNA) require programmers.

As a brief detour, notice how we tell natural and manmade things apart. Nature and human designers typically do things very differently. This excerpt from my book Future Hype: The Myths of Technology Change explores the issue:

By the 1880s, first generation mechanical typesetters were in use. Mark Twain was interested in new technology and invested in the Paige typesetter, backing it against its primary competitor, the Mergenthaler Linotype machine. The Paige was faster and had more capabilities. However, the complicated machine contained 18,000 parts and weighed three tons, making it more expensive and less reliable. As the market battle wore on, Twain sunk more and more money into the project, but it eventually failed in 1894. It did so largely because the machine deliberately mimicked how human typesetters worked instead of taking advantage of the unique ways machines can operate. For example, the Paige machine re-sorted the type from completed print jobs back into bins to be reused. This impressive ability made it compatible with the manual process but very complex. The Linotype neatly cut the Gordian knot by simply melting old type and recasting it. . . .

As with typesetting machines, airplanes also flirted with animal inspiration in their early years. But flapping-wing airplane failures soon yielded to propeller-driven successes. The most efficient machines usually dont mimic how humans or animals work. Airplanes dont fly like birds, and submarines dont swim like fish. Wagons roll rather than walk, and a recorded voice isnt replayed through an artificial mouth. A washing machine doesnt use a washboard, and a dishwasher moves the water and not the dishes.

With DNA, we again see the natural vs. manmade distinction. It looks like the kind of good-enough compromise that evolution would create, not like manmade computer software. The cell has no CPU, the part of a computer that executes instructions. Also, engineers have created genetic software that changes and improves in an evolutionary fashion. This software can be used for limited problems, but it must be treated as a black box.

The same is true for a neural network used for artificial intelligence. It can be trained to recognize something, but that set of interconnections looks nothing like the understandable, maintainable software that humans create.

As another illustration of the how DNA is unlike software, the length of an organisms DNA is not especially proportionate to its complexity. This is the c-value enigma, illustrated with a chart that compares DNA length for many animals here.

We actually have created DNA like a human programmer would create it, at least short segments of it. In 2010, the Craig Venter Institute encoded four text messages into synthetic DNA that was then used to create a living, replicating cell. Thats what a creator who wants to be known does. Natural DNA looks . . . natural. It looks sloppy. Its complex without being elegant. (See more on the broken stuff in human DNA here and how this defeats the Design Hypothesis here.)

If God designed software, wed expect it to look like elegant, minimalistic, people-designed software, not the Rube Goldberg mess that we see in DNA. Apologists might wonder how we know that this isnt the way God would do it. Yes, God could have his own way of programming that looks foreign to us, but then the DNA looks like Gods software argument fails.

Consider more broadly this supposed analogy between human design and biological systems.

But these traits of human designs dont apply to biological systems, and vice versa. So where is the analogy? The only thing they share is complexity, which means that the argument becomes the nave conclusion, Golly, biological systems are quite complicated; I guess they must be designed. This is no evidence for a designer, just an unsupported claim that complexity demands one. And why think complexity is the hallmark of design? Shouldnt we be looking for elegance instead?

The DNA = software analogy brings along baggage that the Christian apologist wont like. The apologist demands, DNA is information! Show me a single example of information not coming from intelligence!

This makes them vulnerable to a straightforward retort: Show me a single example of intelligence thats not natural. Show me a single example of intelligence not coming from a physical brain. These apologists are living in a glass house when appealing to things that have no precedent (and far too comfortable with things that have no evidence, like the supernatural).

Does the Christian imagine multiple Designers of DNA? Because most human designs come from teams. Are those Designers finite? Are they fallible? Were they born? Because these are the properties of human designers (h/t commenter Loren Petrich).

Christians will respond by pointing to the imagined properties of the Christian God, but this is the fallacy of special pleading. They pick the parts of the God/designer analogy they like and dismiss the ones they dont. This might make it an illustration of Gods properties, but by selecting the parts they like based on their agenda, they make clear that its not an argument.

Actually, we find information in lots of nonliving natural things. The frequency components of starlight encodes information about that stars composition and speed. Tree rings tell us about past precipitation and carbon-14 fluctuation. Ice cores and varves (annual sediment layers in a pond) also reveal details of climate. Smell can tell us that food has gone bad or if a dead animal is nearby. Snowflakes record the atmospheric conditions that created them.

Commenter NS Alito observed:

In my sedimentary geology classes, we used various rock deposition construction patterns to determine the environment in which it was formed, such as preserved ripple structures, proportions of sand vs. clay, silica concretions in sandstone, etc. The various programmers of this information were wave energy, upstream eroded material, water chemistry and other natural physical processes.

The popular DNA = software analogy should be discarded for lack of evidence.

To ask an atheist what evidence would change their mindis to admit were in a naturalistic universeand thus make the question void. commenter primenumbers

.(This is an update of a post that originally appeared 3/18/17.)

Image from AndreaLaurel (license CC BY 2.0).

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Responding to DNA is a Program, and Programs Demand a Programmer - Patheos

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He took a DNA test for fun and found out he was not the father of his 12-year-old son – Market Research Telecast

Posted: at 6:14 am

A family was shocked after 12 years to discover that the man was not the father of one of their two children. What started out as fun ended up being something that worried parents from Utah, United States.

In 2007, Vanner and Donna Johnson decided to find their second child. However, after trying naturally, the couple opted for IVF without knowing what was going to happen next. And it is that although both fulfilled the necessary procedure for the treatment, something happened in the middle.

And it is that the couple together with their children decided to have a test of ADN as something funny but the result showed that the child who was born as a product of medical treatment, did not have the genes of his father.

The family performed the test that came with the DNA kit 23andMe, who acquired it as a game that all members of the family would do. When they received the results a month later, they were in shock.

When I looked at that page and saw the phrase: unknown father I thought what do you mean by unknown father, if I am his father?' He revealed Vanner Johnson remembering the moment he learned the truth. When we saw those results we knew there must be something wrong, added Donna.

The test of ADN disclosed that Vanner is not the biological father of her child and that Donnas egg was fertilized by the sperm of another person, whose name or whereabouts is unknown, during the process of In vitro fertilization. I understood that there is a possibility of some error during the treatments, but it is not really common, it is very remote, revealed the frustrated father.

Video de Youtube @abc4utah.

There were a lot of emotions that we had to overcome. We had to separate what is love for our son, who has not changed for a second, from the problem we were dealing with. How could it happen and what do we do now? Added the man, surprised by everything that happened.

According to the parents, it took more than a year to reveal the truth to their son. I took him for a ride in our car, we were actually going to have ice cream. I wanted to make sure his attention was only on our conversation, said the father.

He knew that his birth was the product of a fertilization treatment so I told him: It turns out that when we did it, something happened and we are not sure what happened, but I am not really your biological father,' added the man. .

However, the young mans reaction was to tell the father how much he loved him, making it clear that it would not change their relationship.

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He took a DNA test for fun and found out he was not the father of his 12-year-old son - Market Research Telecast

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The Fight to Define When AI Is High Risk – WIRED

Posted: at 6:09 am

EU leaders insist that addressing ethical questions that surround AI will lead to a more competitive market for AI goods and services, increase adoption of AI, and help the region compete alongside China and the United States. Regulators hope high-risk labels encourage more professional and responsible business practices.

Business respondents say the draft legislation goes too far, with costs and rules that will stifle innovation. Meanwhile, many human rights groups, AI ethics, and antidiscrimination groups argue the AI Act doesnt go far enough, leaving people vulnerable to powerful businesses and governments with the resources to deploy advanced AI systems. (The bill notably does not cover uses of AI by the military.)

(Mostly) Strictly Business

While some public comments on the AI Act came from individual EU citizens, responses primarily came from professional groups for radiologists and oncologists, trade unions for Irish and German educators, and major European businesses like Nokia, Philips, Siemens, and the BMW Group.

American companies are also well represented, with commentary from Facebook, Google, IBM, Intel, Microsoft, OpenAI, Twilio, and Workday. In fact, according to data collected by European Commission staff, the United States ranked fourth as the source for most of the comments, after Belgium, France, and Germany.

Many companies expressed concern about the costs of new regulation and questioned how their own AI systems would be labeled. Facebook wanted the European Commission to be more explicit about whether the AI Acts mandate to ban subliminal techniques that manipulate people extends to targeted advertising. Equifax and MasterCard each argued against a blanket high-risk designation for any AI that judges a persons creditworthiness, claiming it would increase costs and decrease the accuracy of credit assessments. However, numerous studies have found instances of discrimination involving algorithms, financial services, and loans.

NEC, the Japanese facial recognition company, argued that the AI Act places an undue amount of responsibility on the provider of AI systems instead of the users and that the drafts proposal to label all remote biometric identification systems as high risk would carry high compliance costs.

One major dispute companies have with the draft legislation is how it treats general-purpose or pretrained models that are capable of accomplishing a range of tasks, like OpenAIs GPT-3 or Googles experimental multimodal model MUM. Some of these models are open source, and others are proprietary creations sold to customers by cloud services companies that possess the AI talent, data, and computing resources necessary to train such systems. In a 13-page response to the AI Act, Google argued that it would be difficult or impossible for the creators of general-purpose AI systems to comply with the rules.

Other companies working on the development of general-purpose systems or artificial general intelligence like Googles DeepMind, IBM, and Microsoft also suggested changes to account for AI that can carry out multiple tasks. OpenAI urged the European Commission to avoid the ban of general-purpose systems in the future, even if some use cases may fall into a high-risk category.

Businesses also want to see the creators of the AI Act change definitions of critical terminology. Companies like Facebook argued that the bill uses overbroad terminology to define high-risk systems, resulting in overregulation. Others suggested more technical changes. Google, for example, wants a new definition added to the draft bill that distinguishes between deployers of an AI system and the providers, distributors, or importers of AI systems. Doing so, the company argues, can place liability for modifications made to an AI system on the business or entity that makes the change rather than the company that created the original. Microsoft made a similar recommendation.

The Costs of High-Risk AI

Then theres the matter of how much a high-risk label will cost businesses.

A study by European Commission staff puts compliance costs for a single AI project under the AI Act at around 10,000 euros and finds that companies can expect initial overall costs of about 30,000 euros. As companies develop professional approaches and become considered business as usual, it expects costs to fall closer to 20,000 euros. The study used a model created by the Federal Statistical Office in Germany and acknowledges that costs can vary depending on a projects size and complexity. Since developers acquire and customize AI models, then embed them in their own products, the study concludes that a complex ecosystem would potentially involve a complex sharing of liabilities.

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Groping toward appropriate regulation of AI. Data regulation and its offensive potential. – The CyberWire

Posted: at 6:09 am

At a glance.

Wired traces the influences shaping the EUs proposed Artificial Intelligence Act, which is expected to impact policy internationally, as has the GDPR. The legislation would categorize AI applications by risk level and more closely control high risk systems.

Critiques of the bill fall along predictable lines. Some human rights groups want stricter controls and worry about law enforcement, education, health care, public surveillance, border security, social scoring, insurance, transhumanism, and subliminal manipulation applications. They point to the power disparity between those wielding the tools and those on the receiving end, and highlight existing abuses.

Some industry groups describe the law as overbroad, fearing it will impose unmanageable costs, interfere with basic business functions, squash innovation, and drive away talent. Competing studies put total compliance costs between 1.6 and 10 billion yearly.

The EU hopes the bill will level the playing field and spur growth while promoting principled business decisions. Meanwhile, the US is developing its own guidelines and regulations, including a National Institute of Standards and Technology tool and an Algorithmic Accountability Act. In the background, as always, looms Chinese innovation, and what strategic advantages authoritarian rivals will achieve while the West puzzles out competing interests and ethical dilemmasexercising a soft advantage of its own.

Breaking Defense reiterates concerns that the vulnerability disclosure component of Beijings Data Security Law (DSL) will help the CCP stockpile zero days for use against state and private sector targets. As weve seen, the legislation directs researchers, companies, and foreign firms with local offices to disclose to the Ministry of Industry and Information Technology within forty-eight hours uncovered zero days, and restricts their further distribution. Microsoft and Amazon Web Services, both of which contract with the US Defense Department, are covered by the regulation.

Heritage Foundation China scholar Dean Cheng sees the move as an instance of lawfare, or legal warfare, and says Beijing is 100 percent likely to weaponize the disclosed vulnerabilities. Georgetown University security researcher Dakota Cary observed that theyve effectively co-opted a pipeline of research, which costs a great deal of money to do, in order to increase their own offensive and defensive hacking capabilities.

The DSL, Fortune notes, also prohibits unapproved cross-border data transfers. The law took effect yesterday.

SWI reports that Switzerland is working to establish a rapid reaction cyber defense command center staffed by roughly six-hundred military personnel with new capacities to protect private sector and critical infrastructure assets. The center will deliver informational, logistical, and technical capabilities.

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Money & Markets: The latest technology to invest in gene editing – E&T Magazine

Posted: at 6:07 am

Genetic engineering using the new Crispr technology is just hitting the US stock market. This brand new sector has the potential to explode in price and keep on growing for decades.

Most people are aware that the dotcom boom was technology-based, but few realise that since the very start of stock markets in the 1700s, the whole shooting match has been driven by technological advancement. The history of the stock market is the history of funding and the speculation in technology: sail, navigation, canals, railways, radio, automobiles, electronic, computing, the internet and finally the internet applications like Facebook, Google and Amazon.

So the way to invest is to catch new technology at a stage where it is exciting enough to be incorporated into listed enterprises, but not so late as to be a later entrant buying at increasingly lofty valuations.

Some people call this investing, but it is in the end speculation, a less respectful way of typifying someone putting their money down to back an opinion. Some will call it gambling, but the thing to recall about gambling is there are groups of people who make huge sums gambling, namely bookmakers and casinos, and the only difference between them and the customer is that for the house the odds are skewed in their favour. Picking to invest in technology before it breaks into the mainstream is investing with an edge, because skill is the edge in the stock market and spotting technology is certainly a skill.

So I have written about the coming hydrogen economy and why the platinum group metals are a place to invest alongside other producers and IP holders of exotic metals, but one should never stop looking for the next big thing.

For sure a next big thing is genetic engineering and it is just hitting the US stock market. Like nuclear power, genetic engineering has been a taboo since my childhood; sci-fi monster movies are embedded in the minds of many, with evil mutations causing havoc. So the good old trick of a rebrand seems to be doing the job of slipping in this unstoppable technology under the radar.

It is now called gene editing and offers hope and potential almost beyond limit. Fixing genetic diseases, the terrible consequences of which plague millions, is only the tip of a massive iceberg of positive possibilities, and in an incredible breakthrough the ability to fix and change DNA has been slung into a new era by a new technology.

This technology is Crispr. Im no biogeneticist, but my finance guy understanding is that Crispr allows for a cheap, fast and accurate way of cutting out and/or adding in new bits of DNA code to existing living cells. Jennifer Doudna and Emmanuelle Charpentier were given the Nobel Prize for the development of the gene-editing tools that led from Rodolphe Barrangous yogurt research to the development of phage-resistant yogurt bacteria. (Blessed are the cheese makers.)

By the time you read this I will probably own all the Crispr technology companies listed, which include: Crispr Therapeutic, Editas Therapeutics, Intellia Therapeutics and Beam Therapeutics, all in the US, but while this is an exciting cohort today, just like the hydrogen economy theme and for that matter cryptocurrency, this is just the start of a new explosive segment that will grow for decades and provide those investors who care to skill up on the nuances of the field an opportunity to build wealth for much of the rest of their lives.

Right now, these companies are comparative minnows with market caps of $4-$11bn. These might seem a lot, but when you consider Tesla can hold a value of $700bn and merely replaces the internal combustion engine in one form of transport, you can imagine that a technology that transforms the engine of life itself can command some interesting valuations given enough time to penetrate the mainstream investor imagination.

People always want names as tips. Its an entropic method that is as inadvisable as it is popular. The key tip is that this is a new segment that will explode in value and that speculators/investors can adopt it as a platform for long-term gains.

Biotech companies and the so called pharmas are a core segment for investors, especially in the US, and it is only a matter of time before the Crispr-Cas9 revolution breaks out of the specialist press and into the mainstream. Things never go as fast as you expect, especially if you see the future clearly. This shortening of the field of view is a drawback of seeing what is going to happen next, but in the end it does come to pass. You could have been receiving email in 1990 and be clearly expecting online systems to turn everything upside down, yet still have to wait a few years to jump on board the stocks that would then go vertical.

The key idea is that its worth getting in early, hanging on tight while constantly winnowing the sector down to the small sub-group that will be the colossuses in 20 years time. The earlier you can find such a sector, the more upside there is. As such, its a great time to be investing, as there are crypto, hydrogen economy and gene-editing segments that will have a long and lucrative future for those gritty enough to dig in and become experts in these technologies.

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Could gene therapies be used to cure more people with HIV? – aidsmap

Posted: at 6:07 am

Medical science is starting to license and use drugs and procedures that change the genetic code inside the bodys cells, and to correct the bad code that can give rise to conditions such as cancer and the auto-immune diseases. Since HIV is a disease that results from a virus inserting such a piece of bad code into our genes, such therapies could be used to snip out that code and effect a cure.

This was what attendees at last months International AIDS Society Conference on HIV Science (IAS 2021) heard at the workshop on curing HIV. The workshop opened with two introductory talks by Professor Hans-Peter Kiem, the chair of gene therapy at the Fred Hutchinson Cancer Research Center in Seattle in the US (the Fred Hutch) and, in a joint presentation, by the Fred Hutchs Dr Jennifer Adair and Dr Cissy Kityo of the Joint Clinical Research Centre (JCRC) in Kampala, Uganda.

The latter talk was a sign of acknowledgement that, while the prospects for genetic medicine are brighter than ever before, their expense and sophistication do not fit well with the global epidemiology of HIV, which mainly affects the worlds poorest and most disadvantaged communities. Despite this, Fred Hutch and JCRC have embarked upon a joint research programme to develop within the next few years a genetic therapy treatment for HIV that could be realistically scaled up for use in lower-income settings.

A unit of heredity, that determines a specific feature of the shape of a living organism. This genetic element is a sequence of DNA (or RNA, for viruses), located in a very specific place (locus) of a chromosome.

A type of experimental treatment in which foreign genetic material (DNA or RNA) is inserted into a person's cells to prevent or fight disease.

To eliminate a disease or a condition in an individual, or to fully restore health. A cure for HIV infection is one of the ultimate long-term goals of research today. It refers to a strategy or strategies that would eliminate HIV from a persons body, or permanently control the virus and render it unable to cause disease. A sterilising cure would completely eliminate the virus. A functional cure would suppress HIV viral load, keeping it below the level of detection without the use of ART. The virus would not be eliminated from the body but would be effectively controlled and prevented from causing any illness.

The body's mechanisms for fighting infections and eradicating dysfunctional cells.

In cell biology, a structure on the surface of a cell (or inside a cell) that selectively receives and binds to a specific substance. There are many receptors. CD4 T cells are called that way because they have a protein called CD4 on their surface. Before entering (infecting) a CD4 T cell (that will become a host cell), HIV binds to the CD4 receptor and its coreceptor.

HIV cure research pioneer Dr Paula Cannon of the University of Southern California, chairing the session, said: After several decades of effort and false starts, gene therapies now hold out promise for diseases that were previously untreatable.

Hans-Peter Kiem acknowledged the pivotal role of community advocacy in supporting cure research, noting that his project, defeatHIV, was one of the first beneficiaries of a grant from the Martin Delaney Collaboratories, named after the celebrated US treatment activist who died in 2009.

The other factor that gave impetus to HIV cure research was, of course, the announcement that someone had been cured: Timothy Ray Brown, whose HIV elimination was first announced in 2008 and who came forward publicly in 2010. He died in 2019 from the leukaemia whose treatment led to his HIV cure but by then had had 13 years of post-HIV life. He had survived long enough to talk with Adam Castillejo, the second person cured of HIV, and encourage him to come forward too.

Timothy and Adams stories showed that HIV could be cured, and with a crude form of gene therapy too: cancer patients, they were both given bone marrow transplants from donors whose T-cells lacked the gene for the CCR5 receptor, which is necessary for nearly all HIV infection.

But there have only been two cures for two reasons: firstly, bone marrow transplant is itself a very risky procedure involving deleting and replacing the entire immune system of already sick patients. In 2014 Browns doctor, Gero Hutter, reported that Timothy Ray Brown was only one of out of eight patients on whom the procedure had been tried, but that all the others had died.

Secondly, compatible bone marrow donors are hard to come by as it is, and restricting them to the 1% or so of people who lack the CCR5 receptor, all of them of northern European ancestry, means very few people could benefit from this approach. Attempting transplant with T-cells that do not lack CCR5, in the hope that replacing the immune system with cells from a person without cancer will also get rid of their HIV anyway, has produced temporary periods of undetectable HIV off therapy, but the virus has always come back.

(People like Brown and Castillejo, whose HIV infection was cured by medical intervention, need to be distinguished from people who seem to have spontaneously cured themselves, such as Loreen Willenberg: such people are of course of great interest to cure researchers, but the trick is to make it happen consistently in other people.)

Brown and Castillejos cures, as transplants, were so-called allogenic, meaning that the HIV-resistant cells came from another person. Better would be autogenic transplants, in which immune system cells are taken from a person with HIV, genetically altered in the lab dish to make them resistant to HIV, and then re-introduced. This type of procedure written about for aidsmap as long ago as 2011 by treatment advocate Matt Sharp, who underwent one.

The repertoire of gene therapies is not restricted to CCR5 deletion. Gene therapy is immensely versatile, and could be used in a number of ways.

Instead of using gene therapy to make cells resistant to HIV, it could directly repair defective genes in cells by means of cut-and-paste technology such as CRISPR/Cas9. This is already being used in trials for some genetic conditions such as cystic fibrosis and sickle-cell anaemia. Given that HIV-infected cells are also defective in the sense that they contain lengths of foreign DNA that shouldnt be there, they are amenable to the same molecular editing. Early trials have produced promising results but the challenge, as it has been in a lot of gene therapy, is to ensure that the cells containing DNA are almost entirely eliminated.

One way of doing this is not to delete the HIV DNA from infected cells but to preferentially kill off the cells themselves by creating so-called chimeric antigen receptor (CAR) T-cells. These are T-lymphocytes whose genes have been modified so that their usual receptors such as CD4 or CD8 have been replaced with receptors attuned very specifically to antigens (foreign or unusual proteins) displayed by infected cells and cancer cells. A couple of CAR cell therapies are already licensed for cancers; the problem with HIV is that the reservoir cells do not display immune-stimulating antigens on their surfaces. This means that CAR T-cells would have to be used alongside drugs such as PD-1 inhibitors that stop the cells retreating into their quiescent reservoir phase, an approach demonstrated at IAS 2021.

A couple of other approaches could be used to produce either vaccines or cures. One is to engineer B-cells so they produce broadly neutralising antibodies. A way of tweaking them to do this, called germline targeting, is covered was also discussed at IAS 2021, but if we manage to generate B-cells that can do this, we could then in theory directly edit their genes to make them do the same thing.

"Timothy Ray Brown and Adam Castillejo were both given bone marrow transplants from donors whose T-cells lacked the gene for the CCR5 receptor."

The other way is to induce cells to make viral antigens or virus-like particles that the immune system then reacts to. Scientists have been working on this technique for 20 years and it triumphed last year when the Pfizer and Moderna vaccines against the SARS-CoV-2 virus had over 90% success in suppressing symptomatic COVID-19. These vaccines are not genetic engineering in the sense of altering the genome of cells; rather, they introduce a product of the genetic activation in cells, the messenger RNA that is produced when genes are read and which is sent out into the rest of the cell to tell it to make proteins.

However because HIV is more variable and less immunogenic than SARS-CoV-2, the vaccine induced by the RNA would have to be something that looked much more like a whole virus than just the bare spike protein induced by the Pfizer and Moderna vaccines. If there was such a vaccine could be used both therapeutically as well as in prevention, by stimulating an immune reaction to activated HIV-infected cells. Moderna have announced they will now resume the HIV vaccine research they were working on when COVID-19 hit.

The problem with all these more gentle procedures is that it has proved difficult to replace all the HIV-susceptible cells with the HIV-resistant or HIV-sensitised ones: although engraftment takes place, meaning that the autologous cells are not rejected by the body and are able to establish a population for some time (in some animal experiments, replacing as much as 90% of the native immune cells), eventually the unaltered immune cells tend to win out because the introduced cells lack the deep reservoir of replenishing cells.

Kiem said that the way scientists have been trying to get round this is to only select and alter so-called haematopoeic stem cells (HSCs). These rare and long-lived cells, found in the bone marrow, are the replenishing reservoir of the immune system. They differentiate when they reproduce and give rise to all the immune cells that do different things: CD4 and CD8 T-lymphocytes, B-cells that make antibodies, macrophages that engulf pathogens, dendritic cells, monocytes, natural killer cells, and others.

Altering HSCs genetically so that they are able to fight HIV in one way or another could in theory give rise to a persistent, HIV-resistant immune system. They could in theory lie in wait and be ready to produce effector cells of various types. They would be ready when a new HIV infection comes along (if used as a vaccine) or when HIV viral rebound happens and there is detectable virus in the body (if used as part of a cure). If a person with CAR-engineered stem cells could have repeated cycles of treatment interruption, their HIV reservoir could in theory slowly be deleted.

"Gene therapies are astonishingly expensive."

As mentioned above, although genetic medicine shows enormous promise, the complexity and expense of its techniques means that at present it is unlikely to benefit most people who really need it.

Hans-Peter Kiem said that currently about 60 million people have conditions that could benefit from gene therapy. The vast majority of these either have HIV (37 million) or haemoglobinopathies blood-malformation diseases such as sickle-cell anaemia and thalassaemia that are also concentrated in the lower-income world (20 million).

Dr Jennifer Adair, one of the first researchers to have proposed collaboration on gene therapies for HIV with African institutes, said that gene therapies have already been licensed for conditions such as thalassaemia, spinal muscular atrophy, T-cell lymphoma and a form of early-onset blindness.

But they are astonishingly expensive. The worlds most expensive drug tag goes, depending on which source you read, either to Zynteglo, a genetic medicine correcting malformed beta-haemoglobin and licensed in the US for thalassaemia, or Zolgensma, a drug licensed in Europe and given to children to correct the defective gene that results in spinal muscular atrophy.

Both cost about 1.8 million for a single dose. The price is not just due to the cost of the complex engineering used to make them, but because they are used to treat rare diseases and so have a small market.

At present the technology need to engineer autogenic genetically engineered cells is, if anything, even more expensive and complex than that needed to introduce allogenic cells. It can involve in the region of ten staff and a workspace of 50 square metres per patient. Recently a so-called gene therapy in a box has been made available that can reduce the area needed to produce autogenic genetically-engineered cells from 50 to less than one square metre, and the staff need to one or two, But what is really needed is genetic engineering in a shot; a therapy similar to a vector or RNA vaccine that can be introduced as an injection and produces the genetic changes needed within the body.

Undaunted by the challenges, the US National Institutes of Health are collaborating with the Bill and Melinda Gates foundation to work on a combined programme of HIV and sickle-cell-anaemia genetic therapy (given that something that works for one could be adapted to work with the other).

And the Fred Hutchinson Center has teamed up with the Joint Clinical Research Centre in Uganda with the very ambitious goal of making a genetic therapy that would be at least ready for human testing within two years in an African setting, and that could be scaled up to be economical for Africa if successful.

Dr Cissy Kityo of JCRC in Uganda told the conference that as of 2020, there were 373 trials of gene therapy products registered, of which 35 were in phase III efficacy trials. The global budget for regenerative medicine, which includes genetic therapy and related techniques, was $19.9 billion, having jumped by 30% since the previous year. The US Food and Drug Administration projects that based on the current rate of progress and the development pipeline, they may be licensing around 100 gene-therapy products a year by 2025.

This branch of medicine is no longer exotic, she said. Now steps have to be taken to trial gene therapies in the people who needed them most, and to turn the exotic into the affordable, she added.

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How can we protect wild salmon from interbreeding with farmed salmon? CRISPR gene editing is a solution – Genetic Literacy Project

Posted: at 6:07 am

Upon an otherwise unruly landscape of choppy sea and craggy peaks, the salmon farms that dot many of Norways remote fjords impose a neat geometry. The circular pens are placid on the surface, but hold thousands of churning fish, separated by only a net from their wild counterparts. And that is precisely the conundrum. Although the pens help ensure the salmons welfare by mimicking the fishs natural habitat, they also sometimes allow fish to escape, a problem for both the farm and the environment.

In an attempt to prevent escaped fish from interbreeding with their wild counterparts and threatening the latters genetic diversity, molecular biologist Anna Wargelius and her team at the Institute of Marine Research in Norway have spent years working on ways to induce sterility in Atlantic salmon. Farmed salmon that cannot reproduce, after all, pose no threat to the gene pool of wild stocks, and Wargelius has successfully developed a technique that uses the gene-editing technology Crispr to prevent the development of the cells that would otherwise generate functioning sex organs.

In fact, Wargelius team was a little too successful. To be financially viable, commercial fish farms need at least some of their stock to reproduce. So the scientists went a step further, developing a method of temporarily reversing the modification they had already made. Theyve created what they call sterile parents.

The term may sound like an oxymoron, but the sterile parents have the potential to solve one of the most pressing problems facing salmon aquaculture, both in Norway and around the world. Wargelius says it could be up to a decade before the results of her work are commercially available, but once they are, they have the potential to make an already burgeoning food source markedly more friendly on the environment. And by prioritizing environmental concerns and employing a technique that simply turns off a gene rather than introducing one from a different species, Wargelius and her team may contribute to a shift in how genetic engineering is perceived in Norway, a country with some of the strictest regulations regarding genetically modified organisms on the books.

Aquaculture, the cultivation of saltwater and freshwater organisms under controlled conditions, has long been a controversial industry. On the one hand, its been hailed as an answer to overfishing and to a growing global populations demands for protein; on the other, it canpollute the water and spread diseaseamong both farmed and wild fish. Despite these drawbacks, around the world, aquaculture is booming. In the two decades of this century, production has increased an average of 5.3 percent per year, and as of 2018, more than 126 million tons of the seafood consumed annually came from a farm. Of those 126 million, 1.4 million were Norwegian salmon.

In fact, Norway is the worlds largest producer of farmed salmon, raising millions of the fish in sea pens scattered throughout its jagged fjords. Aquaculture is the countrys second-largest industry, and those pens are an important part of its reputation among major seafood producers for relatively sustainable production methods. Up to 260 feet wide and 160 feet deep, they are open-net, allowing the chilly waters of the North Atlantic to circulate freely and more closely replicate part of the salmons habitat.

Exact numbers are difficult to pin down, butone estimateputs the total number of escaped fish at 2.1 million in the last decade, and anotherstudyfound evidence of genes from farmed fish in wild specimens that were caught in 109 out of 147 Norwegian salmon rivers. Already under threat from overfishing the population has been cut in half in the last 30 years the threat to wild salmon biodiversity from this aquaculture gene stock is so great that farms are fined for fish that escape. Inone casethis year, Mowi, a company based in Bergen, Norway, was fined $450,000 for a 2018 incident in which 54,000 fish escaped.

In her early work, Wargelius focused on vaccines as a means of inducing the sterility that would minimize that threat. But her strategy changed soon after she learned about Crispr, the gene-editing technique that functions kind of like a Swiss Army knife, with different tools that make it possible to both insert material into a gene and snip it out.

Dorothy Dankel, a researcher at the University of Bergen who collaborates with Wargelius, recalled when Crispr first popped up. Anna was saying, Wow, theres this new paper that just came out with something called Crispr, Dankel said. She felt like the vaccine approach, its really kind of hit or miss. With Crispr, Wargelius thought, the team could hedge their bets.

But some scientists were skeptical, said Dankel. Genetically modified crops have encountered varying degrees of consumer resistanceglobally, in part because some modification techniques involve inserting genes from one species into another a process that has provoked fears ofFrankenstein foods. People were freaking out, saying, No, its GMO, we cant do that in Norway, said Dankel.

But an exception exists for lab experiments. By using Crispr to treat newly fertilized fish eggs, Wargeliuss team was able to knock out a specific gene calleddead-endordnd that is responsible for the migration of germ cells to the gonad. Germ cells eventually give rise to gametes, or sexual reproductive cells, and without them, the thinking went, the fish in this initial cohort would not reach sexual maturity.

At the same time, the scientists also turned off a gene that controls for pigmentation, because the resulting albinism would make it significantly easier to keep track of which fish had been modified. Sure enough, many of the Crispr-treated embryos grew into yellow-hued salmon that lacked germ cells.

Salmon grow slowly, so it would take just over a year before the biologists could confirm the impact of the missing cells, but by 2016, it was clear: 100 percent of the albino fish failed to reach sexual maturity. They were all sterile.

Using Crispr to change a gene that causes sex organs to develop, scientists have created salmon that are sterile. But, with the right treatment, those same fish may have their fertility returned, and thus breed sterile offspring that still contain the edited gene. Video: Institute of Marine Research

It was a very elegant experiment, says Yonathan Zohar, a professor of marine biotechnology at the University of Maryland, Baltimore County and an expert in aquaculture and fish reproduction technologies. Linking thedead-endgene to an albino gene provided a very good visual indication of which fish had been treated, he said. Her approach made a lot of sense.

There was only one problem: The element of Crispr they were using to produce the sterile salmon required a technician to manually inject each embryo with a protein that cut thedndgene a labor-intensive method that is hardly viable for commercial fisheries. Wargelius wanted to find a way to reverse the impact of the genetic modification without removing it from the salmons DNA. After all, the goal was pass sterility along to the next generation. A fish farm could then keep its brood stock separate from the rest of the salmon.

We thought, okay, maybe the simplest way to produce enough sterile salmon is to enable some of the sterile fish to reproduce, Wargelius explained.

She was skeptical the idea would work. But a year after her team injected a certain mRNA from wild salmon into newly fertilized eggs in an effort to effectively turn the fishs fertility back on, Wargelius received a text from the research station with photos that proved the technique had worked. It read: We have many fish with germ cells here!

Eventually, the treated fish developed gonads and reached sexual maturity, producing offspring that inherited their parents genetic sterility. The scientists wont have the full results until this fall, after the first generation is 8 to 10 months old the age at which salmon normally develop gonads. But so far, they say, everything is on track. Theoretically, yes we should get 100 percent sterility, Wargelius says.

Of course, certain safeguards need to be in place. A Crispr experiment to breedhornless cattlein the U.S. was initially hailed as a major success, but was laterdiscoveredto have introduced an unintended stretch of bacterial DNA into the cows genome. The producers thought that only their edit was being introduced, said Jennifer Kuzma, a professor and co-director of the Genetic Engineering and Society Center at North Carolina State University. You have to be cautious that youre not getting any off-target or unintended effects, she said. One way guard against this: Sequence the offsprings entire genome and look carefully for unintended changes in the DNA.

The Norwegian team is taking care to do this, and Kuzma sees their work as, in many ways, exemplary. The work has a societal benefit, it has biosafety mechanisms in place, and its being done in collaboration with ethicists, she says. Its being done under a pretty solid, good governance model.

The Norwegian scientists havent yet sequenced the salmons genomes to look for any secondary effects, and its still relatively early in the salmons lifespan, so they wont know about behavioral changes until the sterile offspring are transferred to the sea pens; currently the juveniles are living in tanks in the lab. Anna will have to demonstrate that when you take those fish to the net pens, they perform as well as the non-treated ones, says Zohar. And, he adds, shell have to scale everything up.

Those are significant hurdles,but the biggest hurdle, Zohar points out, is regulatory. From the time that genetically engineered crops first became widely available in the 1990s, their production has been regulated to different degrees, with some countries, such as the United States, merely demanding that the crops meet the same health and environmental standards as their conventionally bred counterparts.

Other countries have imposed stricter regulations on selected crops. In Mexico, for example, genetically engineered corn is banned because it poses a threat to the biodiversity of native maize. And other countries especially those in Europe have banned all genetically engineered crops intended for human consumption, as a food safety precaution. (To date, the safety concerns associated with GMOs have not been borne out.)

Norway has some of the most stringent restrictions in the world when it comes to genetically modified organisms: Farmers are barred from cultivating GMO crops and no genetically modified food products can be imported. Those policies, codified in the 1993 Gene Technology Act, were a reflection of both a powerful and fiercely protectionist agricultural sector and a public that is deeply conservationist and prides itself on its close connection to nature.

It was black or white, says Aina Bartmann, CEO of GMO-Network, an umbrella organization of nongovernmental organizations and corporations that represents 1.7 million consumers. It was so obvious, I think, for everyone in Norway, in Scandinavia, and also in the European Union, she said, that GMOs offered no contribution to anything we want.

Under the current legislation in Europe, Crispr is considered a gene modification technique, and no products created through it can be sold in Norway. (It is, however, authorized for research, and is being tested on lettuce and strawberries, in addition to salmon.) But that may be changing. Bjrn Kre Myskja, a professor of ethics at Norwegian University of Science and Technology, is working on a study of the conditions that would make gene editing technology socially and morally acceptable to Norwegians.

His research is currently in progress, but hes already seeing evidence, both in his work and anecdotally, that attitudes are changing particularly when it comes to technologies like Crispr, which dont always involve inserting the genes of one species into another. When you do something that might happen in an ordinary naturally-occurring kind of mutation, he said, then there seems to be a larger percentage that will find that acceptable.

Myskja has also observed in his research that opposition varies depending upon the perceived purpose of the modification. A modification that is intended to increase yields or to make an organism grow faster and therefore increase the profits of the producer is generally frowned upon in Norway. But a modification that achieves a broader good by increasing sustainability, for example, or improving animal welfare, might be tolerated. Therefore, a modification that benefits salmon, such as sterility or resistance to sea lice, may fall on the acceptable part of the scale, says Myskja.

His early findings are echoed in asurveyconducted by GENEinnovate, a collaboration of private companies, research institutions, and the Norwegian Biotechnology Advisory Board, an independent committee made up of 15 members appointed by the Norwegian government. It found that a majority of Norwegian consumers had a positive attitude toward gene editing if it carried clear social benefits and was carefully labelled. Bartmann, of GMO-Network, has noticed the same even among her organizations members. There are a lot of uncertainties associated with many aspects of gene editing, she said, and her members remain concerned about possible risks of releasing genetically modified crops or animals into the wild. We support the research going on now in Norway, she said, and we think that the more knowledge we get about the new methods, the better.

In the U.S., Kuzma has noted similar trends. In surveys, people say they see edits or genes inserted from the same species as slightly more acceptable than transgenic, she said, referring to genes inserted from different species. In the marketplace, in part because there are so few products in the market, a significant proportion dont really care. But there are still years of distrust to get over, and theres a segment of around 20 percent that will reject GMOs in any form.

For the moment, the aquaculture industry in Norway is hedging its bets. Historically, the industry has taken a hardline position against GMOs, conscious that the appeal of their products rests on a public perception of genetic purity. AquaGen, a breeding company that supplies fertilized Atlantic salmon eggs, sent a statement to Undark, writing that producing sterile salmon by Crispr may be a future solution, but many technical, ethical, legislative, and commercial issues need to be solved before commercial implementation. Cermaq, an international salmon farming company, similarly wrote to Undark that farming sterile salmon may have advantages, and research in this area is very interesting, but noted that the company is currently not planning to farm the gene-edited fish.

Yet Dankel has seen change among industry representatives. In 2014, she interviewed a senior manager at AquaGen, and asked if she saw a future for Crispr in her company. Dankel received a hard no: This is playing with fire, Dankel recalls being told. Our customers expect pure genetics; they dont want anything modified. Just a few years later, she says, the company told her the technique is part of their research strategy.

The speed with which Crispr technology is developing and being adopted in laboratories around the world helps explain some of that transformation. But locally, Dankels own work plays a role, too. Within the Wargelius lab, Dankel is the representative forResponsible Research and Innovation, a position devoted to ensuring that ethical and social considerations are embedded into the research.

This involves doing outreach explaining the research to the public and what Dankel calls inreach getting people who arent used to collaborating on a subject to work together. When it comes to something as complex as Crispr, she finds that with these interdisciplinary teams that combine biochemistry and molecular biology with social and economic assessments, it is essential to create a common language for what the goals are, and what success and failure might look like.

Dankel too is noticing a change in the discourse in the wake of the Crispr salmon. The pendulum has swung and now people even the Biotechnology Council of Norway are only saying the good things about Crispr and not anything about off-target effects, Dankel said, or that once you start this technology you can never put it back.

Yet perhaps the clearest indication that Norway may soon adjust its legislation to make room for Crispr is the governments creation, in November 2020, of anew committeeto review the field of genetic technologies. Headed by Wargelius, it will report on its findings and recommendations in June 2022. Norway really wants to promote a public debate about the law that is based in science, says Dankel. They could have chosen a law professor to lead that. They could have chosen someone whos not a biologist.

And Wargelius still has a lot of biology to do. She and her team are just now beginning to work on their second generation of fish and also are planning to sequence the genome of the sterile fish to ensure there arent any unintended edits. Wargelius estimates that any commercial licensing for this application, provided it is approved, is five to 10 years away.

But shes in no hurry. With Crispr, she suspects, Norway is moving toward an application-based process, where the technology will be approved in cases where the need for or benefit from a specific use is sufficient to outweigh the risks. Which is why, she says, she chooses an open and thorough approach for her own research. We also now are trying to start a collaboration with both economic and ethical researchers to see what is the potential in the market, what will people think, said Wargelius. I would like to have a quite slow process, where we really have all the documentation that we need to be certain that its a solid product.

Lisa Abend is a journalist and food writer based in Copenhagen and Madrid. Her work has been published in Bon Appetit, Food and Wine, Time Magazine, The Atlantic, Wired, The New York Times, and Slate, among other outlets. Find Lisa on Twitter @LisaAbend

A version of this article was originally posted atUndarkand is reposted here with permission. Undark can be found on Twitter@undarkmag

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New gene therapies may soon treat dozens of rare diseases, but million-dollar price tags will put them out of reach for many – The Conversation US

Posted: at 6:07 am

Zolgensma which treats spinal muscular atrophy, a rare genetic disease that damages nerve cells, leading to muscle decay is currently the most expensive drug in the world. A one-time treatment of the life-saving drug for a young child costs US$2.1 million.

While Zolgensmas exorbitant price is an outlier today, by the end of the decade therell be dozens of cell and gene therapies, costing hundreds of thousands to millions of dollars for a single dose. The Food and Drug Administration predicts that by 2025 it will be approving 10 to 20 cell and gene therapies every year.

Im a biotechnology and policy expert focused on improving access to cell and gene therapies. While these forthcoming treatments have the potential to save many lives and ease much suffering, health care systems around the world arent equipped to handle them. Creative new payment systems will be necessary to ensure everyone has equal access to these therapies.

Currently, only 5% of the roughly 7,000 rare diseases have an FDA-approved drug, leaving thousands of conditions without a cure.

But over the past few years, genetic engineering technology has made impressive strides toward the ultimate goal of curing disease by changing a cells genetic instructions.

The resulting gene therapies will be able to treat many diseases at the DNA level in a single dose.

Thousands of diseases are the result of DNA errors, which prevent cells from functioning normally. By directly correcting disease-causing mutations or altering a cells DNA to give the cell new tools to fight disease, gene therapy offers a powerful new approach to medicine.

There are 1,745 gene therapies in development around the world. A large fraction of this research focuses on rare genetic diseases, which affect 400 million people worldwide.

We may soon see cures for rare diseases like sickle cell disease, muscular dystrophy and progeria, a rare and progressive genetic disorder that causes children to age rapidly.

Further into the future, gene therapies may help treat more common conditions, like heart disease and chronic pain.

The problem is these therapies will carry enormous price tags.

Gene therapies are the result of years of research and development totaling hundreds of millions to billions of dollars. Sophisticated manufacturing facilities, highly trained personnel and complex biological materials set gene therapies apart from other drugs.

Pharmaceutical companies say recouping costs, especially for drugs with small numbers of potential patients, means higher prices.

The toll of high prices on health care systems will not be trivial. Consider a gene therapy cure for sickle cell disease, which is expected to be available in the next few years. The estimated price of this treatment is $1.85 million per patient. As a result, economists predict that it could cost a single state Medicare program almost $30 million per year, even assuming only 7% of the eligible population received the treatment.

And thats just one drug. Introducing dozens of similar therapies into the market would strain health care systems and create difficult financial decisions for private insurers.

[Over 110,000 readers rely on The Conversations newsletter to understand the world. Sign up today.]

One solution for improving patient access to gene therapies would be to simply demand drugmakers charge less money, a tactic recently taken in Germany.

But this comes with a lot of challenges and may mean that companies simply refuse to offer the treatment in certain places.

I think a more balanced and sustainable approach is two-fold. In the short term, itll be important to develop new payment methods that entice insurance companies to cover high-cost therapies and distribute risks across patients, insurance companies and drugmakers. In the long run, improved gene therapy technology will inevitably help lower costs.

For innovative payment models, one tested approach is tying coverage to patient health outcomes. Since these therapies are still experimental and relatively new, there isnt much data to help insurers make the risky decision of whether to cover them. If an insurance company is paying $1 million for a therapy, it had better work.

In outcomes-based models, insurers will either pay for some of the therapy upfront and the rest only if the patient improves, or cover the entire cost upfront and receive a reimbursement if the patient doesnt get better. These models help insurers share financial risk with the drug developers.

Another model is known as the Netflix model and would act as a subscription-based service. Under this model, a state Medicaid program would pay a pharmaceutical company a flat fee for access to unlimited treatments. This would allow a state to provide the treatment to residents who qualify, helping governments balance their budget books while giving drugmakers money upfront.

This model has worked well for improving access to hepatitis C drugs in Louisiana.

On the cost front, the key to improving access will be investing in new technologies that simplify medical procedures. For example, the costly sickle cell gene therapies currently in clinical trials require a series of expensive steps, including a stem cell transplant.

The Bill & Melinda Gates Foundation, the National Institute of Health and Novartis are partnering to develop an alternative approach that would involve a simple injection of gene therapy molecules. The goal of their collaboration is to help bring an affordable sickle cell treatment to patients in Africa and other low-resource settings.

Improving access to gene therapies requires collaboration and compromise across governments, nonprofits, pharmaceutical companies and insurers. Taking proactive steps now to develop innovative payment models and invest in new technologies will help ensure that health care systems are ready to deliver on the promise of gene therapies.

The Bill & Melinda Gates Foundation has provided funding for The Conversation US and provides funding for The Conversation internationally.

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New gene therapies may soon treat dozens of rare diseases, but million-dollar price tags will put them out of reach for many - The Conversation US

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Felix Biotechnology Awarded Competitive Grant from the National Science Foundation to Power Phage Engineering Platform – PRNewswire

Posted: at 6:07 am

SOUTH SAN FRANCISCO, Calif., Sept. 2, 2021 /PRNewswire/ --The National Science Foundation (NSF) awarded Felix Biotechnology a Small Business Innovation Research (SBIR) Phase Igrantfor$256,000 to further enhance their machine learning-based approach for engineering bacteriophage as a novel treatment for drug-resistant bacterial infections.

Bacteriophage, or phage, are viruses that infect and kill bacteria. Phage have key benefits relative to small molecule antibiotics, but there are several hurdles to turning phage into a true biotherapeutic. First, like traditional antibiotics, bacteria can become resistant to phage. Second, due to their specificity, finding the right phage to treat an infection can be challenging. Felix has made significant headway in addressing the first hurdle. The NSF SBIR grant will support Felix's efforts to address the second hurdle by engineering phage for improved efficacy and utility, starting with proof-of-concept work in Pseudomonas aeruginosa, a pathogen of high clinical need.

"NSF is proud to support the technology of the future by thinking beyond incremental developments and funding the most creative, impactful ideas across all markets and areas of science and engineering," said Andrea Belz, Division Director of the Division of Industrial Innovation and Partnerships at NSF.

"The NSF funding will supercharge our high-throughput methodologies for fast and economical identification and characterization of phage and phage-bacteria interactions. These rich datasets power our ML and genetic engineering tools, creating a platform for tuning phage specificity and producing phage products targeting dangerous human pathogens, like P. aeruginosa and Mycobacterium abscessus," said Felix Biotechnology co-founder and principal investigator on the grant, Natalie Ma, PhD.

Phase I SBIR awardees are eligible to apply for Phase II awards of up to $1 million. Small businesses with Phase II funding are eligible for $500,000 in additional matching funds with qualifying third-party investment or sales.

"Felix is tackling the most challenging technical hurdles limiting the broad application of phage therapy to the clinic. With the antimicrobial resistance crisis only growing, new solutions to treat bacterial infections are absolutely essential for ensuring our global future health," said Dr. Ma.

For more on Felix Biotechnology, please visit: https://www.felixbt.com/

For more on the National Science Foundation's Small Business Programs, please visit: https://seedfund.nsf.gov/

SOURCE Felix Biotechnology, Inc.

https://www.felixbt.com/

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