For a science or technology to have real impact on people, it must have the potential; but it must also have commitment. The first automobiles had potential, clunky though they were. The potential was seen most clearly in the United States, which then provided commitment – commercial (auto companies), governmental (roads, laws), and personal (a love affair with cars).
Stem cells are different than cars, of course; but bear with this comparison: Stem cell research and the technologies that flow from it have great potential, especially in the area of regenerative medicine (repairing damaged body parts). At the moment that potential is mostly prognostication and a few controversial applications. It can be argued that what stem cell research and application needs is commitment, and that the greatest commitment is happening in China. Commercial interests, including many private clinics, are jumping into not only stem cell research, but also applications. The Chinese government is pouring money into stem cells with guidelines unencumbered by the quasi-religious controversy that dogs stem cell research in many Western countries. Worldwide, people have noticed that China is the place to go for ‘last-effort’ stem cell procedures. They have voted with their feet in a form of medical tourism.
As of 2008, China is the fifth most productive provider of stem cell regenerative medicine research papers (in order: United States, Germany, Japan, Great Britain, China). Chinese papers on regenerative medicine, the practical aspect of stem cell research, increased in number from 37 in 2000 to 1,116 in 2008. A paper published by The McLaughlin-Rotman Centre for Global Health at the University Health Network and the University of Toronto has considerable detail on the rise of Chinese regenerative medicine, and is well worth reading:
While unorthodox activities at Chinese clinics and controversial drug approvals have raised eyebrows both in and outside China, dedicated researchers in the country’s labs have been making remarkable contributions to the field.
Among the country’s scientific firsts:
• By transferring the nucleus of a human skin cell into the immature ovum cell of a rabbit, researchers from a Shanghai hospital successfully produced embryonic human cells (a finding popular scientific journals held off publishing for two years due to skepticism and of mistrust Chinese scientific integrity).
• China to date has created at least 25 human embryonic stem cell lines (some estimate over 70 stem cell lines), four of which are of a specialized type that at that time only two other groups worldwide had managed to create.
• A Shanghai hospital cultivated and reintroduced human brain tissue in 2002 after taking a sample from the end of a chopstick implanted in a patient’s frontal lobe following a disagreement at a restaurant.
• Several human tissue types created artificially include blood vessel, tendon, bone, cartilage, skin, cornea and muscle fiber.
There has been much said about the lax ethical practices associated with Chinese stem cell medicine. International organizations, such as the International Society for Stem Cell Research (ISSCR) have taken China to task for not following sanctioned practices. There has also been criticism within China, particularly by academic stem cell researchers, that China has been too eager to turn stem cell research into profitable medical procedures. The result has been a flurry of tightened governmental guidelines. Implementation of the guidelines waits upon regulatory details and funding for mechanisms of supervision. (In colloquial American-speak, like many countries, China knows how to drag the feet and fudge the details.)
It seems clear that China is intent on making advances in stem cell research turn into practical (and profitable) procedures. That’s where the bulk of its governmental support is going, and why so many clinics throughout China have seen the green-light of GO, if through a veil of government admonition.
Since it’s becoming increasingly apparent that stem cells, in their many and various types, will impact the treatment of, among other things: Type 1 diabetes, heart attacks, artery obstruction, liver and neural diseases, Parkinson’s disease, heart, liver and blood diseases, eye cataracts, and to combat aging; expect the Chinese to have a prominent, if not dominant position in the roll-call of leading nations in regenerative medicine. Expect also, that China will use its most prominent resource – manpower – in ways not available to most other countries.