News Review

Horse clone

The world's first cloned horse, called Prometea, was born on 28 May - the only one of 328 attempts to make it. The announcement was made by Professor Cesare Galli, the project's leading scientist, based in Cremona, Italy. Following this success, scientists have raised the possibility of creating human clones in a similar fashion, given the comparable nature of the equine and human reproductive systems.

DNA tests were performed on the young foal, and these were shown to be identical to the mother, also her twin. The process involved extracting a skin cell and egg from the parent, fusing the two cells and reimplanting the embryo into the uterus.

While many clones suffer from genetic defects and physical deformities, Prometea is reported to be in good health. Nevertheless, Prof Galli is being cautious in his assessment that Prometea is unaffected by the cloning process. It is thought that in future, the techniques employed to create Prometea will eventually extend to 'preserving' the characteristics of racehorse champions. Breeders have already been encouraged to freeze the cells of horses that are considered to be outstanding. (Telegraph 2003; 7 August, betterhumans.com 2003; 8 August, Guardian 2003; 7 August)

Embryonic stem cells reach UK

Scientists at King's College, London have created the first embryonic stem cell line in the UK. Unwanted embryos from IVF treatment were used in this research. The embryo that established the cell line was donated by a couple who had completed their IVF treatment.

The King's team were one of two groups granted a licence by the HFEA to work with embryos, since the House of Lords approved such study in 2002. Ethical considerations resulted in the slightly slower pace of research in the UK. Other embryonic stem cell lines have already been established in countries such as the United States, where the first line was created in 1999.

The cells in the UK will be stored in the national stem cell bank, where they will be accessible to other researchers. Future work will go into using these cells to treat type I diabetes mellitus and Parkinson's disease. However, viable treatments are deemed to be some way off. Pro-life groups have already denounced the latest breakthrough, saying that it violated the human rights and interests of the embryos. The ethical alternative of adult stem cells remains a more promising source of potential therapies. (New Scientist 2003; 13 August, bbc.co.uk 2003; 13 August, Independent 2003; 13 August)

Human-rabbit embryos

Human cells have been fused with rabbit eggs following embryonic stem cell research in China. The work was done at the Shanghai Second Medical School, directed by Hui-zhen Sheng. Foreskins were taken from two men and a boy, and facial skin from a woman to create the cells.

The stem cells were shown to have the ability to differentiate into various tissues, making them a potential source of transplantable cells. However, the Chinese group failed to demonstrate that the cultures could grow indefinitely, limiting their usefulness.

Cloning by recruiting material from other species has attracted interest from researchers because of the ethical problems of obtaining discarded human embryos: it is thought that hybrid embryos could bypass such considerations. Previous attempts from other labs to create such interspecies embryos have failed except for closely related animals, leading to scientific scepticism about the latest announcement. In addition, concerns have been raised about remaining rabbit DNA in the hybrid embryonic stem cells that could cause human immune responses.

General scientific opinion has been mixed over the issue, with some hailing this as an important step forward, but others remaining concerned about the 'yuck factor'. (New Scientist 2003; 15 August)

IVF on the NHS

Fertility treatment could soon be offered on the NHS to couples who have unsuccessfully tried for a baby for three years. Doctors fear that this could stretch both the NHS and private clinics beyond their capabilities.

One in six couples have fertility problems and about 24,000 undergo IVF treatment annually. One in five IVF attempts is successful. Private clinics charge £2,000-£4,000 for the treatment with an additional £1,000 for drugs. Some estimate that providing a free service could cost the NHS at least £100 million per year.

The Department of Health asked the National Institute for Clinical Excellence (NICE) to formulate guidelines for couples who cannot afford to pay for treatment. NICE suggested that women aged 23 to 39 should be eligible for IVF if they had failed to conceive for three years. They also recommended that younger women be eligible if there is an obvious cause for the couple's infertility. The woman would be able to have a maximum of three attempts using fresh embryos. Any spare embryos could be frozen and reimplanted before the next full cycle, thus giving a maximum of six attempts at implantation.

Child, a national support organisation for infertile couples, welcomed the draft guidelines but Dr Sue Avery, chairman of the Association of Clinical Embryologists, said it would be necessary to use private clinics to cope with the demand. Her comment was reiterated by Dr Simon Fishel, director of Centres for Assisted Reproduction, one of the largest IVF providers in the country, who said that current units do not have the capacity.

NICE will put its final recommendations to the government next February. (guardian.co.uk 2003; 26 August, news.telegraph.co.uk 2003; 26 August)

Internet conception

A married couple in the south east of England who selected sperm over the internet gave birth to a baby boy in August, after failed artificial insemination and IVF treatments. The website they used, mannotincluded.com, was intended mainly for single women and lesbian couples who wish to become parents. The boy is believed to be one of the first babies born using this method.

Prospective parents are able to order sperm from the site according to physical characteristics of the donor, including race, height, build and eye colour. Upwards of 19 women are already pregnant using this service. A lesbian couple, who used the website after their GP refused them assistance, are expecting a baby in January 2004.

Medical ethics groups have criticised the website and its founder, John Gonzalez, for 'wholly undermining the building blocks of a stable society'. Mr Gonzalez counters that his site 'offers women choice to have children without fear of prejudice or discrimination'. The Human Fertilisation and Embryology Authority (HFEA) has also expressed concerns about possible unsafe laboratory practices and testing of donated sperm. However, the HFEA has no legal jurisdiction over the website because it offers fresh sperm, which is not covered by the Human Fertilisation and Embryology Act. (Telegraph 2003; 20 August, bbc.co.uk 2003; 28 June, Times 2003; 20 August)

Cheaper drugs in developing countries

After a two year row, the World Trade Organisation (WTO) has finally approved a plan to make cheaper generic drugs available for developing countries. This will allow diseases such as AIDS and malaria to be more affordably treated.

Under the deal, developing countries will for the first time be able to import generic drugs and their active ingredients. During health emergencies, the present system allows for countries to bypass patent laws and issue generic drugs through existing local drug companies. The problem is that many of the world's poorest countries have no pharmaceutical industry to manufacture the drugs and so cannot take advantage of this.

In 2002, a previous WTO agreement foundered, despite the backing of virtually all members, when the USA refused to comply, citing patent protection and intellectual property rights as points of concern.

Developing nations will have to submit evidence that the drugs are needed and that they cannot produce them locally. They will also have to ensure that drugs are being used appropriately and not being smuggled abroad. The generic drugs should look different to the expensive original and could have a different name, shape, colour or packaging. Provided these criteria are met, the WTO will then decide if the nation can start importing the drugs.

WTO's director-general, Supachai Panitchpakdi, applauded the new deal, as he said it 'fully respects and protects humanitarian concerns'. However, aid agencies such as Medecins sans Frontieres and Oxfam, were sceptical about the deal, because African nations were already exempt from patent-related issues. They labelled it 'profoundly unfair' and said that it would not make a significant difference to the millions of people who die unnecessarily in the developing world. (Reuters 2003; 30 August, bbc.co.uk 2003; 30 August)

Homosexuality and the church

Anglican leaders are seeking to excommunicate the American Episcopalian wing of the Church of England as a result of the appointment of the actively homosexual Canon Gene Robinson to the Bishopric of New Hampshire.

Just over half of the leaders of the Anglican church have criticised the appointment, and have called for the Episcopal church to cancel his ordination. Pressure is mounting on Rowan Williams, the Archbishop of Canterbury, to excommunicate the American wing unless they meet the demands of the majority of bishops to reverse the selection of Canon Robinson. Dr Williams had written to primates before the confirmation of the appointment, calling for preservation of unity. This was understood to be a call to stop the election of Canon Robinson.

Anglican leaders will meet at a summit called by Dr Williams in October in London to discuss the issue of gay clergy. The leader of the Southern Cone church in the US, Gregory Venables, and the Archbishop of Nigeria, Peter Akinola, have both supported a motion to remove the Episcopalian church from communion. According to Venables, 'they've already stepped outside the historic faith, so they're out'.

While some Anglican officials are seeking a compromise, the Lesbian and Gay Christian Movement are lobbying David Blunkett to prevent Akinola from attending the meeting in Britain for fear of inciting people to hatred of homosexuals.

Earlier on in the summer, Canon Jeffrey John withdrew from the post of bishop-elect of the diocese of Reading in the UK, after pressure from Dr Williams not to take up office. The Archbishop made his decision after conservatives and evangelicals threatened to split the Anglican Communion over the issue.

Since Canon John renounced his willingness to take up the Reading post, he has called for his supporters to remain in the church and fight for change. While evangelicals have welcomed Canon John's decision, liberals in the Church of England have been appalled by his treatment, notably the Dean of Southwark Cathedral, Colin Slee. Canon John is a high profile advocate for issues pertaining to gay rights. He is expected to remain in his present post as Canon Theologian of Southwark Cathedral. (Times 2003; 31 August, Telegraph 2003; 7, 17, 29 July)

Iranian conjoint twins

Controversy still reigns after a failed operation to separate the conjoined twins, Laleh and Ladan Bijani, resulted in their deaths. The adoptive parents of the twins, Alireza Safaian and Iran Karmi, are considering suing the Singapore hospital where the procedure was performed. An unnamed relative insisted on the continuation of the operation even when the surgical team had doubts about its success.

Ben Carson, one of the neurosurgeons from Johns Hopkins Hospital who participated in the surgery, said that he would not now recommend the procedure in future having learnt from the experience, although those words were little comfort for the adoptive parents, who were vehemently opposed to the operation. Alireza Safaian, himself a doctor, had previously taken the twins to a German specialist unit to look at the possibility of separation, but was told that there was a low chance of both surviving. (Telegraph 2003; 13 July)

Public health or corporate profit?

Prof Sydney Brenner, a Nobel prize winner, has said that people should be told to look after their health rather than expecting science to save them. The molecular biology expert said that more money should be invested in health care education rather than in the pharmaceutical industry. He said that focusing on healthy living messages would save more lives and cost less, instead of designing genetically tailored drugs.

He said only drug companies benefited from the current emphasis on medical research: 'everything is being driven into the support of the pharmaceutical industry…. You hear all these things about the genome or personalised medicine and newer and safer drugs. Maybe what we ought to think about is a new public health to be created.'

Prof Brenner, of the Molecular Science Institute in Berkeley, California, added: 'Today everybody does what they like with their bodies and at the end of the day they think the drug companies or medical science will come to their rescue with a pill.'

He said the growth in obesity in Europe and America was an example of how people looked to science for an answer instead of looking at how lifestyle might affect their weight: 'of course all the drug companies are working hard on a pill, but effectively the obesity is self-induced.' (bbc.co.uk 2003; 2 September)