Scientists Consider AIDS, Stem Cell Ethics and Politics
January 14, 2005
Two nationally prominent scientists addressed issues regarding the forces shaping the ongoing efforts to battle AIDS and the “promise and reality” of embryonic stem cell research Jan. 11 at the Keck School of Medicine.
The occasion was a Southern California regional meeting of the Institute of Medicine (IOM).
Former Keck School dean and IOM member Stephen J. Ryan, who hosted the meeting on behalf of Dean Brian Henderson, welcomed the IOM and its members, as well as several members of the W.M. Keck Foundation board and other distinguished guests. Ryan told the almost-overflowing crowd in the Mayer Auditorium that the meeting was “perhaps the best-attended session in my experience.”
IOM President Harvey Fineberg introduced the meeting's speakers, David Baltimore and Fred Gage, calling them “two eminent and extraordinary individuals” whose work in their respective fields assist in “elevating, analyzing and assessing how these problems apply” to science and society.
Baltimore, a Nobel laureate and president of Caltech, spoke first on the interplay between AIDS and U.S. science policy, referring to AIDS as the “defining disease of the last 25 years,” one whose “impact pervades our society today.”
In the early 1980s, Baltimore was among the first to call for a major national program to address the challenge of AIDS, and urged all biologists to consider devoting at least a portion of their research efforts to AIDS.
“Taboos about sex still control much of our response” to the AIDS epidemic, he said, “and only slowly does it change.”
Overcoming AIDS, Baltimore said, requires a bit of a leap of faith, a belief that efforts put into seemingly futile endeavors may result in an enormously beneficial payoff. It requires an even more concentrated effort to find an AIDS vaccine, despite mounting evidence that it may not even be possible to do so. “Scientists are optimists,” he said. “Although the simple conclusion is that no vaccine is possible, they refuse to accept that conclusion.”
However, don't start looking for a vaccine any time soon, he said. Ongoing vaccine trials are in very early stages, and even those aren't necessarily showing exciting results. “There's a lot of activity,” Baltimore observed, “but no clear pathway to success.”
In the meantime? “We need to start right now on behavior modification programs and promote the use of condoms,” he said. “We should be empowering people to protect themselves.”
Whereas expectations for an AIDS vaccine may be underplayed, the potential benefits of stem cell therapies are nothing if not overplayed, claimed Linda Rosenstock, dean of the School of Public Health at UCLA, who moderated a post-lecture discussion and question-and-answer session.
Still, there can be benefits from all of the attention surrounding the use of embryonic stem cells. Fred Gage, the Vi and John Adler Professor in the Laboratory of Genetics at the Salk Institute for Biological Studies, explored several of these benefits in his discussion of embryonic stem cell research.
“This debate [over the use of embryonic stem cells in research] forces us to talk about science to the public,” he said. That's a particularly good thing, Gage added, because of the “experiment” that California has recently embarked upon in the use of embryonic stem cells (See lead story, page 1).
“It strikes me how little thought people have given to these cells,” Gage said. For instance, there are basically two criteria a cell must meet to be called a stem cell: It must retain some amount of potential in terms of the type of cell it can be coaxed into becoming. And two, it needs to be self-renewing, with at least one of two daughter cells created after a cell division being capable of dividing again. And yet, he said, most people — even many involved in discussions of the ethical and political implications of the use of these cells — would be hard put to reliably identify stem cells using these criteria, or to understand the potential applications for stem cell use.
Some of those applications, Gage said, include increasing basic knowledge of human development, providing replacement cells for transplantation, creating models of human disease, developing new drugs and growing organs.
But, truth be told, he concluded, few if any of these uses will come to pass in the near future. “Over the next 10 years, we'll be working on our basic knowledge of these cells,” Gage said. “So much is really unknown.”