Human Germline Editing: A Potential Source of Inequality

If not properly overseen and regulated, human germline editing will exacerbate social and economic inequality as state-of-the-art developments in the field will only be accessible to wealthy individuals.

Inequality Today

Reducing social and economic inequality is one of the biggest challenges world leaders face today. In fact, it is one of the United Nations’ 17 Sustainable Development Goals. Despite progress in some areas, the gap between the world’s rich and poor remains problematic. According to the United Nations, in 2018, 50% of global wealth was concentrated among the top 26 richest individuals, compared to 43 people the year before (1). Moreover, 71% of the world’s population lives in countries where income inequality has grown in the last few decades (2). Therefore, it is critical to consider the extent to which technological developments can impact economic and social disparities around the world.

Human Germline Editing as a Source of Inequality

Gene modification technologies are widespread and cover a broad range of applications. Our focus is on human germline editing, which involves altering the genome of human embryos, resulting in changes that get passed onto the offspring cells. In other words, it affects the individual as well as future generations. We argue that without proper control and regulation, the nature of this technology can lead to an even more unequal society, as illustrated in the negative self-reinforcing cycle below:

Today, the cost of human gene therapies can cost anywhere from hundreds of thousands of dollars to a couple of million (3). For reference, average household income in the United States stands around $67,000 (4). Therefore, it is safe to assume that if and when germline editing becomes available in the market, only people at the very top of the income spectrum will have access to these treatments. Even before germline editing technology becomes readily available, people at the top will already be at a major advantage relative to those at the bottom, given their access to better education, healthcare, jobs, etc. Lack of access to these opportunities already creates major barriers for social mobility. Without any type of control to access germline editing, it isn’t crazy to imagine a future world where the genome of the rich is noticeably “better” (e.g., disease-free) than the genome of the poor. Like with any other technology, we can expect the costs of germline editing therapies to come down over time, and the access to it to rise. But this process will take time. Take the internet, for example. Even after several decades after its introduction and major advancements in the cost of delivery, nearly 40% of the world’s population still lacks access to proper internet connection (5). By the time the majority of the population gets access to germline editing, there will probably be an even better technology that only the rich will have access to, cementing this vicious cycle of inequality.

Mitigating Factors

Besides exacerbating inequality, human germline editing technologies may carry irreversible health risks to the human species. As such, proper regulation around the development and access to this technology is imperative. To mitigate both, inequality and health risks, we propose a combination of the regulatory measures mentioned below:

1. Create one global central organization in charge of conducting all human germline editing technology research and development, releasing only safe technology at accessible prices to the world. In parallel, a global organization must enforce prohibition of experiments done by other organizations.
2. A global organization (e.g., UN, WHO) should proactively set global regulatory boundaries to guide and limit R&D in the human germline editing field. These boundaries should explicitly state the allowed fields of research and applications for commercial use, while prohibiting and sanctioning any other uses.
3. Allow private human germline editing R&D but prohibit any human germline editing technology commercialization until there is validation by a global central regulator.

References

1. “Inequality – Bridging the Divide.” United Nations, United Nations, https://www.un.org/en/un75/inequality-bridging-divide#:~:text=From%201990%20to%202015%2C%20the,per%20cent%20of%20overall%20income.

• Ibid.
• Muigai, Anne W. T. “Expanding Global Access to Genetic Therapies.” Nature News, Nature Publishing Group, 7 Jan. 2022, https://www.nature.com/articles/s41587-021- 01191-0.
• Bureau, US Census. “Income and Poverty in the United States: 2020.” Census.gov, 1 Mar. 2022, https://www.census.gov/library/publications/2021/demo/p60-273.html.
• Johnson, Joseph. “Internet Users in the World 2021.” Statista, 10 Sept. 2021, https://www.statista.com/statistics/617136/digital-population- worldwide/#:~:text=As%20of%20January%202021%20there,the%20internet%20via%20 mobile%20devices.

Martín Restrepo

Martín Restrepo is originally from Medellín, Colombia. He is passionate about aviation and the airline industry. He holds an Industrial Engineering degree from Georgia Tech and is going into management consulting after HBS.

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SR

Sergio Roldán

Sergio Roldán is originally from Querétaro, Mexico. He is passionate about product development and blockchain and holds a Mechatronics Engineering degree from ITESM. He is going into management consulting after HBS.

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