Aihwa Ong

 

On her book Fungible Life: Experiment in the Asian City of Life

Cover Interview of January 18, 2017

A close-up

The book gives a manifold view of emerging Asian post-genomic science. Each chapter features scientists at work in an adjacent field, constantly challenged by the contingencies of making scientific wagers and fortunes.

Americans learn what personalized medicine looks like from Angela Jolie’s cancer story reported in The New York Times. But a different notion of personalized medicine prevails in Asian biomedicine, one that customizes therapies at the ethnic/group level. At stake is not the art of optimizing health, but managing risks and uncertainties that threaten collective life. In emerging Asian contexts, national agendas are scripted into research programs. Medicine is customized less to the person than the group as an affordable way to serve millions menaced by deadly diseases in the developing world. The immediate goal is not to “cure” diseases, but to widen access to therapies that can defer death.

Chapter 3, Smoldering Fire, illuminates the efforts by oncologists to match Asian mutations to specific forms of cancer prevalent in the region. We each have our own internal Galapagos of mutations, but by creating ethnic biomarkers, specialists can test drugs that are effective for Asian patients. Like their patients, doctors are caught up in contrary affects of vulnerability and hope. Because therapies can only douse the flames of tumors, the aim is to change cancer from a fatal to a chronic disease.

It is said that bioethical norms are inadequate in the developing world. In Chapter 4, The Productive Uncertainty of Bioethics, Asian researchers draw attention to the inadequacies of bioethical regimes themselves. They argue that “informed consent” makes little sense when tribal chiefs mediate blood sampling in the field. The “ethical” denial of material compensation to “voluntary” but poor donors seems unjustifiable. Another caution is that ethical “best practices” alone do not ensure good science. Reputable researchers, rigorous regulations, and cross-cultural skills, all elements of a biomedical platform, are necessary. Chapter 5, Virtue and the Expatriate Scientists, probes the tensions between science virtue, careerist moves, and civic virtue.

People interested in stem cell research can read Chapter 6. At Biopolis, there are star PIs such as Alan Coleman of “Dolly-the-Sheep” fame. But Asian scientists have been at the forefront of developing induced pluripotent stem (iPS) cell technology. This is a high stakes field that fuels an intra-Asian race for new discoveries and national prestige.

Chapter 9 brings in BGI Genomics, China, the world’s largest sequencing agency, for a comparative look. The two science centers deploy ethnic-inflected DNA somewhat differently. At Biopolis researchers seek to globally circulate the English ethnic category “Chinese” as a placeless biomarker, but their counterparts at BGI Genomics study genetic variations within the national matrix of Han versus minorities. Groups such as Tibetans are considered gene pools from which therapies can be developed for the Han majority as they anticipate adjusting to a precarious environmental future. The Epilogue dubs the two Asian approaches “DNA bridge” and “Octopus’s garden,” and compares how they contribute to the transformation of the new life sciences.