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Stem Cell Research in India

April 8, 2002 at 12:00 AM EDT
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FRED DE SAM LAZARO: A year ago, Abishek Sharma was almost completely blind from a degenerative corneal disease found mostly in the tropics.

SPOKESMAN: Look down. Look up.

FRED DE SAM LAZARO: Surgeon Virender Sangwan decided the last hope was a stem cell transplant. Doctors at the L.V. Prasad Eye Institute cultured donor stem cells in the lab. These were then sutured on his damaged eyes. The stem cells used in this operation were from adult tissues, not the controversial ones from human embryos. Still, the pioneering experiment is one of the earliest indicators of the immense promise of stem cells. They are human physiology’s most basic starting point, from which grow all the body’s various tissues and organs.

SPOKESMAN: I would say you’re doing really well.

FRED DE SAM LAZARO: Three months later, Dr. Sangwan says, the grafted stem cells, taken from Sharma’s parents to lessen the chance of rejection, seem to be working.

FRED DE SAM LAZARO: Is he out of the woods, doctor?

DR. VIRENDER SANGWAN, L.V. Prasad Eye Institute: It’s not really out of the woods, but we have to be on our own watch, and he has to be on a treatment to prevent rejection.

ABISHEK SHARMA, Patient: Dr. Sangwan is really God for me. He make me able to see, and now I can see and I can read. I can ride my bike, and I have come back to my normal life.

FRED DE SAM LAZARO: About three dozen patients have undergone the procedure at the Prasad Institute in the south Indian city of Hyderabad. It’s one of a handful of Indian facilities doing stem cell research, operating in relative obscurity until developments last summer in the U.S.

PRESIDENT GEORGE W. BUSH: Good evening. I appreciate you giving me a few minutes of your time tonight so I can discuss with you a complex and difficult issue.

FRED DE SAM LAZARO: In August, President Bush announced a compromise plan on federal funding for embryonic stem cell research. Most scientists feel stem cells removed from embryos are more versatile than adult ones, but they are also more controversial.

DEMONSTRATORS SINGING: What a mighty God we serve.

FRED DE SAM LAZARO: That’s because embryos don’t survive the extraction. Opponents say destroying embryos– human life, in their view– is morally unacceptable.

PRESIDENT GEORGE W. BUSH: We should not, as a society, grow life to destroy it.

FRED DE SAM LAZARO: The president approved 64 stem cell lines, or colonies, worldwide. He said these were already in existence, the life-and-death decision already made. Ten of the cell lines are in India, seven at the Bombay-based Reliance Life Sciences, a private lab headed by Dr. Firuza Parikh.

DR. FIRUZA PARIKH, Reliance Life Sciences: Well, our immediate goals are for peer review, for establishing efficient collaboration, and for putting India on this global scenario of biotech, especially in this field of stem cell research.

FRED DE SAM LAZARO: The stem cell lines at Reliance are in an early phase, not fully cultured into self-sustaining colonies, a delicate, uncertain process. Parikh plans to develop additional lines, and says she does not need U.S. Government funds to do so. Her lab is owned by a multibillion-dollar Indian conglomerate.

DR. FIRUZA PARIKH: At this point in time, what we are looking at for the next at least three or four years, is pure research. We are not looking at numbers that are generated commercially. Of course in the long run, when this research fits into hospitals and goes on to the patients, we would certainly look at revenue.

FRED DE SAM LAZARO: The relatively recent arrival on the scene of embryonic stem cell research, particularly in commercial labs, has led to concern that there aren’t adequate regulations to prevent abuses. Could embryos be sold, for example, or eggs removed from a woman without her consent? Could embryos be cloned?

The government of India is only now drawing up guidelines for stem cell research, and laws have not always prevented abuses in a country where modern medicine and medieval poverty are neighbors. For example, many people are forced by desperate circumstances to sell their kidneys to a thriving transplant industry. Like organ sales, it is against the law to use sonograms for sex selection. Still, they are routinely used to detect female fetuses, which are then aborted in a society that favors boys.

DR. D. BALASUBRAMANYAM, L.V. Prasad Institute: I think we are learning… we are a nation that is only very slowly learning about the ethical impact of this. And often I think in a society where you really have centuries of tradition, which suddenly are confronted by newer discoveries and inventions… well, generally technology runs at supersonic speed; jurisprudence is far more languid in its progress. And if it’s also added on to traditions, deadening traditions, I think it’s going to be an uphill, but hopeful, fight.

FRED DE SAM LAZARO: Dr. D. Balasubramanyam, research director at the Prasad Institute, says there’s still time to develop enforceable guidelines governing stem cell work.

DR. D. BALASUBRAMANYAM: We are still yet to get onto a stage where the final product is so easily seen.

FRED DE SAM LAZARO: You don’t worry too much about this particular science because it’s too distant into the future?

DR. D. BALASUBRAMANYAM: That would be right, yes.

FRED DE SAM LAZARO: Some ethicists say India faces more immediate basic needs, like clean water, sanitation, and adequate nutrition. Others, however, say there is also a need for new technology like stem cell therapy, to tackle indigenous diseases as well as those found in developed societies, like cardiac disease or Parkinson’s. Dr. V.K. Vinayak is with the Department of Biotechnology, the chief regulatory agency.

DR. V.K. VINAYAK, Department of Biotechnology: We have lifestyle-related disorders like cardiac disease and diabetes. The age expectancy is going up. It’s more than 60 years. So I see a very great potential for the stem cells.

FRED DE SAM LAZARO: And you think that in India, it can be done in an ethically sound environment…as ethically sound as anywhere else?

DR. V.K. VINAYAK: I’m sure. Right, right, sure.

FRED DE SAM LAZARO: No human cloning?

DR. V.K. VINAYAK: No human cloning. Right, right.

FRED DE SAM LAZARO: No sale of embryos?

DR. V.K. VINAYAK: No sale of embryo, right.

FRED DE SAM LAZARO: Every research project has to get the government’s approval?

DR. V.K. VINAYAK: Right. That’s true.

FRED DE SAM LAZARO: Dr. Parikh insists the embryos she uses to create stem cell lines are voluntarily donated by former patients of a fertility clinic she runs. Donors also sign consent forms, as in the U.S., but unlike their American colleagues, Indian scientists are not caught in a societal debate over when life begins.

DR. FIRUZA PARIKH: As yet, stem cell work in India is apolitical. In India, abortion is an accepted method of family planning. It is a very important need for our country, so I think the moral issues, the ethical issues have already been addressed by us several years ago.

FRED DE SAM LAZARO: And, Dr. Parikh and other scientists add, it will be several more years before the many science issues and challenges are addressed. Stem cell therapy remains very much in its infancy– years, if not decades, away from clinical application.