27 July 2017

The “red revolution” of stem cell technologies in India

Prof. Bharadwaj’s research project examines issues at stake and how to better address them.

India witnesses a rise of “red biotechnologies” and moves to engineer a “Red Revolution” of healthcare based on human tissues and biogenetic substance. Such developments pose profound bioethical and political questions. An ERC project launched in 2013, Mapping the Red Revolution: The Emergence of Stem Cell Biotechnologies in India, analyses the interplay between state, citizens/consumers and emerging markets in human stem cell technologies. More details with Aditya Bharadwaj, Professor of Anthropology and Sociology at the Graduate Institute and project leader.

Why do you describe the emergence of stem cell biotechnologies in India as the “red revolution”?

The biotechnological landscape in India can be conceptually demarcated as green and red. The post-independence, state-supported rise of “green, agricultural biotechnologies” – heralding the fabled “Green Revolution” – is well documented. Less well understood is the recent rise of “red biotechnologies” and moves to engineer a “Red Revolution” of healthcare based on human tissues and biogenetic substance. The research invokes the notion of “Red Revolution” provocatively, cautioning that revolutionary breakthroughs are anything but benign watershed moments. The research’s overarching aim is to explore the “political anatomy” of contemporary science and therapeutic care by illustrating the contested nature of the promissory rhetoric surrounding the revolutionary potential of stem cell technologies. The project shows how the endemicity of politics in science and therapeutic care ultimately produces material conditions for “counter-revolutionary” ideas to emerge that depart from established scientific practices and dare to think outside the established scientific canon. It delves into a range of critical issues stalking the emergence and diffusion of stem cell research and therapies across India and how these relate to developments elsewhere in the world (most notably the Euro-American bio-scientific landscape).

What about the specific situation in India?

Red Revolution studies the emerging research/therapy interface in order to explicate the “high risk and high gain” production of stem cell biotechnologies in India. Through an in-depth multi-sited mapping of the stem cell terrain in the country, the project generates insightful accounts detailing:

  • arenas of stem cell research
  • local and global trajectories of therapeutic application and scientific collaborations
  • lines of public/private sector intersections, and
  • zones of ethical contestation

Concomitantly, the research creates an informed point of departure for assessing future implications for Indian science and biotechnology and the potential for partnership between European science and burgeoning regenerative biotechnology sectors in India. The rapid transformation of stem cell science in India provides for a historic opportunity to capture these developments and document a potentially revolutionary scientific invention in the making.

Can you specify the scientific and policy issues implicit in what you describe as the “unprecedented developments” in stem cell research and therapeutics?

Red Revolution is a conceptual and empirical incision into the rapidly globalising terrain of stem cell science and therapeutic care. The research’s main thrust is to show how, in the Indian context, a myriad of home-grown and global complexities intertwine to both facilitate and disrupt the “revolutionary” promise of stem cells. The research situates stem cells in a number of diverse locales, such as the political economy of health in India, biomedical politics within the public and private sectors in India and beyond, emerging governance frameworks to control these technologies transnationally, and the global mass media as a field for promoting and contesting stem cells. Taken together, these locales unravel the resurgent nature of Indian scientific polity within which a diverse group of stakeholders – ranging from Indian and Euro-American states and policy mavens to clinicians and local and global patients – compete, contest, and connect to appropriate stem cell technologies for political and economic as well as reputational and therapeutic gain.

What is at stake for regulating stem cell research at the global and national levels?

The local, Indian, and global – most notably Euro-American – science policy prescriptions in the arena of stem cell research have rapidly cohered around the notion of robust regulation and standardised ethical oversight. The research endeavours to inject a cautionary note in the face of two popular and explicit suggestions that see vigorous governance of stem cells based on common acceptable principles and instruments as enabling (1) good scientific practice and transnational partnerships and (2) the standardisation and globalisation of ethical concerns. The research suggests that one of these aims, international alliances boosting good scientific practice, is often unachievable given the woeful lack of a level playing field; the other, the regularisation of ethical concerns, is undesirable. This is because in order to better understand science policy and regulation we also need to appreciate how power structures set definite limits to individual and collective negotiating capacities. The resulting manoeuvring produces seemingly new norms, but these reassert the hegemonic view that either seeks to co-opt the emerging new in its own image or reject it altogether, thus stifling the true revolutionary potential of an innovative science in the making.

What kind of data do you collect and what is your methodological approach?

The research is a robust engagement with multi-sited ethnographic practice. It follows the metaphoric traces of Red Revolution through a host of sites, locales and terrains to produce a detailed ethnographic account of the stem cell landscape in India. It links:

  • state-sponsored investments in stem cell science
  • developments in the private sector
  • ongoing regulatory and ethical debates in India and beyond
  • trajectories of local and global patients and their pathways to experimental therapies
  • status of clinical trials currently under development
  • established or nascent links with global research initiatives in the public and private sectors
  • intergovernmental and inter-institutional links between India and the rest of world

These foci have created ethnographically detailed accounts grounded in theoretical development and analytical charting of empirical spaces, boundaries, and flows to reveal

  • zones of knowledge concentration
  • arenas of inter/intrastate interventions
  • lines of economic calculation, and
  • trajectories of (global) “therapeutic footprint” circulation

The ethnographic fieldwork combines:

  • in-depth participant observation in private clinical sites, public/private research and auxiliary laboratories to understand in situ the everyday practices, experience, collaborations and how they digress from subsequent interview accounts
  • semi-structured and biographical interviews conducted with two sets of actors: (1) elite interviews with government officials and policymakers, heads of various state-sponsored biotechnology tasks forces, institutional heads and research teams based in publicly supported stem cell research facilities together with a snowball sample of private companies and clinics across India; (2) biographical interviews with individuals seeking stem cell therapeutic intervention from overseas and within India

Additionally, the research has coopted secondary data ranging from grey literature, previous research data, media accounts and legislative formulations and put these through content and narrative analysis. Overall, this approach has entailed continuous monitoring, data analysis and writing of the results in response to the dynamic thrust of the ethnography.

What are your major findings?

In a rapidly transforming world, both globally dispersed manoeuverings and the indigenous push to truncate a purportedly consensual view of stem cell science and therapeutic care are producing consequences for both Indian and Euro-American investments in stem cells. For example, the consensual scientific view that human embryonic stem cell infusion (hESC) is unsafe for therapeutic use is being challenged by an Indian clinic in this study where hESCs have become well established and producing dramatic results.A social science perspective is uniquely placed to examine and explain the current scientific and therapeutic developments in cutting-edge fields such as regenerative medicine. This perspective reveals how issues ranging from governance to actual bench-to-bedside translations of ongoing scientific research are maturing and inaugurating a new phase in postcolonial science in India. The project is setting the research agenda for future endeavours interested in mapping series of stakeholders and research sites that are key to collaborative work between Indian biotechnology innovation and European research and development expertise. In the present context these range from in-depth analysis of current developments in scientific work, clinical applications, patient perspectives and activism, both local and transnational, to “medical tourism” or medical migrations to India from Europe and beyond, emerging policy and governance protocols, as well as economic opportunities and commercial viability of medical biotechnology landscape in India.

Through a systematic and detailed explication of these intersecting and symbiotic developments the project is making a significant contribution to a deepening appreciation of issues at stake and how to better address them.

ERC project page >

Illustration: 3ds max Red Blood Cell Render, Desmond Talkington/CC BY-NC-SA 2.0.