Looking back at history, public health has always searched for effective ways of preventing disease in the population. With epidemics and endemics threatening to destabilise health, the need for innovation became a topic of importance. Not long after that, biotechnology, which is technology based on biology, became a breakthrough for public health. (Tulchinsky and Varavikova 2014)

Globally, biotechnological innovations go beyond scientific breakthroughs. It also addresses healthcare system challenges, improves treatment outcomes and is focussed on transforming the whole healthcare ecosystem (Anyanwu et al., 2024) Ways in which biotechnology has transformed and continues to improve public health includes reshaping traditional healthcare approaches into more modern, timely and reliable innovations. To further break it down, vaccines used to take longer to be developed, as compared to how timely it is by the use of biotechnology (Anyanwu et al., 2024). If we look at the COVID-19 as an example, the vaccines for this viral disease were developed through the use of mRNA in less than a year (Watson et al., 2022). This breakthrough was made possible by the use of biotechnology. Today, biotechnology is at the core of genetic engineering, a process that use lab-based technologies to alter the DNA make-up of an organism. Genetic engineering is one of the ways insulin is mass-produces, thus making it possible to have diabetes treatment readily available. Other ways in which biotechnology has been applied in public health includes molecular diagnostics techniques, such as the polymerase chain reaction (PCR) (a method used to test COVID-19 and other bacterial, mycobacterial and protozoal infections) and next-generation sequencing (NGS), personalised medicine based on individual genetic profiles, antimicrobial resistance to combat antibiotic-resistant bacterial infections, and last but not least, nutritional enhancements whereby crops are genetically modified to have high levels of essential nutrients
(Anyanwu et al., 2024).

Although there have been many positive uses of biotechnology, there are also challenges, one of which is the ethical concerns of biotechnology. Ethics look at the possible harms that can occur due to biotechnology, and one of the biggest concerns are in genetic engineering and gene editing technologies (Ahmad et al., 2015). The important bioethics principles that should be prioritized in biotechnology are autonomy, whereby an individual’s right to make their own decisions is recognized, non-maleficence, a principles that states to not cause intentional and negligent harm, beneficence, which means choosing what is good over what’s harmful, and justice, which states that there should be a fair distribution of the benefits and costs of rendered services across affected communities (Trump et al., 2023). This highlights a need to have biotechnology policies and governing frameworks.

In closing, it is clear that the use of biotechnology is one of the catalysts of public health as we know it today. With the rise of chronic illnesses and autoimmune diseases, biotechnology can be used to lower the burden of these diseases. Although there have been positive breakthroughs in public health through the use of biotech, it remains imperative to ensure that ethical principles are form part of the processes involved.

 Written by: Carol Netavhani

References:

Ahmad, H.M., Rashid, M., Iqbal, M.S., Azeem, F. and Ali, M.A. (2015). Ethical Issues of Biotechnology, Possible Risks and Their Management. ResearchGate, [online] 5(11), pp.49–54. Available at: https://www.researchgate.net/publication/280094592.

Anyanwu, C., Olawumi, J., Odilibe, P., None Opeoluwa Akomolafe, None Chinyere Onwumere and Osareme, J. (2024). The role of biotechnology in healthcare: A review of global trends. World Journal Of Advanced Research and Reviews, 21(1), pp.2740–2752. doi:https://doi.org/10.30574/wjarr.2024.21.1.0382.

Edemekong, P.F. and Tenny, S. (2022). Public Health. In: Nih.gov. [online] StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470250/.

Trump, B., Cummings, C., Klasa, K., Galaitsi, S. and Linkov, I. (2023). Governing biotechnology to provide safety and security and address ethical, legal, and social implications. Frontiers in Genetics, 13. doi:https://doi.org/10.3389/fgene.2022.1052371.

Tulchinsky, T.H. and Varavikova, E.A. (2014). A History of Public Health. In: The New Public Health. [online] pp.1–42. doi:https://doi.org/10.1016/b978-0-12-415766-8.00001-x.

Watson, O.J., Barnsley, G., Toor, J., Hogan, A.B., Winskill, P. and Ghani, A.C. (2022). Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. The Lancet Infectious Diseases, [online] 22(9), pp.1293–1302. doi:https://doi.org/10.1016/s1473-3099(22)00320-6.

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In 2007-2008 there was a sudden surge in food prices which has raised the issue of food security by the global food system. The abrupt spike was a result of the population growth, increased demand from the current population and climatic change, causing a reduction in food production and disruption of the supply chains. Therefore, there was an innate need to find out alternative solutions that would increase the productivity of agriculture (i.e., the quantity of food) and improve the nutritional qualities of food crops. Agricultural biotechnology has been considered an environmentally sustainable technology that would benefit the poor on a larger scale, improve food security, and gain agricultural profits in the developing countries. With such technology, one can create a crop that was herbicide tolerant, bacterial, fungal, and viral resistant, insect and pest resistant, and abiotic stress tolerant. These potential benefits were seen as a moral imperative to advance plant molecular approaches.

Yet, agricultural biotechnology has been a source of social and environmental conflict for decades, with existing governance institutions relying on traditional processes of scientific risk assessment having failed to address the sources of the persistent and deeply polarised conflict. This included concerns relating to the concentration of ownership and power in agri-food systems, clashing visions of desirable futures, and limited trust in regulatory systems and available science. Finding new ways to approach biotechnology governance that can adequately account for the issues generating this conflict was urgently required as the field was rapidly expanding through tools for genome editing, synthetic biology, and the digitalisation of biological information. In an attempt to better address the sources of conflict, an increasing number of countries have aimed to incorporate socio-economic and ethical considerations in their appraisal of new biotechnologies.

The importance of these considerations was also gaining traction at regional and international levels. For example, the European Directive 2015/412 allows member states to restrict the cultivation of GM-crops based on ‘non-scientific’ concerns, and the Cartagena Protocol on Biosafety has developed a framework for conceptual clarity on socio-economic considerations. While in South Africa GM-crops were regulated by the Genetically Modified Organism Act (Act 15 of 1997), Animal Health Act (Act 7 of 2002), Hazardous Substance Act 15 of 1973, Health Act 61 of 2003, and Biodiversity Act 10 of 2004,  to mention a few. The regulatory framework for biosafety and biosecurity for GM-crop has sparked debated in how GM-Crops are regulated, its implication to research, innovation, development, and as well as import and export matters.

As a result,  the Academy of Science of South Africa (ASSAf) compiled a report titled “The State of Biosafety and Biosecurity of South Africa” in 2015 to identify and come up with solutions in addressing some of the gaps in the regulation of GM-Crops and more, but more specific to issues relating to biosafety and biosecurity. Thus the concepts and practices of biosafety and biosecurity relate directly to the activities and conduct of life scientists and intend to safeguard against exposure to, or the deliberate or inadvertent development or release of, living organisms and/or biological material that may harm humans and/or the environment. It was understood that, biosafety and biosecurity have a common ( general goal), that being,  protecting people and the environment against hazardous living organisms and biological materials, however they mitigate different risks. Biosafety, or more specifically laboratory biosafety, was a fairly well-established concept that refers to the containment principles, technologies, and practices that were implemented to prevent unintentional exposure to (potentially) hazardous biological material, e.g. pathogens and toxins, and/ or their accidental release. More recently the term has also become synonymous with GMOs – specifically referring to the food or feed and environmental safety of these organisms. In general, biosecurity refers to the management systems that was designed to protect society and the environment against potentially harmful organisms and biological materials, but it too has divergent meanings depending on the context in which it may be used.

Since, the concept behind GM-crops has always sounded ‘unnatural’ to the public, due to the belief that human intervention of using different technologies for the insertion of desirable traits added a synthetic and unnatural value to the crop. Conversely, genetic modification of crops does not differ much from conventional breeding that has experienced certain difficulties and limitations, except that the molecular approach was precise, reliable, faster and less expensive. One of the GM-plant breeding programs which has generated the above misconception was the introduction of genetic material from a non-plant species, for instance, when Bacillus thuringiensis (Bt) bacterial insect of a toxin gene sequences were introduced in crops to create transgenic crops that were resistant to pests or the integration of the Arctic flounder antifreeze genetic material into strawberries to extend their growing season. Another aspect of controversy regarding the unnaturalness of GM techniques was the issue of cross pollination between nonGM-crops and GM-crops. The belief was considered a myth since horizontal gene transfer happens normally in nature, but on a longer time scale, whereas genetic modification occurs abruptly. Therefore, if such a sudden release happened into the environment, there might not be enough time for the biological and ecological systems to get adapted with the plant genetic integration.

In conclusion, it was crucial to incorporate a holist approach when dealing with or in the governance of GM-crop, such as the inclusion of socio-economic and ethical consideration and not make it a legal exercise only.  In a nut shell the various concern with GM-crops were: A. Genetic erosion and biodiversity loss, Potential introgression, Contamination, Resistance emergence, Harm to other organisms, Resistance to antibiotic; B. Human health issue -such as toxicity potential and allergies, and damage to food quality and nutrition; C. Socio economic issues- such as Religious belief, Difference in view across areas/ cultures, Labelling and autonomy, and Power in balance and vulnerability. Therefore, it is obvious why a holistic approach in the governance of GM-crop is necessary in order to avoid irreversible damage to the ecosystem, thus,  we must critically analyse, monitor, and evaluate not only the complexity of the biological issues posed by GM-crops. But consider all issues that GM-crops may pose in the present time and in the future, respectively.  

 Written by: Fikile M Mnisi

References:

Abushall, L.T., Salama, M., Essa, M.M. and  Qironfleh, M.W. 2021. “Agricultural biotechnology: Revealing insights about ethical concerns”.  J Biosci. (2021)46:81. DOI:10.1007/s12038-021-00203-0.

Academy of Science of South Africa. 2015. “The Statement of Biosafety and Biosecurity in South Africa”.  May 2015. www.assaf.co.za. 

Winston, F., Preston, C., Binimelis, R., Herrero, A, Hartley, S., Wynberg, R. and Wynne, B. 2017. “Addressing Socio-Economic and Ethical Considerations in Biotechnology Governance: The Potential of a New Politics of Care” . Food ethics. (2017) 1:193–199. DOI:10.1007/s41055-017-0014-4.

Tim, B., 2013. “ Ethical Concerns in Plant Biotechnological Research” . Asian Horizon. Vol 7(4): 647-655.

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Many people find that the aims and themes of traditional medicines stand in a precarious position as we see the imminent rise of technology-based medicines/therapies in the wake of biotechnology. The biggest reason for this may be in the way traditional medicines and health practices, tend to focus on more than just the physical components of sickness and well-being and this does not always communicate well with the new technologies and practices making their way into the healthcare space of South Africa. For instance, someone who may be ailed by a twitching eye, may be diagnosed on the physical aspects of their eye, which is then understood considering pathology around visual/ocular components of the face. Then the additional step of relating this to the psycho-social-spiritual status of the person with the twitching eye. The purpose of this blog entry is to investigate the developing space of biomedicine & biotechnology and how this new paradigm in medicine works with traditional medicines in South Africa.     

To begin, in Southern Africa traditional medicine and health practices are widely used by the population where there are “between 200,000―300,000 traditional healers in South Africa; with the healer-patient ratio of 1:500–1200, as compared to the medical doctor-patient ratio of 1:40000” (Mothibe & Sibanda 2019). This distribution/ratio is one which may have increased or decreased since the census data had been collected but nonetheless emphasises the reliance on traditional medicine even with the availability of Western medicines and practices.

More so, unlike Western medicines that may have emphasis on the physical/material aspects of healthcare along with pathology, traditional medicine is fundamentally different in that it has two branches. The first branch consists of ‘medication therapies, which involve healing by knowledge of herbs and nature’ (Makinde, 1988: 88). The second branch is known as ‘non-medication therapies, which use manual, physical, mental and spiritual methods,’ or even a combination of these to treat the ailed (International Bioethics Committee, 2013: 3). Traditional medicine aims at treating ailments by considering more than just the physical manifestations of the ailments, but also consider psychological, social and spiritual manifestations of the ailments too.

In South Africa, biotechnology is an emerging field with a lot of research being conducted currently relating mostly to the methods and practices of western medicine. Nonetheless, there seems to be a space for traditional medicine to have a closer relationship with biotechnology since traditional medicine and biotechnology/biomedicine are both concerned with the biology and physical make up or organisms and how ailments can be addressed at this level. However, when one must consider the psychological, social and spiritual aspects of traditional medicine, there seems to be an incommensurability that builds between traditional medicine and biotechnology. And thus, the studies of traditional medicine and those of biotechnology diverge quite significantly and even how one becomes a practitioner and practices in each paradigm is really worlds apart. Nonetheless, there is both common ground and unfamiliarity for both that I will discuss below.

The traditional medicine route is not the same, having a fundamentally different structure and institutionalisation. Firstly, when one wishes to become a Sangoma (traditional healer in South Africa) the way in which they receive knowledge and are taught may be irrational or cryptic. “It is often kept secret, being mainly transmitted orally, as pointed out above. It can also combine natural and supernatural resources and be deemed to be acquired at birth or through a gift or special revelation to certain initiates” (International Bioethics Committee, 2013).

One who becomes a practitioner of traditional medicine is one who is already chosen by certain conditions and not necessarily someone who pursuits being a practitioner out of interest or wonder. One who wants to be a practitioner is then initiated by school of traditional medicine, which may or may not be registered under the Traditional Healer’s Council/Traditional Healers Organisation, and that may take months or years, depending on the individual. Once the initiation process is completed, the initiate has a ceremony done and is then granted the cloths/materials that are worn by accomplished practitioners, besides that there is very little to tell regarding the quality of their education or even the roadmap they took to completion. Many of the practitioners of traditional medicine are registered by the Traditional Healers Organisation, yet many more remain unregistered and undocumented, even with the sheer numbers they serve regularly. The presence of traditional healers in the HPCSA is something which is rather removed from the professional body and remains a bit of an anomaly when one must look at health policy in the country.

Biomedicine in this case presents a more scientific approach with rigorous testing, core principles, hypothesis and replicable results and traditional medicine in this case deals with a traditional, spiritual approach, based on tailored-individuated responses to ailments and non-standard tests, dosages and approaches. This means that there is a divergence in the way in which these practices are conducted and based on the view one takes, it is possible to value each for different reasons. Nonetheless, in the era of technology that we find ourselves, one sees that traditional medicine has less and less ground to integrate biomedicine let alone biotechnologies. Moreso, when one looks at the regulatory issues around traditional medicine, there seems to be a big issue of inclusion into the HPCSA.

Traditional medicine practitioners have, for the longest time, enjoyed the perks of being undocumented and non-standard because of how individualised (non-objective) the approaches of many practitioners has been. This freedom has allowed them to experiment and find new ways/old ways in nature without the red tape that professional bodies come with. Nonetheless, this means that the regulation of traditional medicine varies widely, with some practices not subject to the same stringent standards as biomedicine. This can lead to concerns about safety, quality, and efficacy. Many traditional medicine practices have not undergone the extensive clinical trials that biomedical treatments require. This makes it difficult to scientifically validate their efficacy and safety. The quality of traditional medicine products can vary due to differences in preparation methods, ingredients, and dosages. This variability poses a challenge for scientific validation. Traditional remedies often involve complex mixtures of ingredients, making it difficult to isolate the active compounds and understand their mechanisms of action.

From the looks of things, the relationship between biotechnology/biomedicine and traditional medicine is one which is still maturing and may become something fruitful for all in the future. However, as things stands, there is a lot of work to be done to bring them closer to one another and this begins with understanding their individual values. At this stage, nonetheless, traditional medicine has no place in biotechnology and thus cannot be considered biomedicine as of yet, but they may yet change in the future.

 Written by: Tony A  Shabangu

References:

International Bioethics Committee. 2013. ‘Report of the IBC on traditional medicine systems and their ethical implications.’ International Bioethics Committee. Website: https://unesdoc.unesco.org /ark:/48223/pf0000217457, (accessed 19 January 2019).
Makinde, A. (1988). African Philosophy, Culture, and Traditional Medicine. Center for International Studies Ohio University.
Mothibe, M. E. & Sibanda, M. (2019). African Traditional Medicine: South African Perspective. Sefako Makgatho Health Sciences University, Pretoria, South Africa.

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There are methods that can be used to test for male infertility known as the semen analysis. Thus,  the semen analysis (SA) represents the most basic evaluation of male infertility. The evaluation of semen parameters is currently based on the standards defined in the laboratory manual for the examination and processing of human semen created by the World Health Organization (WHO).  The WHO laboratory manual for the examination and processing of human semen 1st Edition was published in 1980 to the current 6th Edition, there have been significant advances with the incorporation of recent developments in semen examination techniques, methods of sperm preparation and cryopreservation, and new technologies to improve quality control and assurance (Boitrelle et al., 2021). Recent scientific advances in the understanding of sperm DNA fragmentation (SDF), seminal oxidative stress (OS), and reactive oxygen species (ROS) testing have shed additional light on the prognosis of reproductive outcomes in terms of natural conception and assisted reproductive technology (ART). Given the growing awareness that chromosomal abnormalities and gene mutations often underlie a diverse spectrum of male infertility, genetic and genomic testing are gaining attention in this new 6th Edition (see chapter “Extended examinations”). In the chapter “Advanced examinations”, some other tests used in research are described, such as sperm acrosome reaction, functional analysis of transmembrane ion flux and transport in sperm, and methods for the evaluation of chromatin condensation (Boitrelle et al., 2021). Even with these new advances in semen analysis the problem with male infertility remains and exacerbate societal issues.

One of the social issues concerning male infertility is its connection to Intimate Partner Violence (IPV) particularly in low-income and middle-income countries. Intimate partner violence IPV is the most common form of violence against women, defined as any form of violence by a current or former male intimate partner within a union, and can present as physical, psychological or emotional, or sexual violence, or as economic coercion and controlling behaviours (Wang et al., 2022). I can only imagine how important this matter is especially in patriotic sociaties and/ or where (toxic) masculinity is high and men think that only the women are responsible for sexual and reproductive health. For example, where men believe that it is only the women that can be infertile and never the men – as it may be so due to some cultural ideas in South Africa and possible Africa. The most recent estimate from WHO indicates that, worldwide, 27% of ever-married or ever-partnered women aged 15–49 years have experienced physical or sexual violence (or both) committed by intimate partners at least once in their lifetime, whereas the prevalence over a 12-month period was 13%. This poses a problem, seeing that De Jonge et al., (2023) mentions that literature database contains many publications demonstrating that in comparison with women, men are characteristically less likely to seek routine healthcare unless intervention for an acute medical issue presents. The reason for this is that men tend to associate seeking medical care with weakness and/ or a threat to their masculinity and/ or  because an underlying health issue may be revealed. So, to fill that void, women make up to 80% of health care decisions for their family and the male partner. They further explain that, in the field of Medically Assisted Reproduction (MAR)  it is frequently said that women provide the primary motivation for an infertility investigation including for that of her male partner. However, it is difficult to find any specific evidence in literature data to confirm or refute this assertion, and thus must be considered as anecdotal. Inference of men taking a ‘passenger’ role in the investigation of infertility for the couple comes from one study showing that both men and women felt that fertility is a woman’s issue (De Jonge et al., 2023). This is obviously a problem, because as research indicates many of the sexual and reproductive issues are not always or only the women’s problem. Therefore, one can notice how it is important to have a more male inclusive sexual and reproductive health.  

As the saying goes: prevention is better than cure! Therefore, how do we prevent or rather help lessen male infertility. The more obvious way is to have awareness campaigns around this matter.  To develop community (public) education and from as early as male puberty starts so that no one is left behind.  Starting early can help lessen the stigma that also comes with male infertility and decrease the burden on IPV. The focus on education and public awareness on women fertility has not particularly solved the injustices that are linked to sexual and reproductive health. Hence, we need to also think and strategise how we can have these programs aligned or be complementary to those existing men’s health and/ or Gender Based Violence (GBV) awareness campaigns program. For example, non-profit organisation such as the men’s forum or men imbizo could be used for dialogues on this matter from a community based model. In addition, promotion of healthier lifestyle is imperative since there are many behavioural and environmental factors which can have a direct or indirect impact on how a man’s body ‘produces’ semen. Therefore, one can adopt the following healthy lifestyle habits:

• Avoid drug and tobacco use and drinking too much alcohol, which may contribute to male infertility.
• Avoid high temperatures found in hot tubs and hot baths, as they can temporarily affect sperm production and motility.
• Avoid exposure to industrial or environmental toxins, which can affect sperm production.
• Limit medications that may impact fertility, both prescription and non-prescription drugs.
• Exercise moderately. Regular exercise may improve sperm quality and increase the chances for achieving a pregnancy. However, avoid excessive exercise.
• Avoid wearing very tight underwear for prolonged periods of time
• Cut back on caffeine consumption. (Two cups of coffee a day is fine)
• Avoid steroids used in body building. These compounds disrupt hormone production, and can actually stop your body producing sperm.
• Eat more antioxidant-rich foods like fresh fruit and vegetables. Not only can this assist in conditions like high levels of ROS (Reactive Oxygen Species) in semen, but will improve your overall health too! (Winjland Fertility 2024).

In conclusion, male infertility is a serious matter and can affect the individual and couple in question. Not addressing this matter is an injustice. An injustice that needs to be ratified and addressed. Therefore, we can start rectifying these injustices by developing policies that are inclusive of male sexual and reproductive health, then develop some education and advocacy campaigns to raise awareness on this matter, and promote healthy lifestyle amongst men. This will not only ensure human rights, i.e., rights to health, but will also aid in helping to address some of the short comings that may be found in science and technology for male sexual and reproduction in terms of  analysis, health promotion, diagnostic tools, affordability, accessibility, and specialist in this research field.  

 Written by: Fikile M Mnisi

References:

Boitrelle, F., Shah, R., Saleh, R., Henkel, R., Kandil, H., Chung, E., Vogiatzi, P., Zini, A., Arafa, M., & Agarwal, A. 2021. “The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis”.  Life. Vol. 11 (1368): p. 1- 13.

De Jonge, C. J., &  Gellatly, S.A., Vazquez-Levin, M. H., Barratt, C.L.R. 2023. “Male Attitudes towards Infertility: Results from a Global Questionnaire”. World J Mens Health. Vol 41(1): p. 204-214.

Wang., Y, Fu., Y, Ghazi, P., Gao, Q., Tian, T., Kong, F., Zhan, S., Liu, C., Bloom, D.E., & Qiao, J. 2022. “Prevalence of intimate partner violence against infertile women in low-income and middle-income countries: a systematic review and meta-analysis”. Lancet Glob Health. Vol. 10 (8): p 20-30.

Wijnland Fertility.  2024. “What is Male Infertility”. Accessed: 8 June 2024.  Accessed from: https://www.wijnlandfertility.co.za/male-infertility/#:~:text=Male%20factor%20infertility%20makes%20up,African%20couples%20struggling%20to%20conceive.

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In a South African context, this innovation can help address health inequality particularly disparities in screening and treatment. However, this can only be achieved if it is applied in public sector. Public sector serves 71% of the South African population and is funded by the State. Public health care facilities in South Africa often grapple with constrained resources, significantly impacting access to quality care for many citizens. These limitations manifest as shortages in human resources, essential medications, and critical equipment. Additionally, concerns around waste management and infrastructure maintenance further exacerbate the situation.

This lack of resources disproportionately affects individuals from lower socioeconomic backgrounds who rely on these facilities due to limited financial means to access health care from private facilities. This creates a situation of limited distributive justice, where access to essential health care services is not equitably distributed amongst the population. This highlights the urgency for interventions that address these disparities and ensure that vulnerable populations have access to the quality care they deserve. The potential of AI in breast cancer imaging to improve patient outcomes through earlier diagnoses, personalised treatment plans, and ultimately, a reduction in breast cancer mortality rates is significant.

However, the technology’s current development and prevalence within private organisations raises concerns about affordability and equitable access, particularly in resource-constrained settings like South Africa. The cost of procuring such technology will most likely be significant, which will be a barrier for State funded facilities. 

While private facilities catering to a limited portion of the population, approximately 29%, may have the financial means to acquire this technology, a utilitarian perspective compels us to consider the potential for maximising overall benefit. In this case, the ethical principle of utilitarianism argues for prioritising broader accessibility to ensure the technology serves the greater good of the South African population. While private facilities may possess the financial means to acquire this technology, its true potential for good lies in serving the broader population. The ability to prevent deaths and improve countless lives through early detection far outweighs the benefits of a technology confined to the privileged few.

Should the technology be introduced in a South African context, and hopefully it will be, the conversation should be geared towards using this technology in the public sector to maximise its use. The technology promises accurate breast cancer image analysis with limited human assistance. This can be used in rural areas where there are no radiologists on site or to assist facilities burdened with large number caseloads and limited health care workers on site. The deployment of AI technology in public health facilities transcends mere economic considerations. It embodies the core principle of health care as a human right, enshrined in the South African constitution. Limiting access solely to those with financial means creates a stark ethical challenge, exacerbating existing health care disparities within a country already grappling with significant socioeconomic inequalities. By ensuring equitable access, we can harness the power of AI to create a more just and effective breast cancer screening system for all South Africans.

Furthermore, this necessitates exploring strategies to make AI-powered screening financially viable within the public health care system. This could involve public-private partnerships, exploring cost-effective implementation models, and potentially leveraging international collaborations to make this life-saving technology more readily available to all. While the potential of AI for breast cancer screening is undeniable, we must acknowledge the ethical challenges it presents.

One of the most concerning issues is bias. AI algorithms are trained on vast datasets, and if these datasets lack sufficient representation of African populations, it can lead to biased decision-making and poor clinical outcomes.  This has significant implications for accuracy. AI trained primarily on European or Western data may struggle to interpret mammograms or ultrasounds from individuals with different skin tones or breast tissue densities. Inaccurate readings could lead to missed diagnoses or unnecessary biopsies, posing a real health risk.

It is paramount to advocate for responsible development and implementation of AI in health care. This requires inclusive dataset to ensure the technology can be applicable to all individuals across the globe.

 Written by: Nomfundo Maseko

References:

Dlamini, Z., Molefi, T., Khanyile, R., Mkhabele, M., Damane, B., Kokoua, A., Bida, M., Saini, K.S., Chauke-Malinga, N., Luvhengo, T.E. and Hull, R., 2023. From Incidence to Intervention: A Comprehensive Look at Breast Cancer in South Africa. Oncology and Therapy, pp.1-11.

Image: https://www.biomedcentral.com/collections/spot-breast-cancer

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Conversely, this is sometimes not the case as seen in many instances such as with the: “Age-and education-related effects on cognitive functioning in Colored South African women” from Stellenbosch University’s “Intelligence & Slaves Exports from Africa” a collaboration between the University of Cape Town (UCT) & University of Kinshasa; and “Why are black South African students less likely to consider studying biological science” from UCT.

What could be considered unethical decision-making in research studies is also noted with international collaborations. For example, the collaboration between the Universities of Oxford and UCT for a drug trial on a TB vaccine using infants in SA as participants, where researchers of this study used a technique of ‘picking and mixing’, basically misrepresenting their research findings to report the desired result that will assist them in gaining access to desired research subjects or participants.

The above examples are only based on a few research studies; there are or may be many more if we were to intentionally look closely at research studies. Howbeit, there is not much work reported concerning the use (distributive justice) of innovations to be able to link them with unethical decisions (specifically) and how such decisions may have affected socio-economic values. Therefore, one can assume that unethical decisions are made in terms of how innovations from bedside to the market are made. Clearly, this may require research studies that are intentional in order to evaluate and indicate this. But in the absence of such, it is difficult to really say.

In addition, when looking at the level of reported corruption and cases of corruption in South Africa, Africa, one can only wonder how such corruption or corrupt acts have affected and/or influenced decision-making in fields such as science and innovation. Particularly if we were to look at the above-mentioned cases, what could be revealed if we were to weigh and/or compare the researchers or decision-makers actions to corruption? What impact (social and socio-economic) do we think these cases have on society at large and their contribution to public mistrust of science, apart from other societal and economic issues? Maybe once we start understanding and taking ethical decision-making very seriously and the impact it has on values (economic values being one of those values), we will begin to give this a priority in science and innovation.

Part of corruption is caused by the actions of a moral agent who acts unethically; this action is the making of a decision. Which is the same as what happened in those research cases and what could happen in research, development, and innovation. But why then don’t we see political parties and civil rights organisations fighting against such cases as they do with corruption? Is it because they don’t see unethical decision-making as corruption? Or because they don’t understand the impact it has—not only the moral impact but also the economic and research impacts? Perhaps this is because in many of the cases, they tend to fight for or highlight these unethical decisions, which are termed corruption and mainly reported in monetary values, which is an important factor that makes individuals and organisations see how much is being (mis)spent unlike in research and innovation. This could mean that if people were able to place a monetary value on unethical research and innovation, they would give this a priority as they do with other corruption cases. Therefore, we may need to change how we report unethical cases by indicating the monetary losses and the impact they have on socio-economic justice for us to take decision-making in research and development seriously. 

So how do we do that? We do that by attaching monetary values to our (un)ethical decisions. If we can do this, we will take ethical decision-making seriously, especially in science and innovation. The effect and impact that corruption has on society as well as the economy are the same as with unethical research studies and the unjust distributions and allocations of innovations and technologies from research. Not only that, but they also have other socio-economic effects for future research studies, caused by the buildup of mistrust that may result from these types of research studies. Therefore, it is imperative that ethical decision-making be considered a tool that can play a role in increasing and improving the economy and result in better socio-economic justice, equity, and equality.

Since unethical decision-making is not only a violation of human rights and dignity, but it also has a huge impact on socio-economic developments. History has shown us how research where participants are misled, mistreated, or their rights are violated has impacted their trust in science as well as their voluntary participation in research, even if it’s for their own gain. The same goes for innovation, but maybe not as evident as with research studies since many of the decisions made are based on policies and/or legislation. I am of the opinion that, the COVID-19 vaccines have shown us the importance of having an ethical decision-making framework regarding science and innovations. Since we now have cases of mistrust in new health technologies with all the misinformation shown through the newspapers, individual cases, and social media reports on these vaccines. Albeit, I am only assuming this based on the results or impact of what transpired during the COVID-19 vaccination rollout: that an ethical decision-making process for COVID-19 vaccines was not applied, or if it was, the consequences were not significant enough to indicate ethical decision-making considerations. However, decisions are made by an individual(s), which may affect the socioeconomic value to some degree and affect equality and social justice, irrespectively.

Therefore, how do we measure the link between ethical decision-making and economic value in science and innovation? How do we determine the impact that it has on society? Is it even necessary to measure the economic value of decision-making? How will the determined economic value influence ethical decision-making tools and/or frameworks? What values or ethical principles should we use to inform our decision-making? What economic theories can be used as well?

These and many more questions are needed to understand how (un)ethical decision-making can affect socio-economic justice, equity, and equality. Certainly, one thing is for sure: we need to start applying ethical decision-making to research and innovations for a better society and economic gain. But to also distinguish the monetary value of (un)ethical decision-making in science and innovation. 

 Written by: Fikile M. Mnisi, Ph.D

The post Considering Ethical Decision Making in Research and Innovation for Socio-Economic Justice and Equality first appeared on KHACA.

Within the dynamic landscape of biotechnology, the ethical implications of gene editing the human genome, have sparked intense debates and discussions. As we grapple with the power to manipulate the very building blocks of life, such as gene editing, it becomes crucial to consider ethical frameworks that prioritize the well-being of both individuals and the community. In this blog post, I will explore the application of Ubuntu, a Southern African philosophy emphasizing, harmony, interconnectedness and communal values, to address the controversial issues surrounding gene editing.

“You know when ubuntu is there, and it is obvious when it is absent. It has to do with what it means to be truly human, to know that you are bound up with others in the bundle of life.”

–          Desmond Tutu

1. Community Deliberation: Fostering Inclusive Decision-Making

As an ethic Ubuntu is commonly associated with the maxim “umuntu ngu muntu nga bantu” which roughly translates as I am because we are. Ubuntu encourages collective decision-making, urging us to seek consensus through inclusive dialogue. In the realm of biotech ethics, this has implications for a diverse group of stakeholders, including scientists, ethicists, community representatives, and affected individuals, in the decision-making process. When it comes to engagement and involvement, Ubuntu recognises all the stakeholders and their consensus is a vital element when it comes to enabling harmonious decision making and deliberation. By engaging in transparent and inclusive deliberations, we can ensure that the voices of the community shape the ethical landscape of gene editing technologies.

2. Balancing Individual and Community Interests: A Harmonious Approach

When it comes to the specific approach, Ubuntu calls for a harmonious balance between individual and community interests. In addressing gene editing controversies, this principle invites us to consider the potential benefits and risks at both the individual and societal levels. It also invites us to engage in a way that is charitable, engaging with a variety of voices and traditions to rather bridge the gap created by our differences, or to use our differences as means to generate new ways of thinking about some of these vital issues. Striking a balance ensures that advancements in biotechnology contribute positively to the well-being of individuals while safeguarding the broader community’s interests.

3. Cultural Sensitivity: Embracing Diversity in Ethics

With everyone being recognised as a human being for their humanity, regardless of differences, Ubuntu places a high value on cultural diversity. Applying this principle to biotech ethics means recognising and respecting diverse cultural perspectives on genetic modifications. This means the entire spectrum, from traditional to progressive models, are equally considered regarding the ethics of gene modification. Moreso, even the spiritual dimensions are considered in this case even if they may not have as much evidence backing them. Different communities may have distinct views on what is ethically acceptable, and incorporating these perspectives fosters a more inclusive and culturally sensitive approach to decision-making.   

4. Shared Responsibility for Ethics: Engaging the Whole Community

Because consensus is a condition for Ubuntu, this philosophy also underscores shared responsibility. The members are equally valued for their contributions, roles and responsibility and everyone has value in this context. In the context of biotech ethics, this implies that ethical decision-making is not the sole responsibility of scientists or policymakers. Instead, it involves the active engagement of the broader community. Decisions about gene editing should be collaborative, with input from those who will be directly affected, ensuring a more democratic and collectively responsible approach. Moreso, the onus of policymaking falls on all the stakeholders and the maintenance of any policy equally requires all the stakeholders too.

5. Sustainable and Responsible Innovation: Looking Beyond the Horizon

Ubuntu encourages an approach to biotech innovation that is inclusive, sustainable and responsible. Considering the long-term consequences of genetic modifications on both individuals and the community aligns with Ubuntu’s principles of interconnectedness and shared well-being. This approach ensures that advancements in biotechnology contribute positively to the present and future health of our communities. Moreso, the innovations of biotechnology ought to have sight of the various distinctions of various communities, looking at ways in which their traditions and identity are not overlooked and erased by these innovations. Instead, biotechnologies rather look for ways in which innovations, such as gene editing, are expressed in ways that give value to the identities and traditions of various communities.

“Genetic engineering is a result of science advancement, so I don’t think that in itself is bad. If used wisely, genetics can be beneficial, but they can be abused, too.”

–          Hideo Kojima

In conclusion, the Ubuntu philosophy offers valuable insights for navigating the ethical challenges posed by gene editing in humans. By embracing collective decision-making, balancing individual and community interests, respecting cultural diversity, fostering shared responsibility, and promoting sustainable innovation, we can build an ethical framework that aligns with the principles of Ubuntu and ensures the responsible development of biotechnologies for the benefit of all.

 Written by: Tony A. Shabangu, Ph.D

Written with the aid of ChatGPT 3.5.

The post Ubuntu and the Collective Ethics of Biotechnology: Navigating Gene Editing first appeared on KHACA.

Subsequently, I decided to use ChatGTP to look at the field of biotechnology and AI in South Africa, I did not expect to receive a lot of information concerning this topic from South Africa, because I am aware of the limitation in this area, which may be due to limited research and authorship in this field. Conversely, there was enough information mainly from organisations that are affiliated with the State.  This was an indication (at least to me) that there is something happening in this field and it is not all gloomy. Next is the blog article that was written when asking ChatGPT to write on ‘biotechnology and AI in South Africa’ is seen below, and please use your own discretion to see if it may be considered a professional blog as is on not, and whether it the information could be used for writing research publications.

“I think the biggest innovations of the 21st century will be at the intersection of Biotechnology and AI in South Africa (SA), biology and technology. A new era is beginning”

–          Steve Jobs

Biotechnology and AI (Artificial Intelligence) have been emerging fields with significant potential in South Africa. Let’s explore each of them individually:

1. Biotechnology: Biotechnology involves using living organisms, systems, or processes to develop or manufacture products or solve problems in various sectors, including healthcare, agriculture, and environmental sustainability. In South Africa, biotechnology has gained considerable attention and has been supported by government initiatives and research institutions. Here are some key aspects:

a. Healthcare: Biotechnology plays a vital role in the healthcare sector, contributing to the development of new drugs, diagnostics, and therapies. South African researchers and institutions have been involved in studying infectious diseases such as HIV/AIDS and tuberculosis, as well as genetic disorders. Biotechnology also has applications in personalized medicine, genomics, and regenerative medicine.

b. Agriculture: South Africa has a strong agricultural sector, and biotechnology has the potential to improve crop yields, develop disease-resistant plants, and enhance agricultural productivity. Genetically modified crops, such as insect-resistant maize and drought-tolerant crops, have been researched and cultivated in the country.

c. Conservation and Environment: Biotechnology is used to study and preserve biodiversity, protect endangered species, and manage ecosystems. South Africa’s rich biodiversity and unique ecosystems make it an important hub for bioprospecting and biopreservation initiatives.

2. Artificial Intelligence (AI): AI involves the development of computer systems capable of performing tasks that typically require human intelligence. In South Africa, AI has gained momentum and is being applied in various sectors, including:
3. Healthcare: AI has the potential to enhance medical diagnostics, optimize treatment plans, and improve patient outcomes. Applications include medical imaging analysis, predictive analytics, and personalized medicine. AI-based chatbots and telemedicine platforms also help expand access to healthcare services, particularly in remote areas.
4. Finance and Banking: AI is used in fraud detection, risk assessment, and algorithmic trading in the financial sector. It helps automate routine tasks, streamline operations, and provide personalized financial services to customers.
5. Smart Cities: AI technologies are being used to develop smart city solutions in South Africa. These include intelligent transportation systems, energy management, and urban planning. AI-based algorithms analyse data to optimize resource allocation, improve traffic flow, and enhance overall urban sustainability.
6. d. Education: AI has the potential to revolutionize education by enabling personalized learning experiences, adaptive assessments, and intelligent tutoring systems. South Africa is exploring AI-driven education technologies to improve access to quality education and address learning gaps.

The South African government, research institutions, and private companies are actively investing in biotechnology and AI to harness their potential and promote innovation in these fields. Initiatives such as research funding, collaborations, and incubators have been established to foster growth and development in biotechnology and AI sectors.

1. areas such as medical imaging analysis, disease prediction, and telemedicine. Studies and research papers published in journals like “South African Journal of Radiology” and “Healthcare Informatics Research” provide insights into AI applications in the healthcare sector.
2. AI in Finance: Financial institutions in South Africa have been exploring AI applications in areas such as fraud detection, risk assessment, and algorithmic trading. Reports from organizations like the South African Reserve Bank and industry publications like “BusinessTech” may provide insights into AI adoption in the finance sector.
3. AI for Smart Cities: Initiatives related to AI-driven smart city solutions in South Africa can be found in government publications, research articles, and reports from organizations like the South African Cities Network (SACN) and the South African Local Government Association (SALGA).

Please note that the references mentioned above are indicative and not exhaustive. Conducting further research using academic databases, scientific journals, and relevant South African government websites will provide you with more specific and detailed information on the biotechnology and AI landscape in South Africa.

“ChatGPT is incredibly limited, but good enough at some things to create a misleading impression of greatness.  it’s a mistake to be relying on it for anything important right now. it’s a preview of progress; we have lots of work to do on robustness and truthfulness.”

–          Sam Altman, CEO OpenAI.

In my opinion, ChatGPT may be sufficient enough to be used for writing a blog article and for some research purposes, however, not sufficient to be used alone even as a blog article. The above information from the ChatGPT had some mistakes but not big mistakes that could not be changed or deleted. Moreover, the author must be able to verify that the information provided is true and based on sound scientific facts before using them for any scientific blog or papers or assays.  On the other hand, ChatGPT is very quick in giving the information and friendly to use as you can ask for information with references or without reference (which may be worrisome to think about for academic and publication purposes).  But, using ChatGPT is like getting bare information that must still be unpacked and analyse before being used. This makes one wonder about the value and integrity of the information from ChatGPT. What standard is used to verify this information? And even with this standard in place there could be more concerns that one will have to take into consideration.

 I confess that I do feel like using ChatGPT is cheating or maybe in a more direct sense plagiarism. Plagiarism is a serious concerns particular in academic and scientific research, and it has taken time for plagiarism to be effectively address within these fields. There are notable ethical concerns when it comes to using ChatGPT for research and publications but many could be the same as for other academic and scientific publications and purposes. However, the main ethical issues with ChatGPT may be; could it be enough to reference ChatGPT for journals? Recent scientific blogs from Nature indicate how ChatGPT’s publication may be dishonest or has published fake (scientific)  data. Is ChatGPT making our lives easier? Probably, but will referencing a ChatGPT be acceptable for journal publication and/ or academic work? That is yet to be discovered. Howbeit, I do foresee some ethical issues particularly those concerning scientific integrity when it comes to the publication space that we may need to unpack and address.  Maybe in the coming blogs.

 Written by: ChatGPT, Biotechnology and AI in South Africa , July 2023 & Fikile M. Mnisi, Ph.D

References:

Hetler, A. no date. “Definition ChatGPT”. TechTarget. Available from: https://www.techtarget.com

The post Using ChatGPT to Write a Blog or Scientific Article: Should We Be Concerned? first appeared on KHACA.

While biotechnology has immense potential, it is not without controversy. Ethical concerns surrounding gene editing, the use of GMOs, and data privacy issues in personalized medicine are critical aspects that society needs to navigate. We understand that one size doesn’t fit all. That’s why we offer training programs tailored to your specific goals, =meline, and learning styles. Our training materials are always up-to-date and reflect the latest industry trends and
best practices.

“The rewards for biotechnology are tremendous – to solve disease, eliminate poverty, age gracefully. it sounds so much cooler than Facebook” – George M. Church

At Khaca, we’re committed to your success. As a biotechnology enabler business, our mission is to empower individuals and organizations to thrive in an ever-changing world. We provide the tools, knowledge, and support you need to reach your full potential. Our main focus is on biotechnology and using ethical principles for deliberations and analyses. We hope to promote and advocate for the growth of biotechnology and innovations in South Africa and Africa by
ensuring accessibility, affordability, inclusivity, diversity, and equity. Howbeit, we are also open to other research topics that may have an impact or influence the growth of biotechnology and innovation, respectively.

“I actually think that the assault on facts is creating a counter-reaction, where more and more people are looking for institutions they can trust to provide them with a real sense of what’s going on in the massive amounts of disruption people are seeing every day.”- Neera Tanden

My focus area is research ethics in Animal Care and Use, Biological and Environmental Safety and permit compliance for work indigenous fauna and flora. I have a background in science and theology and serve on a number of research ethics committees. My role in the organization is in stakeholder and social engagement, capacity building, development, and training. Whereas, Dr Fikile M Mnisi’s focus is on day to day operations of the business and her background is in Biotechnology, Tissue/ Regenerative Medicine, and has a Doctorate in Philosophy with a focus on Bioethics, Health Law, and Social issues. Her area of focus is ELSI, bio-policy research, professionalism, ethics education & training, ethics consultant, research ethics, biotechnology-based therapies, biomanufacturing, societal issues and activism. While, Dr Tony Shabangu has a background in Psychology and a doctorate in Philosophy with a focus on Ubuntu and/ or African philosophy. His role in the organization is in research, development, and media engagement. His focus area is African Philosophy, Moral Development, health and medical philosophy, ethics education, and training, professionalism, & offender’s rehabilitation ethics.

Written by: Generated with AI input, by Winston A Beukes

The post Introduction to our World first appeared on KHACA.