Banking
On Indian Umbilical Cords
By Scott Carney
18 November, 2006
Wired.com
CHENNAI, INDIA --
An Indian blood bank plans to take advantage of the country's booming
birth rate by opening a repository for blood taken from umbilical cords.
But critics worry that without
proper oversight, the massive bank could put a price tag on umbilical
cords, putting the country's millions of impoverished women and children
at risk of exploitation.
Cord blood is used in the
treatment of many ailments, especially blood diseases like leukemia,
thalassemia and sickle cell anemia.
With 43 million births a
year, India is poised to be the largest supplier of umbilical cord blood
in the world.
LifeCell,
based here, hopes to open a cord-blood bank in December. The bank would
serve anyone in the world with access to FedEx.
Most experts agree that public
cord-blood banking is a good idea. Stem cells from both cord blood and
bone marrow treat many blood diseases, but cord blood is easier to obtain.
Cord blood is also less likely to be rejected than bone marrow, which
requires an exact match, usually from a family member. Similar to a
blood bank, a cord-blood bank relies on donations to cover a broad range
of immune types. The more donors, the more likely patients in need will
find a match.
But in India, where female
infanticide and body-organ sales are not uncommon, watchdog groups worry
that a massive cord-blood bank like LifeCell's could create a dangerous
demand for umbilical cords.
"The notion of worldwide
registries that can supply transplant tissue to each other has obvious
attractions," said Satyajit Rath, a medical activist at the National
Institute of Immunology in New Delhi. "The cord-farm notion, on
the other hand, is very troubling. Given the reality of poverty, it
is not impossible to imagine a situation where people would have (or
even abort) babies simply in order to sell umbilical cord blood."
In December, LifeCell will
begin collecting thousands of umbilical cord-blood samples, and will
charge a fee for withdrawal. The fee hasn't been disclosed. The service
will categorize the available stem cells into a searchable database.
Doctors who find matches for their patients can order an overnight shipment.
"We will be able to
sell to anyone in the world," said Prasad Mangipudi, vice president
of LifeCell.
The United States has seven
public cord banks that charge up to $18,000 per unit -- a fee that is
often paid by insurers. But in India, this is the kind of profitability
that raises eyebrows.
The Indian government has
been slow to impose regulations on any stem-cell research. The Indian
Council of Medical Research announced last month that it would draft
guidelines to govern cord banking. The draft
proposal, once approved, will be quite comprehensive. The
approval process, however, could take years. Until then, India is something
like the Wild West.
"It is dangerous to
proceed with stem-cell banking without clear government guidelines,"
cautioned Chandra Gulhati, editor of the Monthly
Index of Medical Specialties and a leading authority on
medical ethics in India. "Without them there is nothing to stop
a company from harvesting stem cells from aborted fetuses."
Once the guidelines are approved,
enforcement is not guaranteed. The ICMR can approve or reject applications
from companies that want to establish a bank. But if a company violates
the law, there is no government organization tasked with shutting them
down.
Mangalpudi says LifeCell
will never pay for umbilical cord blood for precisely this reason. For
now, the company plans to amass cord blood through private donations.
Mangalpudi says it will not offer any sort of remuneration other than
the knowledge that the donation might help someone in need.
For the past two years, LifeCell
has run a private cord-blood bank, which caters to 4,000 paying donors
who can afford their own personal biological insurance policy. Its customers
bank their own blood in case they need a stem-cell treatment one day
and can't find a viable donor. In a collaboration with Florida-based
CryoCell,
LifeCell has aggressively expanded to 19 locations throughout India.
It plans to have 31 centers up and running by 2007.
Critics of private banking
say it's a waste of money because the chances are slim that a patient
will ever need their own stem cells. Plus, a diverse public bank will
serve everyone, including those who can't afford private banking.
The lack of regulations has
already derailed one public bank in India that would have served the
masses.
Last year,
Histostem, a South Korean biotech company, announced it
would invest $20 million in what would have been the world's largest
public umbilical cord stem-cell bank. The bank would have been located
outside Mumbai. But according to Yung Ke, vice president of Histostem,
the lack of medical guidelines in India played a key role in the breakdown
of talks between Histostem and the government of Maharastra, which the
company planned to partner with.
Now that LifeCell has filled
the void left by Histostem, the company says it wants to ensure the
cord-blood business maintains a good reputation. It is fearful that
one company that violates basic ethical principles could endanger the
whole industry.
"We hope that the ICMR
speeds up the approval process," says Mangipudi. "Right now
we are using the guidelines issued by the Food and Drug Administration
in the United States."
Wired.com © 2006 CondéNet
Inc
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