* Globalization, Biotechnology and Women’s Health
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By Shree Mulay, McGill Centre for Research and Teaching on Women, Canada
THIS DOCUMENT APPLIES TO THESE EVENTS:
|Plenary #3: The Geneticization and Commercialization of Women’s Health and Assisted Reproduction|
I will talk about Globalization, Biotechnology and Women’s Health in the context of commercialization of assisted reproduction and contrast that with the experiences of women in the South with contraceptive technologies on the ground.
Yesterday, my dear friend Lynda Yanz from Toronto, who works very hard for the Maquila Solidarity Network, casually asked me how I was. I replied flippantly “I wish I could clone myself to do the work that needs to be done”. “And I would clone you too, if I could”. This casual conversation made me think about how our language is infected and pervaded by the language of the Gene Age.
Aldous Huxley predicted in 1931 that the twentieth century would be the century of major breakthroughs in the life sciences. And he was right! Marsha Darling referred to it as the industrial, electronics and now the biotechnology revolution. As feminists, as women, and as women of colour we do need to think about how we can contain the “genie that is out of the bottle”.
Aldous Huxley in the rather bleak and grim novel the Brave New World described the events in the year 632 A.F. i.e. “After Ford” – it makes you think about it - sitting in this room in the bowels of the Ford Foundation building, created from the wealth of the Ford Empire. In his opening chapter Huxley describes A SQUAT grey building of only thirty-four stories. Over the main entrance the words, CENTRAL LONDON HATCHERY AND CONDITIONING CENTRE, and, in a shield, the World State's motto, COMMUNITY, IDENTITY, STABILITY.
“This is the fertilizing room” says the director of the hatchery and shows embryos in the artificial wombs. “I shall begin at the beginning," said the D.H.C. and the more zealous students recorded his intention in their notebooks: Begin at the beginning. "These," he waved his hand, "are the incubators." And opening an insulated door he showed them racks upon racks of numbered test tubes. "The week's supply of ova. Kept," he explained, "at blood heat; whereas the male gametes," and here he opened another door, "they have to be kept at thirty-five instead of thirty-seven. Full blood heat sterilizes." Rams wrapped in theremogene beget no lambs.”
In the novel, reproduction has been removed from the womb and placed on the conveyor belt, where reproductive workers tinker with the embryos to produce various grades of human beings, ranging from the super-intelligent Alpha Pluses down to the dwarfed semi-moron Epsilons. In Huxley’s Brave New World, men and women of different levels of intelligence were created to match the tasks they performed. People were simply clogs of the state for the greater good of society and in return the state provided continual pleasure as a substitute for freedom. In a global world of have and have-nots, you don’t need to tinker with the genes to produce epsilon type of workers to do the menial jobs. The poor, the underclass, will do those tasks gladly, for a pittance, to fill their bellies. Huxley in his grimmest nightmares could not have imagined that the “greater good of society” referred to by Judith in her talk today, is not the driving force for the development of new reproductive and genetic technologies. It is crass profit motive that has exploited women’s fears of infertility and dished it up as “expanding women’s choices” to market motherhood and commercialized the trade in sperm and eggs. The same fears have been exploited in the South; the consequences of infertility are much greater for women in the South.
The population control discourse ignores the fact that infertility is a major concern in the South and its consequences for women are far greater than for women in the North. Around the world, 8%–10% of couples experience infertility during their reproductive lives. In India, WHO studies show that primary and secondary infertility are 3% and 8%, respectively. It will come as no surprise to anyone in the room that infertility treatment, like most health services, is not covered by health insurance and certainly not offered to the poor in government health clinics.
Two weeks ago, I was in Bhopal, India – notorious for the Union Carbide Gas tragedy. I spent some time in a health clinic for the gas victims. I also visited the colonies next to the factory. The Union Carbide factory has been shut for many years but the conditions in the colonies continue to be horrible. I visited an endocrinology lab and talked to the endocrinologist running it. I learnt from him that polycystic ovarian syndrome (PCOS) rate was high in Bhopal and many of the men from the colonies had azoospermia. Right next to the lab is an IVF clinic and a big bold sign: “we aim to deliver”.
I inquired about success rates from a gynecologist who runs such a clinic. Her reply was the success rate is very high. I asked, “You mean live births?” Her reply was “No- with chemical pregnancies”. This is a euphemism for detection of HCG in the serum. If we are concerned about regulation of assisted reproduction in North America, we should be very concerned about the lack of regulation of such activities in India. The Drug and Cosmetic Act, adopted in 1941 is essentially the same document that was designed during colonial rule. Some sections have been added to include reproductive technologies but there are no provisions to punish people who violate any prohibitions. Regulation is left to professional associations, who are not known for anything but their laissez-faire attitude towards professional practice. I would contend that there are not even minimum standards to regulate the laboratories where the IVF is done.
IVF-India has a website that advertises the benefits of what I call “Repro-tourism”. It blares, “Come to India to get IVF done. It is cheaper and you can visit India too.” Of course medical tourism is not restricted to IVF. It covers coronary by-pass surgery, kidney transplant and cosmetic surgery. Some of the medical procedures, I learnt from a woman hired by Apollo Hospital to expand the overseas market, are covered by the National Health Service in the U.K. She said that in U.S. she mainly reaches out to the Non-Resident Indians (NRIs) who are covered by private insurance. The National Council for Applied Economic Research (NCAER) has suggested that India will be a major beneficiary from economic activities like medical tourism once it joins the WTO and GATS come into full force. Another area is in the supply of nurses and attendants to meet the demands for such services as the population ages in the West. The economists in India consider outsourcing of work for call centers in India as an excellent example of how medical services could also be marketed successfully.
While IVF may be out of reach for the vast majority of Indians experiencing infertility, amniocentesis and ultrasound are available for sex-selection despite the ban on the use of these technologies for detection of sex of the fetus. We have seen that rural centers that do not have the capacity to diagnose tuberculosis will have capacity to do ultrasound.
For women and men who live under the shadow of the Union Carbide factory and continue to bathe and drink the water polluted by the toxic chemicals dumped by the plant, where is the justice? What recourse do they have to deal with their infertility? They are simply fighting to get clean water, a clean-up of the area and compensation for lost livelihood.
Many women have spoken today about the contrast between women in the North who are offered an expansion of reproductive choices and women in the South who become guinea pigs in clinical trials for unsafe contraceptives at the hands of ruthless experimenters . Sterilization on a mass scale is a common practice. The average age of sterilization now is 26 years. Our recent study, albeit a qualitative study, shows some alarming tendency, which if proven to be correct, has enormous implications for women’s health. The first was an increase in the number of women who experienced early menopause between 28 and 35 years of age. The second was a high incidence of cervical abnormality among women who had Quinacrine non-surgical sterilization. I must emphasize that these findings need to be confirmed with a larger sample but it is enough to raise alarm bells. The proponents of unproven methods like quinacrine sterilization are not concerned about the quality of life for a woman who enters menopause early in poor developing countries.
Commercialization and exploitation of NRGT and indeed biotechnology as a whole tend to cloud our judgment about biotechnology when we criticize, and rightly so, the lack of social justice and I am well aware that science is not neutral but embedded in the social political framework of our society. Yet I know equally well that feminist critique must not conflate the full potential of biotechnology with the social ills of the troubling aspects of NRGT. Indeed biotechnology has the potential of developing new and very effective vaccines against diseases like tuberculosis, malaria, and sleeping sickness. So let us not throw the baby out with the bath water.
Participation by civil society in determining the research agenda and priorities is the only way to ensure a rational health policy that balances the needs for primary and secondary health care with that of tertiary health care. As feminists we must engender a healthy public debate. It is equally important that in the context of the international trade agreements, like General Agreement on Trade in Services (GATS) and Trade Related Intellectual Property Rights (TRIPs), developing countries, like India, have a critical mass of scientists with a social commitment develop an infrastructure to conduct research in diseases of the poor. They must not depend on multinational corporations to provide the technology. Developing countries have already experienced exploitation through structural adjustment programs; they must develop their own indigenous technology and put biotechnology to use, if and when they are needed, for the benefit of their own people.