Development, 2006, 49(4), (6–15) r 2006 Society for International Development 1011-6370/06 www.sidint.org/development
Upfront
Nanotechnology for Health and Development
GREGOR WOLBRING
ABSTRACT Gregory Wolbring looks at the promises and perils of nanotechnology and -nano-bio-info-cogno-synbio (NBICS) for the global community in terms for development in general and health in particular. He argues that given today’s governance of science and technology research and development and policy, NBICS might improve the lives of a few but could well make the lives of many others worse. If NBICS is truly to benefit the global community, the engagement around NBICS has to change dramatically. KEYWORDS nanomedicine; techno poor; disableism; disability; medical health; social health; UN Millennium Development Goals; transhumanism
What is nanotechnology? The term nanotechnology was used first to describe a way to manufacture something from atomic molecules (like the food replicator in many science fiction films) (Wolbring, 2006a, http://www.innovationwatch.com/choiceisyours/choiceisyours.2006.07.15.htm) However, the term nanotechnology has evolved to mean ‘nanoscale technology’ and nanoscale sciences covering ‘nanotechnology’ research and development products, ideas and processes with controlled size below 300 nm (Wolbring, 2006a). Many nanotaxonomies exist which show the numerous fields, processes and products covered under nano today (Wolbring, 2006a). Nanotechnology in all its meanings allows for the manipulation of materials on an atomic or molecular scale and enables a new paradigm of science and technology which sees different technologies converging at the nanoscale:
nanoscience and nanotechnology; biotechnology and biomedicine, including genetic engineering; information technology, including advanced computing and communications; cognitive science (neuro engineering); and synthetic biology, which is the design and construction of new biological parts, devices, and systems, and the re-design of existing, natural biological systems for useful purposes (Wolbring, 2006b, http://www.innovationwatch.com/choiceisyours/ choiceisyours.2006.05.30.htm).1
The US government spent nearly twice as much on nanotechnology in 2004 as it did on the Human Genome Project (HGP) in its peak year. Predictions are that expenditures Development (2006) 49(4), 6–15. doi:10.1057/palgrave.development.1100309
Wolbring: Nanotechnology Table 1. Global distribution of nanotechnology activity by country and classification (Maclurcan, 2005)
Least developed
Other: Developing
National Activity or Funding Argentina; Armenia; Brazil; Chile; China; Costa Rica; Egypt; Georgia; India; Iran; Mexico; Malaysia; Philippines; Serbia & Montenegro; South Africa; Thailand; Turkey; Uruguay; Vietnam
Individual or Group Research Bangladesh Botswana; Columbia; Croatia; Cuba; Indonesia; Jordan; Kazakhstan; Moldova; Pakistan; Uzbekistan; Venezuela Country Interest Afghanistan; Senegal; Tanzania
Albania; Bosnia and Herzegovina; Ecuador; Ghana; Kenya; Lebanon; Macedonia; Sri Lanka; Swaziland; Zimbabwe
Transitional
Developed
Belarus; Bulgaria; Cyprus; Czech Republic; Estonia; Hong Kong; Hungary; Israel; Latvia; Lithuania; Poland, Romania; Russian Federation; Singapore; Slovak Republic; Slovenia; South Korea; Ukraine
Australia; Austria; Belgium; Canada; Denmark; Finland; France; Germany; Greece; Iceland; Ireland; Italy; Japan; Luxembourg; Netherlands; New Zealand; Norway; Portugal; Puerto Rico; Spain; Sweden; Switzerland; Taiwan; United Kingdom; United States of America
Macau, (China); Malta; United Arab Emirates
Liechtenstein
Brunei Darussalam
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Development 49(4): Upfront in nanotechnology will soon outstrip investments to date in genomics and biotechnology (Lux Research, 2004, https://www.globalsalespartners. com/lux/#) ‘By the end of 2005 governments had sunk US$18 billion of taxpayers’ money into nanotechnology R&D. With an additional US$6 billion forecast for 2006, nanotechnologies will have received the same level of funding in absolute dollar terms as the entire Apollo program’ (Cientifica, 2006, http://www.cientifica.com/ www/details.php?id ¼ 340). Many countries are increasingly involved in NBIC (see Table 1).
Nanotechnology and development A recent survey (Salamanca-Buentello et al., 2005: e97) concluded that the top ten nanotechnology applications for development are:
energy storage, production and conversion; agricultural productivity enhancement; water treatment and remediation; disease diagnosis and screening; drug delivery systems; food processing and storage; air pollution and remediation; construction; health monitoring; and vector and pest detection and control.
However, there is more to the issue than nanotechnology to the rescue for the ‘poor’. Noela Invernizzi and Guillermo Foladori (see their article in this issue of Development) in direct response to the top ten nanotechnologies for development list stated,
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Despite the optimistic assessments recently offered, experience suggests that nanotechnology could follow the mainstream economic trends that increase inequality. First, the development of nanotechnology faces many of the same problems faced by prior technological developments because large multinational corporations are patenting the majority of the nanotechnology products. Patents are monopolistic guarantees of earnings for twenty years ^ something that certainly works against the rapid diffusion of the beneficial potentials of this technology for the poor (Invernizzi and Foladori, 2005).
The UN Millennium Project’s Task Force on Science,Technology and Innovation identifies nanotechnology as an important tool for addressing poverty and achieving the Millennium Development Goals (UN Millennium Project’s Task Force on Science and Calestous Juma and Lee Yee-Cheong, 2005, http://bcsia.ksg.harvard.edu/ BCSIA_content/documents/TF-Advance2.pdf). However, as ETC Group states in their report ‘The potential impacts of nanoscale technologies on commodity markets: the implications for commodity dependent developing countries’ written for the South Centre, ‘For the majority of developing countries, commodity production is the backbone of the economy. Commodity dependence and poverty are closely intertwined. Commodities provide the primary source of income for the South’s rural poor. Ninety-five out of141developing countries depend on commodities for at least 50 per cent of their export earnings; 46 developing countries depend on three or fewer commodities for more than half of their total export earnings’ (ETC Group, 2005, http://www.etcgroup.org/documents/SouthCentre. Commodities.pdf). ‘Governments, industry and scientists in OECD countries are quick to point out the potential contributions of nano-scale technology to development in the South. To date however, the potential disruptive impacts of nanotech on developing economies and human development have received far less attention. South Africa’s Minister of Science and Technology, Mosibudi Mangena, warned in February 2005’ (ETC Group, 2005) ‘With the increased investment in nanotechnology research and innovation, most traditional materialsywillybe replaced by cheaper, functionally rich and stronger [materials]. It is important to assure that our natural resources do not become redundant, especially because our economy is still very much dependent on them’ (ETC Group, 2005). ‘Nanotech’s new designer materials could topple commodity markets, disrupt trade and eliminate jobs.Worker-displacement brought on by commodity obsolescence will hurt the poorest and most vulnerable, particularly those workers in the developing world who don’t have the economic flexibility to respond to sudden demands for new skills or different raw
Wolbring: Nanotechnology materials. It is also important to note that nanoscale technologies could offer potential for developing countries to innovate and add value to current commodities. In addition, proponents of nanotechnology point to future environmental benefits of revolutionary manufacturing processes associated with ‘‘bottom-up’’ construction that will minimize waste and offer the potential to recycle raw materials’ (ETC Group, 2005). ‘The potential impacts of nanotech for the South cannot be categorized as monolithically ‘‘good’’ or ‘‘bad.’’ However, it is clear that commodity dependent developing nations are the poorest, most vulnerable and will likely face the greatest socio-economic disruptions’ (ETC Group, 2005). Safety and intellectual property (IP) are other issues in regards to nanomaterial, which receive increasing attention in the public and in the governance of nanotechnology domain. However, there are other important issues that are much less addressed such as nano as it relates to human health (with the exception of safety issues of nanomaterials).
Nanomedicine and development Medicine is in most countries the biggest or second biggest nanotechnology application. Avariety of nanomedicine taxonomies (Gordon and Sagman, 2003, http://www.regenerativemedicine. ca/nanomed/Nanomedicine%20Taxonomy%20 (Feb%202003).PDF; Freitas, 2005: 2^9) and nanomedicine roadmaps exist (BMgedal et al., 2003: 97, http://www.nanoforum.org/index.php?scc¼ pub lications&s_nfp¼1&modul¼showmore&folder¼ 99999&action¼longview_publication&scid¼162 &code¼de594ef5c314372edec29b93cab9d72e& userid¼1977453&wb¼031058&, last accessed 4 August 2006; The National Institute for Health (NIH), 2005, http://nihroadmap.nih.gov/nano medicine/index.asp; de Groot,2006, www.nanoroad. net/download/roadmap_mh.pdf). According to Frost and Sullivann, nanotechnological processes in medicine will reach a sales volume of about $180 billion until 2015. (2005: 6) According to the Freedonia group (Infoshop,
2005, http://www.the-infoshop.com/press/fd29054_ en.shtml; http://www10.nanotechcafe.com/nbc/ artices, last accessed 4 August 2006), ‘demand for nanotechnology health care products in the US is projected to increase nearly 50 per cent per year to $6.5 billion in 2009 and by 2020, demand for nanotechnology health care products is projected to exceed $100 billion’ (Infoshop, 2005). Numerous applications are envisioned, in development or already in use for every field of NBICS medicine (BMgedal et al., 2003: 97; The National Institute for Health (NIH), 2005; Wolbring, 2005, http://www.ahfmr.ab.ca/download.php/954da 463c9a6c633bdafefd1aaf23844//; http://www. ahfmr.ab.ca/publications/?search¼&type¼5&sort¼ date&dir¼DESC&dept¼1, last accessed 4 August 2006; de Groot, 2006). Some examples are cancer research, brain^machine interfaces; bionic implants; bionic ear; bionic eyes; next generation autonomous wheelchair control; bionic legs and arms; bionic knee; neural prostheses; spinal cord prostheses; speech; cranial, neural, and other implants; artificial joints, artificial muscles, artificial nose and tongues, nose on a chip, artificial kidney, artificial liver, artificial lungs and artificial discs (Wolbring, 2005). Other envisioned products relate to immortality/ longevity, the artificial womb, the separation of our consciousness/mind from the human body and the generation of new life forms (synthetic biology). The first three nanodrugs have recently been approved by the Food and Drug Administration (FDA) in the USA: Emends, Tricors and Rapamunes (Till et al., 2005, http:// pubs.nanolabweb.com/nlb/vol2/iss2/6;Flynn and Wei, 2005: 47^51). As in nanotechnology for development in general, there are many questions to be raised about nanomedicine for development in particular: how much of the vision will become reality; who will have access to the products; are they safe; how do certain product impact on the ‘social contract’ between humans; which health problems can they fix and under what circumstances; will they really fix the ‘health’ problems of the poor and marginalized, how is the concept of health changing, how is the concept
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Development 49(4): Upfront of disability changing, who is disabled and non-disabled?
Conceptual and practical issues for NBICS medicine in global health and development
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There is an important link between the governance of science and technology and the concepts of health, disease, wellbeing and ‘disability’ and ‘impairment’. On the one hand, technologies such as NBICS impact on concepts of health, disease well-being and ’disability/impairment’. On the other hand, concepts of health, disease, wellbeing and ’disability/impairment’ impact on the direction and governance of research and development of NBIC. Many national and international documents use the term ‘health’. But what is the meaning of the term health? One definition links different domains of well-being (physical, mental and social) under the umbrella term ‘health’ combining ‘medical health’ and ‘social health’. Another defines health as purely the absence of disease and illness limiting the term ‘health’ to mean ‘medical health’/ ‘medical illness’ as the ‘medical’ determinant of ‘wellbeing’. This second version ignores the ‘social health’of people. (Wolbring, 2005) There are medical, social and transhumanist models and determinants of health and disease (Wolbring, 2005). Within the medical model, disease/illness is defined as a sub-normative speciestypical functioning of biological systems such as those of the human body and the cause of and solution for ‘ill medical health’ is interpreted in two ways. Medical determinants of medical health lead to medical interventions based on what is assumed to be the human bodily structure and functioning norm with a focus on individualistic cures. Social determinants of medical health identify external factors as the cause of the ‘ill medical health’. The social determinants of medical health are often misleadingly referred to as the ‘social model of health’ or the ‘social determinants of health’. However, they only address social factors contributing to ‘ill medical health’/
‘medical illness’; the ‘social health’ of a person is not addressed. A real social model of health using social determinants of health would examine how social determinants influence‘physical, mental, and social wellbeing’ not just at how social determinants influence and worsen ‘medical health’. One does not have to be a ‘patient’ or ‘patient to be’ in order to be included in a social model of health. Advances in and converging of NBIC allow for a new model of health which takes into account the increased ability of science and technology to modify the appearance of the human body and its functioning beyond existing norms and species boundaries. Within the transhumanist/enhancement model, all people’s bodies ^ no matter how conventionally ‘medically healthy’ ^ are defined as limited and defective in need of constant improvement made possible by new technologies appearing on the horizon (a little bit like the constant software upgrades we do on our computers). Medical and social health in this model is the concept of having obtained maximum enhancement of one’s abilities, functioning and body structure (Wolbring, 2005). Who is a non-disabled person, who is a disabled person? A non-disabled person was defined as someone whose body functioning was seen as performing within species-typical acceptable parameters (medically healthy). The term non-disabled was used as a counterpart to the medical/patient type understanding of disabled people. However, this is changing. The transhumanist model of health and disease sees every person’s body as defective in need of improvement. Every person is, by definition,‘disabled’ in the impairment/medical/patient sense. Within the transhumanist model of ‘disability/impairment’, disabled people are those who are not able or do not want to improve themselves beyond Homo sapiens normative functioning (techno poor disabled). The enhanced people are the new non-disabled people. The dynamic around the meaning of health leads to a variety of practical issues.
Wolbring: Nanotechnology The appearance of enhancement medicine3 An increasing number of people believe that we can, will, and should try to overcome our biological limitations. But how do they present this? The medicalization of the human body: more and more variations of human body structure and functioning are labelled as deviations as diseases (dynamic of medicalization). The transhumanization of medicalization: the transhumanist model of health and disease elevates the medicalization dynamic to its ultimate endpoint, namely, to see the enhancement beyond species-typical body structures and functioning as a therapeutic intervention (transhumanization of medicalization). Enhancement medicine: the emerging field of enhancement medicine provides the remedy through surgery, pharmaceuticals, implants and other means and it could become the number one cash cow for many hospitals and medical practitioners such as ‘body engineers’, ‘body designers’ and body techno-maintenance crews (Wolbring, 2005). The above dynamics make the line drawn between therapies versus enhancements or therapeutic versus non-therapeutic enhancements untenable. Many therapies have enhancement aspects. Many enhancements can be classified as therapies and many therapeutic interventions can and are used later on for non-therapeutic purposes.
The decrease in curative medicine and the appearance of the transhumanist/ enhancement burden of disease Curative medicine to the old ‘normative functioning’of humans might be seen increasingly as futile medicine, a waste of health care and medical resources. The disability-adjusted life years (DALY), a measure developed originally in the 1990s, was explicitly set up according to the main author to ‘curtail allocative inefficiency’. (Murray and Acharya, 1997: 703^30) If Murray’s findings ‘that individuals prefer, after appropriate deliberation, to extend the life of healthy individuals rather
than those in a health state worse than perfect health’ (Murray and Acharya, 1997: 703^30) are correct, this would mean two things. It would mean that we focus on fixing the health problems of the people who deviate the least from species-typical functioning and it could become the foundation of moving resources towards ‘enhancement medicine’ and away from ‘curative medicine’. A transhumanist/enhancement burden of disease is the logical endpoint of ‘Murray’s vision’ linking the burden of disease not to a deviation from traditional Homo sapiens-typical functioning but to the lack of enhanced functionalities and life extension and productivity modification of sentient beings.
Disabilism A transhumanized version of disableism: Disableism is a network of beliefs, processes and practices that produce a particular kind of self, body and abilities which are projected as the perfect and essential while at the same time labelling deviation (real or perceived) from this essential self, body and abilities as a diminished state. Disableism has been long used to justify hierarchies and the exclusion of people not necessarily classified as ‘disabled people’. For instance, at the end of the 19th century women were viewed as biologically fragile and emotional, and thus incapable of bearing the responsibility of voting, owning property, and retaining custody of their own children (Silvers et al., 1998: 55; Wolbring, 2003: 232^43, http://www.wtec.org/ConvergingTechnologies/; http://www.bioethicsanddisability.org/nbic.html). Disableism is still used today in regards to socalled non-disabled people but it is not identified as disableism as such (i.e. using judgment of cognitive abilities of different groups to justify racism). Today the concept of disableism plays itself out mostly in regards to disabled people where the issue revolves around ‘species-typical functioning’ versus ‘subnormal species-typical functioning’ (Wolbring, 2005). However, this is changing. Advances in science and technology are increasingly enabling science and technology R&D products to modify the appearance and func-
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Development 49(4): Upfront tioning of the human body beyond existing norms and species-typical boundaries. The direction and governance of science and technology and the concept of ability are inter-related. On the one hand, technologies such as NBICS have an impact on the very concept of ability and how we judge and deal with abilities. On the other hand, how we judge and deal with abilities influences the direction and governance of NBICS processes, products and research and development. A new transhumanized form of disableism is appearing that takes into account the increased ability of science and technology R&D products for body modification and is ‘a network of beliefs, processes and practices that perceives the improvement of human body and functioning beyond species-typical boundaries as the norm, as essential and judges a non-enhanced human body as a diminished state of existence’ (Wolbring, 2006c). Transhumanism ‘is a way of thinking about the future that is based on the premise that the human species in its current form does not represent the end of our development but rather a comparatively early phase’.2 The techno poor disabled and the ability divide
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As more powerful, less invasive and more sophisticated enhancements become available, the market share and acceptance of enhancement products will grow. This could very likely develop into a situation where those who do not have or do not want certain enhancements (the techno poor disabled) will be discriminated against, given negative labels and suffer difficult consequences (transhumanism of disableism). For any given enhancement product, there will not be a bell curve distribution, but rather a distribution jump from the ‘have nots’ to the ‘haves’ which will lead directly to an ability divide. What will change ^ depending on the social reality such as GDP of the economy, income levels and other parameters ^ is how many people end up as ‘haves’ or ‘non haves’ (techno poor disabled). The ability divide will be bigger between low- and high-income countries than it will be within low middle and rich countries. The ability divide will develop between the
poor and rich within every country. Not everyone can afford the enhancement of ones body. And no society can afford to enhance everyone’s body if everyone so wishes. Those deemed healthy by most people today, but who cannot afford or do not want the technological enhancements, will became the new class of ‘techno-poor disabled’. Billions of people who today are seen as healthy will become disabled not because their bodies have changed, but precisely because they have not changed their bodies in accordance with the transhumanist norm. The transhumanization of disableism is a logical extension of the disableism-disabled people are facing. Therefore, it is of importance how much of this type of disableism is visible, investigated and rejected or supported. As much as human enhancement technology will become an enabling technology for a few, it will become a disabling technology for the many. As we are unable to close other divides, that is, the digital divide between blind and non-blind people (98 per cent of WebPages are inaccessible to blind people), it is doubtful we will be able under today’s policy environment to close the numerous forms of ability divides generated by enhancement technologies.
High tech versus low tech Are high-tech solutions the best option or are low tech or no tech solutions available and more effective/feasible? It is not self-evident and a forgone conclusion that high-tech technology is the best or only solution for poverty, hunger and malnutrition (UNICEF, 2004, http://www.unicef.org/ media/files/Africa_DAR.pdf). Identifying a potentially beneficial technology is not enough. Nanotechnologies as with every other technology cannot meet the development needs of poor people in developing countries if proper societal, political, cultural, ethical, human rights frameworks do not exist and are not considered (Cientifica, 2005, http://www.cientifica.com/archives/2005_01.html).
Nano and the UN millennium development goals The UN Millennium Development Goals with their targets and indicators are an extensive
Wolbring: Nanotechnology global effort to address problems pervasive in ‘developing countries’. A recent survey (Salamanca-Buentello et al., 2005: e97) identified the top ten nanotechnology applications for development linking them every to different UN Millennium Development goals. Water treatment and remediation is number three on the list of nanotechnologies for development and is also seen by others as a main nanoapplication (Meridian Institute, 2004, http://www.anoandthepoor.org/Final_Report_ Responsible_Nanotech_RD_040812.pdf; http://www. nanoandthepoor.org/Attachment_F_Responses_and_ Background_Info_040812.pdf, last accessed 4 August 2006). However, other water purification systems exist and are developed without the nano label (Krotz, 2005; Hussain, 2006, http://www. unu.edu/env/Arsenic/Hussain.pdf). That begs questions such as do we need nanotechnologies; why are the technologies available today not reaching the billions of people in need of clean water and sanitation; why and how would a functioning nanotechnology solution be different; would it not have to fight against the same forces which prevent the implementation of existing technologies? For disabled people, the issue is even further complicated, for example, clean water and sanitation is not enough if the delivery is not taking into account the different modes of functioning of disabled people. It is highly problematic that disabled people are never mentioned in the water debate ^ not in the UN water report, not within the NGO/ CSO/government deliberations, not in the water conferences such as Kyoto and Mexico, despite existing literature on a disabled people angle on water (Water for All, 2006, http://wedc.lboro. ac.uk/projects/new_projects3.php?id¼60; http:// www.developments.org.uk/data/issue27/water-all. htm; http://wedc.lboro.ac.uk/projects/proj_contents /WEJY3%20-%20WSS%20Special%20Needs/www/ outputs/E-conference%20report_watsan%20for% 20disabled.pdf; http://wedc.lboro.ac.uk/projects/ proj_contents/WEJY3%20-%20WSS%20Special %20Needs/www/outputs/Inception%20Report_ watsan%20for%20disabled.pdf; http://wedc.lboro.ac. uk/projects/proj_contents/WEJY3%20-%20WSS%
20Special%20Needs/www/outputs/Literature%20 review_watsan%20for%20disabled.pdf; http://www. lboro.ac.uk/wedc/projects/auwsfpdp/disab%20 watsan%20litreview2.pdf). Science and technology alone are not the answer to sustainable development challenges. Like any other science and technology waves, nanoscience and nanotechnology are not ‘‘silver bullets’’ that will magically solve all the problems of developing countries; the social context of these countries must always be considered’ (Salamanca-Buentello et al., 2005: e97).
The situation is similar for the health-related MDG’s To quote the Health Research for Equity in Global Health statement by the Global Forum for Health Research: ‘Point 3. Achieving all the MDGs will require addressing health and its determinants in a comprehensive way and will necessitate further health research focused on the needs of developing countries. This research must encompass the spectrum from the biomedical sciences (such as affordable and accessible drugs, vaccines and diagnostics) to health policy and systems research, social sciences, behavioural and operational research. It must give systematic attention to cross-cutting issues of poverty and equity, including taking account of inequities based on gender, ability, race and social class/ caste; the needs of both the aged and the largest generation ever of young people 0^19 years; and the needs of other specifically disadvantaged groups such as migrants and refugees’ (Global Forum for Health Research, 2004).
Conclusion Nanotechnology and NBICS hold much promise for the global community; however, under today’s governance of science and technology research and development and science and technology policy, it is more to be expected that NBICS will improve the lives of a few and make the lives of many worse. If NBICS is truly to benefit the global community, the engagement around NBICS has to change dramatically. 13
Development 49(4): Upfront Notes 1 ‘NBICS’ -nano-bio-info-cogno-synbio is envisioned as being useful in areas such as the environment, energy, water, weapons and other military applications, globalization, and agriculture, global health, extreme lifespan extension, if not immortality and the pursuit of morphological freedom (Anders Sandberg, 2001, http://www.nada.kth.se/Oasa/Texts/MorphologicalFreedom.htm). 2005, Nanoroadmapavailable at: /http://www. nanoroadmap.it/S, /http://www.nanoroadmap.it/sectoral%20reports/sect%20report%20health.PDFS 2 According to the World Transhumanist Association, see http://www.transhumanism.org/index.php/WTA/faq21/46/ 3 For an extensive discussion of this issue see Wolbring (2005). References
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Anders Sandberg (2001) ‘Morphological Freedom ^ Why we not just want it, but need it’. Available online. BMgedal, Morten, Michael Gleiche, Jean-Charles Guibert, Holger Hoffschulz, Sandrine Locatelli, Ineke Malsch, Mark Morrison, Carole Nicollet and Volker Wagner (2003) ‘Nanotechnology and its Implications for the Health of the EU Citizen. 97. 2003’, Available online. Cientifica (2005) ‘TNT Llog Global Nanotechnology ^ The where, the when and the why’. Available online. Cientifica (2006) ‘Where Has the Money Gone?’Available online. Dan Krotz (2005) ‘Water Filter Could Help Millions of Bangladeshis; Innovative technology could also help California comply with tighter US EPA standards for arsenic in drinking water’, Research News Berkeley Lab, 2005. ETC Group (2005) ‘The Potential Impacts of Nano-scale Technologies on Commodity Markets: The implications for commodity dependent developing countries South Centre. Available online. Freitas, Richard (2005) ‘Nanomedicine: Nanotechnology, biology and medicine’, Nanomedicine: Nanotechnology, Biology and Medicine 1(1): 2^9. Global Forum for Health Research, Forum 8 Mexico City (2004) ‘Health Research for Equity in Global Health’. Hussain, M.D., M.A. Haque, M.M. Islam and M.A. Hossen (2006) ‘Approaches for Removal of Arsenic from Tubewell Water for Drinking Purpose’, in Ahmed M.F., Ali, M.A., Adeel, Z. (eds.) Technologies forArsenic Removal from Drinking Water. Tokyo, Dhaka: The United Nations University, Bangladesh University of Engineering and Technology, 69^75. Available at: http://www.unu.edu/env/Arsenic/Hussain.pdf. Infoshop (2005) ‘US Nanotechnology Health Care Product Demand to Reach $6.5 Billion in 2009’. Available online. Lux Research (2004) ‘The Nanotech Report 2004 (TNR 2004)’. Available online. Maclurcan, D. (2005) ‘Nanotechnology and Developing Countries, Part 2:What Realities?’, AZoNano ^ OnlineJournal of Nanotechnology. Available at:http://www.azonano.com/Details.asp?ArticleID¼1429. Meridian Institute, Meeting Chair Roco MC (2004) ‘International Dialogue on Responsible Research and Development of Nanotechnology’. Available online. Murray, Christopher J.L. and Arnab, K. Acharya (1997) ‘Understanding DALYs (disability-adjusted life years)’, Journal of Health Economics 16(6):703^30 available at: PM:10176780. Neil, Gordon and Uri Sagman (2003) ‘NanomedicineTaxonomy of the Canadian Institute for Health Research (CIHR)’. Available online. ReneŁ, de Groot, Jonathan Loeffler and Ulrich Sutter (2006) ‘Roadmap Report Concerning the Use of Nanomaterials in the Medical & HealthSector’. Available online. Salamanca-Buentello, Fabio, Deepa L. Persad, Erin B. Court, Douglas K. Martin, Abdallah S. Daar and Peter A. Singer (2005) ‘Nanotechnology and the Developing World’, PLOS Med 2(5): e97, available at: PM:15807631. Silvers, A., D. Wasserman and M.B Mahowald (1998) Disability, Difference, Discrimination: Perspective on justice in bioethics and public policy (Point/counterpoint: Philosophers Debate Contemporary Issues), Landham, Bolder, New York, Oxford: Rowman & Littlefield. Ted, Flynn and Chiming Wei (2005) ‘The Pathway to Commercialization for Nanomedicine’, Nanomedicine: Nanotechnology Biology and Medicine 1(1): 47^51. The National Institute for Health (NIH), USA (2005) ‘Roadmap for Nanomedicine. 2005’. Available online. Till, Mary C., Michele M. Simkin and Stephen Maebius (2005) ‘Nanotech Meets the FDA: A success story about the first nanoparticulate drugs approved by the FDA’, Nanotechnology Law and Business 2(2):163^7. UN Millennium Project’s Task Force on Science,Technology and Innovation and Calestous Juma and LeeYee-Cheong (2005) ‘Innovation: Applying knowledge to development, Earthscan, United Nations Development Programme, available online. UNICEF (2004) ‘Vitamin and Mineral Deficiency in Sub-Saharan Africa’, Available online. Water for all (2006) ‘Water and Sanitation for Disabled People’. Available online.
Wolbring: Nanotechnology Wolbring, G. (2003) ‘Science and technology and the triple D (disease, disability, defect)’, in Mihail C. Roco (ed.) Converging Technologies for Improving Human Performance: Nanotechnology, biotechnology, information technology and cognitive Science, national,William Sims Bainbridge, Dordrecht: Kluwer Academic. Available online. Wolbring, G. (2005) ‘HTA Initiative #23. The triangle of enhancement medicine, disabled people, and the concept of health: a new challenge for HTA, Health Research, and Health Policy Alberta Heritage Foundation for Medical Research, Health TechnologyAssessment Unit’, Edmonton, Alberta Canada, available online. Wolbring, G. (2006a) ‘From Nanotech to Nanoscale Technology and Sciences’. Available online. Wolbring, G. (2006b) ‘Synthetic Biology 2.0’. Available online. Wolbring, G (2006c) Science and Public Policy forthcoming.
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