21st Century Trust - 2006 Conferences & Events

Recent advances in genetic science – human, animal and plant – have been dramatic in recent years, and more are promised for the coming decades, which are likely to be among the key developments of the 21st century. It is time to review both the science and the debates which surround it about how we best establish ethical boundaries while nurturing creativity in research and application, and, in the light of this, assess how well we are setting the direction of public policy in Europe and the world at large, and developing the relationship between science and society. Topics will include: what can realistically be expected from genetic science in the coming decade; the ongoing debates which link ethics, risk and benefit (such as stem-cell research, cloning, the use of GM crops, xenotransplantation, and the enhancement of animals or even humans); how public engagement, governance, and accountability in these areas can best be improved and structured; issues of the ownership of individual and population genetic information, and the proper balance between its use and the privacy of individuals; as well as how best to encourage dynamic, responsible research, whether public or private, addressing needs both at the national and global level.

Countries everywhere except for Sub-Saharan Africa will have older populations in the near future, with the world’s percentage of those over 65 rising from 6.9% to 12% by 2030. Japan and Europe are already starting to see this trend: developing parts of Asia will, if anything, experience it to an even greater degree. This shift is of key importance for a host of political, economic, and social issues.

One central concern will be health care, already undergoing technology and cost induced upheavals of its own. Issues at the interface of changes in demography and health care include: the likely degree and nature of the demographic shift, involving political questions such as immigration; the real impact of this shift as older individuals may well be ever healthier in the future and behave more like younger ones; the effect on provision, research priorities, and populations themselves of the changing disease load, particularly the shift to chronic care brought about by aging, but also by increased wealth and environmental factors such as global warming. Added to these questions are the growing demands from ever better informed patients who are expanding what they expect from doctors. The issue of knowledge points up the need for social as well as medical and scientific responses to these upheavals, given the inverse correlation at the individual level between educational attainment and need for medical resources in old age. And changes in social assumptions and attitudes in connection with aging, as well as new technologies, are expanding the boundaries of medicine itself, with cosmetic surgery and pharmacological interventions in developed countries making it a technology to ‘stay young’.

With population change, technological advance, and changes in social norms, medical costs are rocketing, and this has a considerable impact on the roles of public and private sectors both in developed countries and in fast-developing ones, which are likely to see rapid and controversial expansion of the latter. As well as the challenge of funding, there is the problem of finding enough trained medical personnel, as they like all others experience aging cohorts, and there are the practical and ethical issues of health services in developed countries attracting ever greater numbers from the developing world.

Finally, many present assumptions may have to be revised, given newly emerging diseases. This has already been the case with regard to HIV/AIDS, and not just in sub-Saharan Africa, and avian flu may yet make its mark on population profiles around the world.

This conference will use a scenario-building approach to map the uncertainties ahead. Different approaches to public policy making in this area will be assessed, along with public engagement with the medical science and the politics which will affect people’s fates on through the 21st century as individuals, cohorts and whole societies.