Examination of Witnesses (Questions 1702
- 1719)
WEDNESDAY 8 MAY 2002
DR ANDRÉ
MENACHE AND
DR CLAUDE
REISS
Chairman
1702. Dr Menache and Dr Reiss, you are most
welcome. Thank you for coming here to see us this afternoon. Would
you like to begin perhaps by making an opening statement briefly
and then we will proceed to questions.
(Dr Reiss) Thank you. My name is Claude Reiss. I was
born in Strasbourg, close to the German border, so that is the
reason for my somewhat German accent I have when I speak English.
I have been heading a research laboratory in molecular biology
for 35 years with the French National Centre for Scientific Research
and lately I started to develop a new therapy on AIDS, which we
have patented and which we are going to develop to try to set
up a new approach to the therapy of AIDS. For 10 years now I have
been involved also in toxicology, trying to modernise what is
called toxicology, to have a scientific-based toxicology being
developed and having people being trained in this field. Why did
we come to this conclusion? The main reason is that no animal
species can be considered as a model for another species. The
proof of this is very simple.
1703. We will ask questions about that. Dr Menache,
do you want to say anything?
(Dr Menache) No, I think I will just wait for questions.
1704. The first question is: How many members
does DLRM have and approximately what proportion are doctors and
what proportion are lawyers?
(Dr Menache) DLRM has approximately 500 members, of
which 150 are doctors, 10 are lawyers and the remainder are various:
nurses, veterinarians, scientists and members of the general public.
1705. That is a purely factual question, so
we will proceed to the next question. What are the principal aims
of DLRM and, in particular, what do you mean by "Responsible
Medicine"? Do you consider that there is a need for any animal
research?
(Dr Reiss) We consider that medicine should take advantage
of the last progress, the last knowledge which has been obtained
from science to improve the way people are cured and the way people
are treated. But, with this point of view, I think responsible
medicine is a medicine which sticks to rational, logical procedures,
so that the people who are treated, the patients, can have the
best treatment possible. Why is the animal model not acceptable
in this frame? The reason is quite simple. As I started to say
earlier, no species can be considered as a biological model for
another species. The proof of this is very simple, it takes two
sentences to prove this. All biological activities of a given
individual depend on its genetic outfit. There are the chromosomes,
of course, and inside the chromosomes the genes, how the genes
are structured and how the expression of the genes is organised
within the cell. A species is defined by what is called the reproductive
isolation; that is, no member of the species can cross with a
member of another species. This defines a species. Because the
genetic outfit of each species is very specific and since the
biological activity of the species is completely determined by
its genetic outfit, this means that the biological activity of
a given species is specific for the species and is different from
that of another species. It is possible that, facing a given stimulus,
two species may react the same way, may react differently, may
react in the opposite way, and you cannot forecast. As a simple
example of this point, let us take our closest relative in evolution,
chimpanzees. We had common ancestry about five million years ago—which
is yesterday in the scale of evolution. If you inject into a chimpanzee
the AIDS virus HIV, it does not develop any disease and it will
go on living the 46 or 50 years the of normal life of a chimpanzee.
If you inject this animal with the hepatitis B virus, for instance,
one out of 10 will develop some kind of hepatic disease, but it
will recover very quickly. In our own bodies, hepatitis B gives
rise to chronic hepatitis and sometimes, unfortunately, to liver
cancer. If you inject this animal with the Ebola virus, for instance,
it will die of haemorrhagic fever, and so would we. You see in
these three examples how our closest relative in evolution, the
chimpanzee, behaves in an opposite way—AIDS is of no concern
to him, of course in humans it is a big problem—differently
(HBV) and similarly (Ebola). You cannot forecast what is coming
out of animal model experimentation. It may happen to be similar,
but, even if it is similar in the short term, it is possible that
it will turn out on the long term, say at a 10/20 year delay,
to have a very different outcome. Many animals, rodents for instance,
are used heavily to test chemicals for carcinogenic effects. Now,
spontaneous carcinogenesis in rodents, in mice for instance, begins
at about 10 months, in humans past the age of 40 years. Obviously,
the mechanism of cancerization in rodents is quite different from
that in humans. Furthermore, even assuming that rodents are faithful
models for human carcinogenesis, how can rodents, who live some
20 to 30 months, assess cancer risk for humans, knowing that for
the latter it takes on average 5 to 10 years between cellular
displasia and diagnosis of the resulting tumor?
1706. You are saying there is no possibility
of a read across from one species to another, that they are all
totally discreet.
(Dr Reiss) That is true by the very definition of
a species.
1707. Do you want to add anything?
(Dr Menache) If I may add a few sentences, my Lord
Chairman. The principal aims of Doctors and Lawyers for Responsible
Medicine, in addition to what Dr Reiss has mentioned, is to encourage
meaningful dialogue between the general public and the scientific
community—we think it is really important to have open discussion—on
issues deserving of urgent public debate in the field of public
health and medical research; for example; animal experimentation;
genetic engineering; xenotransplantation; patients' rights; and
so forth. In response to your next point, by "Responsible
Medicine" we mean primum non nocere (first do no harm).
We also mean respect for all life. We also refer to public accountability,
transparency in medical research, medicine based on sound methodology,
and the application of patients' rights. As far as I am aware,
the UK still lacks a bill of patients' rights. Animal research
is necessary in veterinary medicine. However, every effort should
be made to make progress through the observation and treatment
of animals which are already diseased and not through making healthy
animals ill by artificial means.
1708. When you say you aim to enter into a dialogue
between the science community on the one hand and the general
public on the other hand, could you give me some "for instances"
how that takes place?
(Dr Menache) Yes. There are all sorts of issues actually
in the modern day: for example, cloning; for example, the use
of human embryonic stem cells. I feel it is very important that
the public has a full say before scientists go ahead.
1709. Through what medium do you communicate
this to your fellow scientists and medics and the general public?
(Dr Menache) I think it is actually at the governmental
level. It is government, for example, which could use the advice
of a public committee—for example, the Danish-style public
committee, which is a group of people who interview the experts
and then give their conclusions to, let's say, the government
regulatory body.
1710. In other words, you are campaigning for
an institutional creation which would undertake this sort of dialogue,
rather than you yourself initiating this dialogue through various
forums in public and with your fellow scientists.
(Dr Menache) Yes. We encourage the active participation
of the public and I think at some stage it has to be institutionalised,
yes.
Lord Soulsby of Swaffham Prior
1711. Can I be clear from what you have said
and what you have written, that you believe that all work to develop
new approaches to human disease can be done on humans and not
on animals.
(Dr Reiss) Yes. But, by humans, you mean systemic
response; that is whole body. No, we start studying what is going
on on cells, on human cells. Human cells.
1712. I am sorry to interrupt you, but for human
diseases, human illnesses, you believe that animals play no role
in developing new approaches to human diseases.
(Dr Reiss) That is exactly what I mean.
1713. But your colleague has just said that
it is permissible to use animals in experiments for animals, if
I heard correctly.
(Dr Menache) Yes.
(Dr Reiss) There is no contradiction here that I can
see.
1714. If I may just carry on, in your submission
you published a paper by Dr Liela Harvey, in which she says, "Drugs
and environmental pollutants are the major cause of the following
health statistics . . ." and then lists: cancer; heart disease;
diabetes; and auto immune diseases. I would submit to you that
those are all diseases of an ageing population. These are geriatric
disorders; they are not really caused by the misuse of drugs or
animal testing. They are part of normal life as we grow older,
but how can you link that to the misuse of drugs? I am not sure
I can get a connection here. I hope you can help me.
(Dr Reiss) Of course there are defects in our cells
which we inherit from our parents and also which we acquire from
the environment which give rise to diseases like the ones you
mentioned. For instance, at the age of 60 usually people start
getting some neurological diseases, like Alzheimer, etc, but no
animal so far has developed this kind of disease. There have recently
been attempts to create a mouse model for Alzheimer and to develop
a vaccine against this. It failed.
1715. I am sorry to interrupt you, but the paper
says, "Drugs and environmental pollutants are the major cause
of the following . . ."
(Dr Menache) I am sorry, my Lord, Chairman, could
I interrupt? Liela Harvey is no longer with the organisation and
I think it is unfair to ask Dr Reiss to respond to a document
presented by Liela Harvey if she is not here in person to defend
it. We subsequently presented another paper to the Committee.
Earl of Onslow
1716. I am sorry, this paper was submitted by
your organisation. If that is the case, are you saying that this
paper is all a load of rubbish?
(Dr Menache) No.
1717. Therefore, it is perfectly reasonable
to have asked the question. I am sorry, my Lord, Chairman, I wanted
to make that point. You say the ". . . undisputed deterioration
of the health of the nation." How does that lie with the
fact that we are all living longer? Is it a sign of sickness that
we live longer or a sign of health that we live longer?
(Dr Reiss) I do not know about the British/UK statistics
on deaths, for instance, due to cancer. I know the figures in
France. We have more than doubled within 30 years the number of
diseases due to cancer. If you incorporate into these figures
the extent of the life expectancy and the increase of the population
without taking account of the fact that the treatment of cancer
has improved tremendously over the past 10-20 years, we still
have about a doubling of the number of cancer diseases within
the last 30 years. So you must understand that, indeed, there
are environmental factors, especially using chemicals, especially
pesticides, which are hugely responsible for many disorders in
humans. You have these endocrine proliferators. Many pesticides
mimic hormones and can start proliferation of cells—all
cancers depending on hormones in humans, like breast cancer in
women or ovarian cancer, prostrate cancer in men has increased
tremendously over the past 20 or 30 years. The same is true for
neurological diseases—90 per cent of insecticides are neurotoxic.
It is proven now that many of these pesticides are responsible
for Parkinsonism. There is direct proof of this.
1718. Dr Reiss, you still cannot answer me,
as a non-scientist, this fact: if people are living longer why
is the health of the nation deteriorating. That seems to me so
contradictory.
(Dr Reiss) No, there is no contradiction because actually
medical science has improved very much. Presently we can diagnose
very carefully what is going on in the body of an individual.
We can target the precise cells which are in cause. We can determine
in the enzymes within a cell which are responsible for the disease,
and we can now propose therapies which can, indeed, get around
the problem. So I think the increase of the life expectancy in
humans, in developed countries especially—
1719. What you are telling me is this: we can
now cure more diseases and people are living longer and therefore
the health of the nation is falling. I am very sorry, Dr Reiss,
but I cannot follow that logic.
(Dr Reiss) You must look at the statistics.[1]
1 Note by the Witness: The increase of life
expectance is the consequence of better cure, not of less diseases
and specially not of less prevalence of diseases, as testified
by morbidity and mortality statistics of cancer and dementia. Back
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