The ninth episode of the series "Human 2040", entitled "I take care of myself", shows what solutions may soon support us in taking care of our health. How can technology improve our physical fitness? Will genetic diseases in the future be diagnosed and treated even before birth? And how might a pill we swallow allow us to control our body's condition? In the latest part of the "Man 2040" series, analysts from Polityka Insight discuss such issues as personalized medical therapy or the development of bionics. In the podcast on trends in taking care of oneself, the guest of Andrzej Bobiński, managing director of Polityka Insight, is Daria Abramowicz - a sports psychologist who has been working for many years with athletes, coaches, sports and business organisations, as well as parents of athletes of different ages, both in individual and team sports.

A CHINESE PROVINCE TESTS THE HUMAN 2.0 PROGRAM

The authorities of the Chinese Province of Hubei have announced a pilot program providing for the removal of restrictions on the modification of human embryo genetic material. A study group of 1,000 couples will not only be able to stop the inheritance of diseases, but also decide on selected external and internal characteristics of their children, such as height and eye color, but also intellectual and physical predispositions. The test will not allow the creation of human embryo hybrids with elements of genome of other species.

The controversial liberalization is a part of the ‘research section’ of the next National Prodemographic Program (NPP) announced by the Communist Party of China (CPC). The aim of the legislation is to stop demographic decline and aging of the population. The turnaround in the family policy of the CCP took place in 2015 when it was decided to move away from the ‘one child policy’ and couples were allowed to have two children, and then three children in 2021. Despite efforts by the authorities, Chinese citizens are not deciding to start families because of the need to change their lifestyles and the high costs of raising children. Although ethically questionable, the possibility of ‘modifying’ future offspring, together with the ‘from the cradle to adulthood’ financial support program, is intended to change this attitude.

Modifying human embryo genes to eliminate inoperable diseases (e.g. Huntington disease) has been common practice for several years. In many countries, however, the controversy over defining and shifting the boundaries of the permitted scope of change continues. These issues are regulated differently, but so far, no country has chosen to legalise the adaptation of the characteristics of the foetus to the wishes of parents. Such a practice was the domain of a thriving underground world of illegal clinics, where far-reaching gene modifications were common practice, albeit exclusively reserved for the richest. 

This is not the only shocking solution provided for in the NPP. In the event of insufficient improvement in the fertility rate by natural means, the Chinese government envisages, within five years, a pilot ‘embryo generation’ program in artificial wombs using genetic material owned by government research agencies. This evolving technology, which previously replaced incubators, now enables premature babies to survive for up to several days. Soon it is expected to permit foetal development from as early as artificial insemination in a test tube. 

‘HERE’S TO YOU’ PHARMACIES CLOSE THEIR LAST OUTLET

The outlet in Bielawa (part of the Wrocław and Świdnica megalopolis area) will remain open until the end of the year. The decision is a natural consequence of changes in the purchasing habits of Poles and the multifaceted revolution of the healthcare system, which has been taking place for years. The owner of the largest pharmacy network in Poland has not yet decided to close its traditional online shop, although automatic purchases made by e-physicians, i.e. algorithms using information provided by sensors located on and in the patient, account for 80% of orders.

In the last 15 years, sales in brick-and-mortar pharmacies, like stores in other market segments, have continued to decline and have stopped at 5-10%. However, in the case of the medicine market, there is no factor that has given a second life to some of the stores and shopping centers – the consumer does not need to try, see and physically interact with the product. Clothing stores have turned into ‘showrooms’ and traditional pharmacies have lost their meaning. In recent years, the facilities were mainly acting as pick-up stores where patients received medicines previously ordered. With improved logistics solutions responding to the so-called last-mile problem and adequate conditions for the transport and storage of medications (standalone drones or refrigerated vehicles), this aspect has also lost its meaning.

The fate of traditional pharmacies was also determined by the development of medicine and medical technologies, which have accelerated over recent years. Medicines available on the shelf with one specific dose and form (e.g. pills) have lost their raison d’etre. With the data collected and analyzed on an ongoing basis by algorithms and medical applications, it is possible to develop personalized medicaments, with a composition and structure that best respond to the biological needs or shortages of the particular organism. The whole process, from diagnosis, through ordering and delivery, until the medication is taken by the patient, is usually carried out without human involvement.

The phasing-out of pharmacies is also complementary to the ongoing changes in health protection. Nanotechnologies and miniaturization of medical devices have led to an increasing number of treatments and medical services in homes. Hospitals receive only the most difficult cases where non-standard treatment requires direct supervision or the involvement of a physician – a human. Others, in the privacy of their homes, use medicines and health analysis devices, which are ordered by virtual health assistants. Smart pills swallowed by patients provide live information and data from the human body: from gas concentrations and poten-tially hazardous substances to microcamera images to better diagnose malfunctions of the heart, stomach or other organs. Nanorobots, in turn, are micro-devices that support and pinpoint precise operations both outside (e.g. retina) and inside the body, but also perform needle biopsies. This type of treatment is not only more effective but also significantly reduces the period of convalescence of patients and the risk of post-treatment complications.

The abandonment of brick-and-mortar pharmacies is a decision that, although commercially justified, will have negative effects on some parts of society. People in rural areas and small towns will suffer the most. Older people usually living there already (because of digital exclusion) do not have access to the highest level of healthcare, and sometimes even to basic medical services. For them, the brick-and-mortar pharmacy was the last place where they could purchase necessary medicines and consult about their ailments ‘live’ with a doctor or pharmacist.

ATHLETES WITH BIONIC MODIFICATIONS WILL COMPETE IN THE NEW DELHI 2044 OLYMPIC GAMES

The International Olympic Committee has decided to allow athletes using, among other things, bionic prostheses to participate. During the event, which will take place in four years, the division between traditional and bionic athletes will be maintained. From the next Olympics onwards, everyone will compete together.

The IOC Decision is another step towards restoring the popularity of the Olympic Games. The actions taken so far, namely the introduction of disciplines geared closer towards younger audience (e.g. skateboarding and breakdance in the 20s) or the revolution in the 30s, allowing competition in several e-sport disciplines, have not produced the desired results. The Olympic Games, or more widely traditional sports events, have attracted a smaller audience for several years than the leagues and competitions organized by private operators, where bionic athletes compete. Their contests, available online in pay-per-view systems, are more spectacular and the contestants themselves achieve better results than traditional athletes.

The decision of the IOC will probably result in a complete departure from organizing the Paralympic Summer Games. The development of bionics has made it possible for people with disabilities and post-accident injuries to regain full function of their organs or to replace them with bionic prostheses directly controlled by the brain thanks to BCI (brain-computer interfaces). In the latter case, their results even outweighed those of traditional athletes. In the long term, athletes who rely exclusively on their own bodies will not be able to compete with bionic athletes.

The scope of permitted modifications of the organism remains a matter to be clarified by the IOC. Bionic prostheses will certainly be allowed, and exoskeletons, i.e. external devices covering the whole body or a selected part (e.g. legs), are not likely to raise much controversy. There may already be concerns, for safety reasons, about the modification of eyeballs (in shooting sports) and breathing organs (in swimming), which are technologies that are still in their infancy.

Undoubtedly, the challenge for the Olympic Committee will be to ensure the safety of competition. Most of the technologies that will be allowed from 2044 were originally developed for military purposes, enabling the creation of ‘‘super-soldiers,’ technologically supported and modified recruits used in wars, but also to help combat the negative effects of climate change. While the technologies themselves are not dangerous, due to the extreme performance of bionic athletes (e.g. speed, height or impact force), they carry a higher risk of injury or even death. According to critics of the IOC, the Olympic Games will be turned into a ‘death games’ (a reference to the dystopian series of novels written by Susan Collins at the beginning of the 21st century). The IOC, in allowing bionic athletes, also failed to address the ethical aspect of the problem of replacing organs with bionic ones by fully healthy people. This will certainly be done by most traditional athletes who want to be counted among the medal winners.