INFORMATION IS THE BLOOD OF THE NATION
By
SENATOR MIRIAM DEFENSOR SANTIAGO
(Keynote speech at the 30thAnnual Convention of the PhilippineBlood Coordinating Council
held on 28 August 2013 at the Crowne Plaza, Galleria Hotel)

The Search for Synthetic Blood

The Philippine population is becoming old. Over the coming decades, we shall have more and more senior citizens who are likely to suffer from chronic and debilitative diseases. At the same time, there will be fewer and younger donors. Thus, the search for more blood is a long-term concern.

There is a quiet but strong need to augment the regular blood supply, particularly during times of shortage. Shortages occur when people are on holiday, or when there is a sudden increase in demand. In the words of Professor Marc Turner, director of the Edinburgh University's Scottish National Blood Transfusion Service: "We are 100% dependent on our blood donors and on generosity, and that is not going to change anytime soon."

One problem is that blood shortage occurs not only in the Philippines , but also in the entire Third World. The developed world has a blood donor base far bigger than that of the developing world. Experts recently said that there are over 100 million units of blood collected around the whole world each year, but around 60% go to developed countries.

Another key issue of our time is transfusion-transmitted infections. In the past, many countries had to deal with infections like HIV, Hepatitis B and Hepatitis C. Now the new testing regimes render the blood supply very secure, and yet there are always new, emergent infections on a worldwide basis. Hence, all Filipinos should support our country's National Blood Program.

I shall try to survey very briefly the history of the search for synthetic blood.

In 2009, in Britain, scientists announced that they had launched what could possibly be unlimited amounts of synthetic human blood from embryonic stem cells for blood transfusion. In effect, the project would produce "synthetic" blood made from the stem cells of spare IVF embryos. The goal is to revolutionize vital blood transfusion services, so that they would no longer rely on a network of human donors. The researchers tested human embryos left over from IVF treatment to find those that are genetically programmed to develop into the "O-Negative" blood group, which is the universal donor group. Its blood can be transfused into anyone, without fear of tissue rejection.

But this proposal involved the destruction of embryos to create stem cells. Thus, it raised difficult ethical and philosophical questions, specifically of whether the synthetic blood will have come from someone who never existed.

Two years later in 2011, in China, scientists announced they could use rice to make albumin, a protein found in human blood. Albumin is often used for treating burn trauma, shock, and liver disease. The experts said that blood protein from rice is "physically and chemically equivalent to blood-derived human serum albumin (HSA)."

The Chinese first genetically engineered rice seeds to produce high levels of HSA, then they purified the protein from the seeds. But at the same time, the researchers said that more research is needed to evaluate the safety of the rice-derived protein in animals and humans, before it could be considered for the market.

In the same year 2011, at the University of Paris, a team of researchers led by Professor Luc Douay succeeded in producing blood cells in a petri dish that could serve as back-up blood supply. The researchers used hematopoietic stem cells (HSCs) that give rise to all blood cell types. HSCs were obtained from a human donor. The researchers managed to generate billions of red blood cells (cRBCs) in culture and get them back into the donor body.

Incredibly, the life span and survival rate of the cultured cells imitated the way that blood from a human donor is introduced into the donor body. The researchers said: "The results from our study established the feasibility of the concept of transfusing cRBCs and show promise that an unlimited blood reserve is within reach."

In 2010 in the United States, the Pentagon reported that scientists working for an experimental agency managed to develop artificial blood for use in transfusion for wounded soldiers in battle field. The artificial blood is made from hematopoietic stem cells from discarded human umbilical cords. These stem cells are turned into large quantities of red blood cells. It uses a method called "blood pharming" that mimics the functions of bone marrow. The researchers defined pharming as "a method of using genetics on engineered blood of animals to create medical useful substances in large quantities." They said that, for example, using this process, the cells from one umbilical cord could produce about 20 units of blood, enough for over three transfusions for an injured soldier. At that time, 2010, the scientists said that a unit of blood - around a pint - could cost $1,000, much less than the price in 2010 of $5,000.

Last year 2012, in Stanford University, researchers found that young blood can reverse some effects of ageing, based on research. This thesis was proposed after a study showing that blood from young mice improved learning and memory in older mice, and increased connections between its brain cells. It also showed that a number of stem cells in the brain had increased. Professor Saul Villeda who led the research team said: "At some point in the future, people in their 40s or 50s could take therapies based on the rejuvenating chemical factor in younger people's blood against the debilitative issues of ageing."

My personal comment on this particular development is that it can speed up the population of vampires.

This year, in May 2013, in Scotland, scientists were able to obtain permission to conduct the world's first trials in humans of synthetic blood. Its goal is to use stem cells to improve blood on an individual scale. The researchers said they would concentrate in stem cells from adult donors, and no longer on the controversial embryonic cells.

These stem cells from adult tissues are known as induced pluripotent stem cells. The cells are taken from an adult and specifically tested so that they regress to a state with qualities similar to embryonic stem cells. The Scot scientists hope that their move away from embryonic stem cells would help to appease concerns of prolife campaigners who have continued the use of embryo as a way of harvesting "spare parts" for medical research. Their goal is also to produce stem cell blood that will cost less than £500 a pint.

But other scientists were quick to point out the potential implications of synthetic blood. They raised certain serious socio-economic and ethical issues. According to Ruha Benjamin, a sociologist at Boston University, one potential implication is that the production of synthetic blood will involve big money, in order to offer a stipend to donors. But stipends have produced professional guinea pigs who are transient workers who make a living by participating in clinical trials. They are paid roughly $15,000 to $20,000 for each trial.

The donors should have bodies that are not already full of drugs. This means that there would be more exploitation of the working class, and maybe even outsourcing to developing countries.

The second implication is that if the researchers of synthetic blood choose to patent their technology, that might destroy a lot of potential for future research on the process. The price tags on synthetic blood will be high. One pharmaceutical is now charging more than $3,000 for a test that would generically cost about $300.

The Search for Information

Let us now go to politics. After the inspirational People's March at the Luneta last Monday, the next stop after abolishing the pork barrel should be to provide information on the internet on how much income every individual public officer makes monthly. It appears that the monthly official income of a senator is merely P90,000 monthly; but this is misleading because in reality, it is much more.

In truth, Congress has devised a labyrinthine method of paying individual senators and congressmen very much more than their salaries under the Salary Standardization Law. It is like the ancient Japanese capital cities which were designed with labyrinthine roads to prevent the enemy from penetrating the ultimate castle of the shogun.

Here are the sources of a senator's approximate income:

Salary                                                        P90,000
If chair of two oversight committees               70,000

As member of seven oversight committees    210,000

As member of Commission on Appointments  200,000

Approximate Total Monthly Income      P570,000

And in addition, here are the discretionary funds under the control of a senator:

Budget for Office of the Senator          P1,522,240 to P2,302,425

Budget for the Permanent Committee  P1,228,995 to P2,295,732

Approximate Total                             P2,751,235 to P4,598,157
Monthly Discretionary Funds

If we add up all the sources of individual income, a senator could be making P600,000 to P5M monthly. And this does not include the commission of 10% to 50% from the pork barrel.

And there is more. If the senator is elected as one of the Senate officials, that senator gets even much more than his colleagues. The 2011 COA report said that in addition to the personal income of a senator, the following officials received much more just being officers of the Senate:

Enrile         As Senate President        P 71.7M
Estrada      As Senate Protempore       P 9.3M
Sotto         As Majority Floor Leader    P 9.3M
Cayetano   As Minority Floor Leader   P 10.2M

Therefore, I propose that a government website should make information available on the range of income that a senator or a representative makes monthly, together with a specification of all discretionary funds at his disposal. The website should also contain a list of all discretionary funds, by whatever name - pork barrel, Maintenance and Other Operating Expenses (MOOE), intelligence funds, etc.

We need to democratize information, because the 1966 International Covenant on Civil and Political Rights, to which the Philippines is a party, provides that access to information is a basic human right. Moreover, the Philippine Constitution provides in our Bill of Rights: "The right of the people to information on matters of public concern shall be recognized." (Art. 3, Sec. 7). Access to information is necessary for self-preservation of the nation. For example, Harvard economist and Nobel Prize winner Amartya Sen observed that there has never been famine in a country with a free press. To avoid being tagged as failed state, we must now stabilize our democracy with computer network by connectivity.

Particularly, I advocate a program similar to the Open Government Initiative started in 2009 by the Obama administration. Under President Obama, the US government has developed a website called Data.gov to make government data available to everyone.

I am particularly excited by the example of the IT dashboard, a site that enables the public to track federal technology investment projects. The IT dashboard would be able to show the citizens which IT projects are over budget or behind schedule. We can replicate this government dashboard for each pork barrel project, if pork barrel continues in2014; as well as for each discretionary fund of every public official, national and local. A provision for a government dashboard should be part of the FOIA.

It is a natural consequence of the People's March last Monday that netizens should now call for passage by Congress of the Philippines Freedom of Information Act (FOIA). The American version was passed way back in 1966.The FOIA will not require agencies to answer specific questions or to create documents. Instead, it will merely require government agencies to produce records they already have in their possession, such as rules, opinions, orders, files, and proceedings that they have created or that they control, that exist in any format -as paper, photos, film, digital bytes, or three-dimensional objects. Under this proposed bill, anyone can request information from the government. The requester's identity and purpose are irrelevant.

In the US, the justice department maintains a FOIA site that provides contact information for all federal agencies. All requests for information must be submitted in writing. The request does not need to precisely name the document. Agencies will be entitled to charge reasonable fees for research time and duplication costs. But certain favoured requests - such as those from media representatives, as well as from educational and non-commercial scientific institutions - should be given two hours for search time and the first 100 pages free. An agency should have 20 business days to fulfil the request.

Although the US Congress passed the FOIA in 1966, it amended the law in 1996 to apply to electronic records. Therefore, our present bill should require agencies to publish on-line indices of documents they possess. Certain indices should include full-text documents for download.

Government agencies should have the discretion, but not the duty, to deny a request for information if it falls under nine exemptions:

1. National security
2. Internal agency personal rules and practices
3. Information exempted from disclosure by other statutes
4. Trade secrets and commercial or financial information that is privileged or confidential
5. Interagency or intra-agency memoranda or letters that would not be available by law to a party other than an agency in litigation with the agency.
6. Personal and medical files or similar files that would involve an unwarranted invasion of privacy.
7. Investigatory records of law enforcement agencies
8. Reports prepared on behalf of agencies that regulate or supervise financial institutions
9. Geological and geophysical information.

In 2007, the US Congress passed the Open Government Act. It established an office in the National Archives and Records Administration to review agency compliance with FOIA policies and procedures, and to offer mediation services. In the US, the National Security Archives is an independent depository for documents obtained under the FOIA. The archive is housed at George Washington University in Washington DC. Each year, it names the government agency with the worst FOIA record. The Philippines should provide for a similar National Security Archives.

Meaning of the People's March

The People's March last Monday meant that our people are exploring an agenda for peaceful protest and dissent against the lust for money among our present generation of politicians.

This is the same message in the poem "Battle Hymn of the Republic" by Julia Ward Howe, which I recite to you:

Mine eyes have seen the glory of the coming of the Lord:
He is trampling out the vintage where the grapes of wrath are stored;
He hath loosed the fatal lightning of his terrible swift sword:
His Truth is marching on.
In the beauty of the lilies Christ was born across the sea,
With a glory in his bosom that transfigures you and me:
As he died to make men holy, let us die to make men free,
While God is marching on.