Sir

As you write in a recent editorial, the forthcoming 18th International Congress on Genetics in Beijing will provide a rare opportunity to continue discourse on the ethics and science of eugenics1. But a number of fundamental problems facing geneticists in China deserve mention. Without a thorough understanding and awareness of these problems and their cultural and psychological roots — as eloquently expounded recently by Chen-Lu Tsou2 — the discourse may not produce significant tangible results.

We acknowledge that the Chinese Maternal and Infant Health Law, which has been the focus of much recent debate, represents a well-intentioned step towards reducing the burden of debilitating diseases perceived to be hereditary. By sheer scale, the enormous social and economic cost to the most populous nation has no equal in the world, and would surely prompt any sensible society to react. Indeed, given the urgency of the population problem confronting the nation, it may appear logical to concentrate on the segments of its society considered the least productive and least able to contribute to the future, if a major effort is launched to reduce its population size3.

But the good intention of the law is seriously undermined by its shaky scientific foundations. For example, where is the evidence that 20 million people are handicapped by hereditary diseases? In a nation where more than half the adult male population smoke, and environmental pollution is rampant in some areas, could a significant proportion of those presumed hereditary handicaps be prevented by a reduction in smoking, a cleaner environment, and improved pre-, peri- and postnatal care? Should one take the current search for genetic mechanisms underlying many complex diseases or disorders, such as schizophrenia, as the fait accompli that these diseases are preventable through sterilization? How strong is the evidence that enforcement of the law alone will prevent many or all of the handicaps? Without solid documentation, any claims about the law and its intended effects are merely opinions, without scientific validation.

The fact, as pointed out by the sponsor of the law, that births of “inferior quality” are relatively more common among “the old revolutionary base, ethnic minorities, the frontier, and economically poor areas”4 suggests that many so-called “inferior births” may in fact be of environmental origin, and so preventable through improved living standards and better pre-, peri- and postnatal care (for example, taking folic acid, reducing perinatal trauma, and eliminating iodine deficiency).

The law was drafted with input from geneticists in China, but it is questionable whether the scientific part of the law was based on the best knowledge available. Judging from Chinese human genetics textbooks and scant publications in international journals, it is evident that basic research in genetic epidemiology is still in its infancy in China. This situation is undeniably the result of political turmoil and the chronic shortage of government funds for this type of research.

The lack of a rigorous grant review system allows scope for excessive importance to be given to popular acclaim and to the political goals of scientific research in allocating funding. In a country where political loyalty is often considered more important than scientific talent and integrity, this can be an effective strategy for attracting government funds.

Indeed, the recent substantial increase in funding for genetic research in China5 was largely the result of a letter to the Chinese president from a prominent geneticist urging protection of China's human genetic resources, because of the fear of losing the resources to foreign organizations.

As for issues relating to international collaboration, the importance given to popular acclaim and political goals can easily lead to narrow-minded nationalism, which can be generated by provoking painful memories of imperialist aggression and humiliation in the past. This type of nationalism, coupled with the lack of ‘checks and balances’ in the system, provides a recipe for abuse. Ironically, efforts to protect China's human genetic resources are seriously compromised by inadequate research in basic genetic epidemiology.

The best protection against over-politicization and ignorance may be an overhaul of China's research evaluation and grant review systems. For example, experts from other countries should be invited to participate in evaluating large scientific grant applications and research institutions. For a poor country such as China, this is also the best way to ensure that scarce and meagre resources are well spent. The science part of the eugenics law — which unfortunately has no quick fix — requires years of basic genetic research which will ultimately benefit not only the Chinese people, but all humankind.

The opinions expressed here are the authors' own and should not be taken to represent those of their institutions.