Nafeez Ahmed explores the troubling implications and assumptions of the Government’s AI-driven gene programme.
In Part 1 of this investigation, I looked at how the convergence of an AI Superstate and corporate interests with health data lies at the heart of a new frontier for profit and surveillance. But the Government’s response during the COVID-19 pandemic has revealed something even more profoundly disturbing: a fascination with genomics which moves from a merely descriptive tool to something so prescriptive it verges on eugenics.
The NHS AI-driven Gene Programme
The NHSX app is simply one project with a questionable design which appears to result from the Government’s much wider project to remake the NHS.
At the core of the new NHSX AI drive is the goal of “predictive, preventive, personalised and participatory medicine”, according to an NHSX document published in October 2019. Pivotal to this AI-driven transformation is genetics:
“Key to unlocking the benefits of precision medicine with AI is the use of genomic data generated by genome sequencing. Machine learning is already being used to automate genome quality control. AI has improved the ability to process genomes rapidly and to high standards and can also now help improve genome interpretation.”
The NHS Genomic Medicine Service is starting with a focus on cancer, rare and inherited diseases, but its broader goal is far more comprehensive. Initially, the hope is that genomics will “expand to cover other areas, such as pharmacogenomics, which looks at how an individual’s genes influence a particular biological process that mediates the effects of a medicine,” according to The Pharmaceutical Journal.
But the end-goal is to convert the NHS into a health service oriented fundamentally around the role of genetics in disease. The aspiration is that “from 2020, and by 2025, genomic medicine will be an embedded part of routine care” to enable better prediction and prevention of disease and fewer adverse drug reactions. The GMS aims to complete five million genomic analyses and five million early disease cohorts over the next five years.
By 2025, genomic technologies will be “embedded through multiple clinical pathways and included as a fundamental part of clinical training. As a result, it is hoped that there will be a new taxonomy of medicine based on the underlying drivers of disease”.
But, this entire premise is deeply questionable. There is little evidence that the “underlying drivers of disease” are primarily genetic.
Last December, a study in the journal PLOS One found that genetics usually explains no more than 5-10% of the risk for several common diseases. The study examined data from nearly 600 earlier studies identifying associations between common variations in the DNA sequence and more than 200 medical conditions. But its conclusion was stark: more than 95% of diseases or disease risks – including Alzheimer’s, autism, asthma, juvenile diabetes, psoriasis, and so on – could not be predicted accurately from the DNA sequence. A separate meta-analysis of two decades of DNA science corroborated this finding.
The implication is startling: that the entire premise for the billions of pounds this Government is investing in building a new privatised NHS infrastructure for AI-driven genomic medicine is scientifically unfounded.
Behind the NHS Genomics Plan: An Eugenics-Inspired Agenda?
The obsession with genetics can be traced directly back to the Prime Minister’s chief advisor, Dominic Cummings.
Cummings set out his vision for the NHS in a February 2019 blog, which – although previously reported on – has not been fully appreciated for its astonishingly direct implications. While focusing on disease risk, the blog flagged-up Cummings’ hopes that a new NHS genomics prediction programme would ultimately allow the UK to, not just prevent diseases, but to do so before birth – in effect a nod toward the selective breeding techniques at the core of eugenics.
They are using the COVID-19 crisis to erect a corporate superstate powered by mass surveillance and AI. Their grim ambition is to reach into the very DNA of every British citizen.
His vision for what a genomics-focused NHS would look like bears startling resemblance to the core ideas of eugenics – the discredited pseudoscience aiming to improve the genetic quality of a human population by selecting for superior groups and excluding those with inferior genes. Its worst manifestations were exemplified by the Nazis.
In the blog, Cummings wrote:
“Britain could contribute huge value to the world by leveraging existing assets, including scientific talent and how the NHS is structured, to push the frontiers of a rapidly evolving scientific field – genomic prediction.” He called for “free universal ‘SNP’ [single-nucleotide polymorphis] genetic sequencing as part of a shift to genuinely preventive medicine”, to be rolled-out across the UK. This approach holds the promise of “revolutionising healthcare in ways that give Britain some natural advantages over Europe and America”.
Later in the post, Cummings allowed himself to speak more directly to what “natural advantages” could actually entail. He claimed that a combination of AI-driven machine learning with very large genetic sampling could enable the precise prediction of complex traits such as “general intelligence” and “most diseases”.
The two scientists Cummings cited as the primary sources for his vision were educational psychologist Robert Plomin and physicist Steven Hsu.
Plomin, described by Cummings as “the world’s leading expert” on the subject, is a renowned scientist. But he also has a history of association with the eugenics movement, according to Dr David King, founder of Human Genetics Alert and previously a molecular biologist. (Sir David King, the former chief scientific adviser to the UK Government, has also criticised the “genome sequencing goldrush”).*
When The Bell Curve – a book advocating the genetic inferiority of African Americans – was published, Plomin was a key signatory to a statement defending the science behind the book, explained Dr David King in a paper for the non-profit watchdog Human Genetics Alert. The statement carefully avoided explicitly endorsing The Bell Curve’s racist conclusions (aptly summarised by Francis Wheen as “black people are more stupid than white people: always have been, always will be. This is why they have less economic and social success”), while failing to repudiate them. Plomin’s fellow co-signatories included several self-proclaimed scientific racists, Philippe Rushton and Richard Lynn. Plomin has also published papers with the American Eugenics Society and spoken at several meetings of the British Eugenics Society (the latter rebranded itself as the Galton Institute in 1989) – both of which advocated racial science.
In December 2013, Plomin was called as an expert witness to the House of Commons’ Education Select Committee, where he called for the Government to focus on the heritability of educational attainment. Twenty-five minutes into the session, Dominic Raab – who as Foreign Secretary and First Secretary has stood in for Boris Johnson during his period of absence due to COVID-19 – prompted Plomin to focus more specifically on explaining his views about genetics, intelligence and socio-economic status.
Just two months before Plomin’s parliamentary testimony, a 237-page dossier by Cummings – then a top advisor to Education Secretary Michael Gove – was leaked to the press. The paper claimed that genetics plays a bigger role in a child’s IQ than teaching and called for giving “specialist education as per Eton” to “the top 2% in IQ”. Pete Shanks of the Centre for Genetics and Society described Cummings’ policy proposal as a “blatantly eugenic association of genes with intelligence, intelligence with worth, and worth with the right to rule”.
The Cummings dossier – which cites Plomin extensively – further reveals that, according to Cummings, he “had invited Plomin into the DfE [Department for Education] to explain the science of IQ and genetics to officials and ministers”.
The Education Select Committee’s report shows that, at the time of Plomin’s testimony, the Government was resistant to these views. But, the position appears to have changed since then, with figures such as Cummings, Raab a