THIS WEEK

WORLD VIEW Quicker diagnosis is

key to the fight against
Ebola outbreak p.145
LEVITATION Double-magnet
trick manages to float
nylon screw p.146
Ebola: time to act
Governments and research organizations must
mobilize to end the West African outbreak.
A
fter disproportionate media attention on Ebolas negligible risk
to people in Western and Asian countries, the focus seems at
last to be shifting towards how to stop the outbreak in West
Africa. The grim reality is that medical organizations are struggling:
the flood of new cases far outpaces available beds and treatment
centres. Many of those who are ill are not receiving the basic health
care that could keep them alive.
The tragedy is that we know how to stop Ebola. Well-informed
communities can reduce the main routes of spread by avoiding
Genetic rights and wrongs
Australias decision to uphold a patent on biological material is in danger of hampering the
development of diagnostic tests.
brief to the US Supreme Court written by biologist Eric Lander, head
of the Broad Institute in Cambridge, Massachusetts, wounded the held
idea that isolating DNA changed it from a product of nature to a human
product, thereby making it patentable. He pointed out that isolated bits
of DNA can be found floating free in the blood, and that the isolated
BRCA1 and BRCA2 genes had in fact been found doing just that.
In Australia, no such limitation on patenting natural products exists.
Instead, the debate there has centred on whether the patent claims a
method of manu facture. Last week, five Australian justices unani-
mously ruled that it does, because to isolate
DNA from its natural setting requires effort.
This, they say, describes an artificially cre-
ated state of affairs for economic benefit, and
is therefore fair game for a patent.
The plaintiffs in the case are considering
an appeal to the High Court of Australia, and
some patient advocates are crying for changes to the law to do away
with gene patents.
For now, the Australian decision is certain to please patent law-
yers and some biotechnology executives. This seems to have been the
justices intent: the bulk of their rulings have focused on preserving
incentives for innovation and business. There has been little, if any,
attention from the court to what this means for science, or for patient
access to information about their genes.
Business concerns are important: the biotechnology industry depends
on patents for its livelihood, and many patients lives depend on the
industry. But the business model pursued by Myriad is a fading one,
and it is time to look to the future. That future has little place for patents
that could hold up the development of bigger and better medical tests.
I
t is perhaps unexpected that the United States the oft-lampooned
home of patents on peanut-butter-and-jelly sandwiches and ways
to swing a swing is emerging as one of the most hostile towards
patents on naturally occurring genes.
Last week, Australia had the opportunity to join the United States in
taking a dim view on such licensing of nature. But a federal court there
instead upheld a patent claim on the cancer-associated gene BRCA1. In
doing so, the country remains with Canada, Japan and several countries
in the European Union, all of which, unlike the United States, recognize
such patents.
The patent on BRCA1 has become a touchstone in the debate over
gene patents, a broad term that can cover a wide swath of patent claims
on DNA sequences. Certain mutations in BRCA1 increase the risk
of, in particular, breast and ovarian cancers. And Myriad Genetics,
a genetic-testing company in Salt Lake City, Utah, has aggressively
defended its patents, which cover the abnormal BRCA1 sequence and
tests to identify it.
In the United States, debate on gene patenting has been tied to clear
public-health concerns. Myriads monopoly bred worry that women
would have only a single option for BRCA1 testing, with no possibility
of receiving a second, confirmatory test elsewhere. So when advocates
challenged US patents on BRCA1 and the closely related gene, BRCA2,
the case provoked a passionate response from the public. The patents
were defeated in a landmark decision last year that changed decades
of legal practice in the field (see Nature 498, 281282; 2013).
Australia is in a different situation. The BRCA patents have not been
enforced there, either by Myriad or by the company that has licensed
them in Australia: Genetic Technologies of Melbourne. Despite the
fervent involvement in the case of patient advocates, including cancer
survivors, the spectre of gene patents in Australia remains more
theoretical.
Still, the case, and the attention it has received, shines new light on
how such patents will affect the future of medical diagnostics, par-
ticularly as genetic tests expand to cover large numbers of genes, and
even the full genome.
In the run-up to the US decision on Myriad, an academic subfield
was born from a handful of patent lawyers and scholars who wanted
to know just how many gene patents might be affected no easy task
in a system that awards around 300,000 patents a year. Answers var-
ied, but the general conclusion was: not as many as you might think.
One study found that most patents that mention DNA sequences do
not claim the sequences as an invention (O. A. Jefferson et al. Nature
Biotechnol. 31, 10861093; 2013). Nevertheless, even a few hundred
patents on genes can be enough to scare off potential investors and
entrepreneurs looking to pioneer methods of genetic testing, because
they might infringe on protected genetic property.
In the United States, gene patents were defeated because they ran afoul
of a prohibition on patents claiming a product of nature. An influential
Debate on gene
patenting has
been tied to clear
public-health
concerns.
INTERRUPTED Amorous frogs
prove easier target for
hungry bats p.146
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Orbital assembly
The space launch of a 3D printer does not
herald a brave new era but it is a good start.
P
erhaps the most famous DIY job ever done in outer space was
performed in April 1970 after an explosion disabled Apollo 13
on its way to the Moon. The three astronauts on board the craft
scrambled together a makeshift adapter from cardboard, plastic bags
and duct tape to scrub poisonous carbon dioxide from the air.
What if they had had access to a device that could design and manu-
facture replacement parts to order?
Last year, an engineer demonstrated just such a device: a three-
dimensional (3D) printer. Working for Made in Space in Moffett Field,
California, the engineer spent an hour on the computer designing an
adapter for the Apollo 13 scrubber, and the rest of the day printing it
and demonstrating how it would work. Problem solved?
Perhaps it would be if every spacecraft had a 3D printer. Working
with NASA, Made in Space is about to launch the first such printer into
space (see page 156). If dreamers have their way, it will be the start of
a new generation of manufacturing in orbit.
Imagine a rocket carrying little but a machine that can print the
infrastructure for a colony on Mars. Or a spacecraft that can unfurl
robotic tethers, printing and braiding giant ribbons into a starshade so
that a telescope can stare, unblinded, at extraterrestrial worlds.
If this sounds impractical, its because it is. For decades, enthusi-
asts have dreamed up ambitious ways to manufacture structures in
space. A 1970s concept known as the beam builder would have welded
aluminium tubes together to create huge trusses spilling out of the
back of the space shuttle. But in the 1990s, when countries began
building hardware components for the International Space Station,
they opted to do so in the familiar environment of planet Earth. Each
large element was sent into space individually; only once aloft were
the parts joined together to form the sprawling complex.
It would be wise to remember such lessons as the enthusiasm
for 3D printing runs high. In July, a US National Research Council
report concluded that there is a vast gap between what people think
the technology can do and what it really can. It is all very well to pack
a 3Dprinter for a journey to deep space but what should a space
traveller do when the printer itself breaks down? Carry a backup?
There is a place for 3D printing in space applications. Among other
things, designers on the ground can dream up bizarre and fanciful parts,
then print them regardless of many conventional design constraints.
In principle, this means slimmer spacecraft that are cheaper to launch.
That can be a big deal for an industry that must weigh every nut and bolt.
NASA is even talking about printing CubeSats, small box-shaped
satellites that can be launched in flocks from a single launch vehicle
or off the space station itself. A PrintSat, a CubeSat printed from a
polyamide-based material, is slated for launch later this year as a
test for how well such devices might survive in the harsh environ-
ment of space.
NASA is not alone. The European Space Agency is developing ways
to use plastic and metal printed parts on the space station; the Italian
Space Agency is hoping to send its own printer to the station in 2017.
Such experiments may not lead directly to
a Martian base, but that is no reason not to
encourage the fledgling technology. The maker
ethos has permeated everywhere, it seems
even beyond the gravitational pull of Earth.
unprotected home-based care of infected people and by modifying
traditional burial practices. Infection-control measures protect health-
care workers. Together with rapid identification and isolation of ill
people, and tracing and monitoring of their contacts for 21days (the
maximum incubation period of the disease), such measures have
stopped Ebola outbreaks in the past.
But the dysfunctional health-care infrastructure of the three coun-
tries at the centre of the outbreak Guinea, Sierra Leone and Liberia,
which are poor and struggling to emerge from years of war is simply
not up to the task. The nations need help, and urgently.
The international community must mobilize now. Aid is increasing,
but most of those involved, from governments and the World Health
Organization (WHO) to researchers, all initially underestimated the
threat. This is perhaps because most past outbreaks have been small
and relatively straightforward to control.
The WHO has a part to play, but contrary to a widespread assump-
tion, it does not have the in-house capacity to send large teams into the
field. The agencys funding for outbreak responses has been slashed,
and it has shifted focus to helping countries to reinforce their health
systems so that they can respond better themselves. How the interna-
tional community should best react to outbreaks, and what role the
bureaucratic WHO should have, is a debate for after this outbreak is
over. The pressing need now is to bring all available resources and
talent to bear.
It is a sign of how desperate the situation has become that on 2Sep-
tember, Joanne Liu, international president of medical group Mdecins
Sans Frontires (or Doctors Without Borders), called on countries to
immediately deploy their military and civilian bio defence teams
units that have been developed to respond to bioterror attacks. The
crucial priorities, she said, are to scale up isolation centres, deploy
mobile diagnostic labs (see page145), build a network of field hos-
pitals and establish dedicated air links to shift staff and equipment
to where they are needed. In short, a military-style response, with its
associated strong chain of command, logistical capacities and speed.
The concept makes a lot of sense and is an approach that governments
should consider adopting or explain why, if they choose not to do
so. US President Barack Obama indicated last weekend that he would
deploy the US military to assist in the outbreak.
It cannot be repeated enough that public-health measures and good
old-fashioned epidemiological tracking of the infected and their con-
tacts will bring this outbreak to an end. The
priority must be to scale these up, alongside
establishing more Ebola treatment centres on
the ground. For instance, Ebolas high death
rate could be slashed by better patient care, in
particular by giving intravenous rehydration.
A highly effective Ebola vaccine would be
a game-changer. A WHO-convened meet-
ing on 45September agreed on an unprecedented set of measures,
including relaxing regulatory requirements so that experimental drugs
and vaccines can be quickly tested under the difficult field conditions
of this outbreak, and perhaps even widely deployed. The measures
will, for example, permit expedited vaccine trials and informal clinical
studies of drugs that could produce useful initial data within months.
Regulators and researchers should be applauded for their speed and
pragmatism in exploring innovative methods for conducting trials
during this outbreak. Crucially, all those who organize trials must be
willing to standardize and share the data they collect to maximize their
scientific and medical value, and to allow rapid decisions to be made
on which products to prioritize.
West Africas outbreak illustrates the serious weaknesses in the
international communitys ability to respond to outbreaks of emerg-
ing diseases, despite years of debate. It should also hammer home a
truism for future planning the costs of setting up infrastructure to
ensure an early response are small compared with the huge social and
economic costs of a large deadly disease outbreak.
The pressing
need now is
to bring all
available
resources and
talent to bear.
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EDITORIALS THIS WEEK
2014 Macmillan Publishers Limited. All rights reserved