Abstract
In the Israeli ‘start-up nation’ biotechnology has emerged as one of the most thriving knowledge-intensive industries. Particularly the med-tech and repro-tech sector are widely regarded as world class in their ability to develop experimental therapies and medicines based on topnotch ‘pioneering’ biomedical research. These developments have rightly been attributed to the neoliberal turn of the late seventies when Israel started to position itself as significant player in the global health and research market. By exploring the (dis)continuities between Pergonal, a fertility drug developed in the late 1950s by the Israeli scientist Bruno Lunenfeld and the Swiss-Italian pharmaceutical company Serono, and the experimental stem cell therapies that are currently being developed by the Israeli biotech company Kadimastem, this article argues, however, that a much older, but still ongoing history of Zionist settler colonial warfare in Palestine/Israel also lies behind the emergence of Israel’s flourishing reproductive-embryonic industry. A Zionist demographic logic that aims to consolidate a Jewish majority in a Jewish state has created fertile conditions for the emergence of a reproductive-industrial complex in which the interests of a pronatalist Jewish state and a biomedical establishment – consisting of academic entrepreneurs, venture capitalists, biotech companies and pharmaceutical giants – have coalesced. The bodies of Israeli women play a pivotal role in this process, not only as reproducers of the settler nation but also as providers of the raw biological materials that are needed to produce experimental research results and to generate surplus bio-value.
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Notes
According to David Rosenberg’s analysis (Haaretz, 29 January 2015) Israeli start-ups raised $3.4 billion in investments in 2014, the most ever. Venture capital funds, which provide most of the investments for start-ups, drew in $910 million. Exits – money received by companies acquired or conducting initial public offerings – reached $6.9 billion in 2014, making it one of the best years ever. www.haaretz.com/blogs/david-s-harp/.premium-1.639703 last entry 1 March 2015)
In 2008, the OECD average expenditure on R&D was 1.9 per cent (OECD, 2008). In 2008, Israel was the highest of all OECD countries, with an expenditure on civilian R&D of 4.7 per cent of its GDP, mostly directed toward the industrial sector.
www.globes.co.il/en/article-doctors-perceived-as-most-respected-profession-1000927018 (last entry 24 February 2015)
Israel performs the highest number of IVF treatment cycles per capita in the world. In 2013, 3844 IVF cycles were conducted per million, while in Spain “only” 2051 and in the United Kingdom 661(ICMART, 2013 www.icmartivf.org/icmart-world-report-art-2004.pdf last entry 1 March 2015). In 2010, 34 538 treatment cycles were performed in Israel, resulting in 29 961 transfer cycles and 5 612 live births that equated 4.1 per cent of the total live births (Ministry of Health, Department of Health Information, Medical Facilities and Equipment Licensing Division, 2013). In that same year, in the United Kingdom 57 652 treatment cycles of IVF or ICSI were performed, resulting in less than 2 per cent of the total live births (HFEA, 2010 www.hfea.gov.uk/docs/2011-11-16_-_Annual_Register_Figures_Report_final.pdf last entry 1 March 2015). In Spain, 58 735 treatment cycles were performed in 2010, resulting in 17 014 live births which stands for 2.2 per cent of the total live births.www.eshre.eu/~/media/emagic%20files/Data%20collection/EIM/Manuscript%20EIM%202010%20published.pdf last entry 1 March 2015).
Although pronatalist, Israel’s reproductive policies should be viewed as highly stratified. The work of Amir and Benjamin (1992), Portuguese (1998), Kanaaneh (2002), Weiss (2002) and Vertommen (2015a, 2015b) has indicated that it was mostly European Jews or Ashkenazim and not and Palestinians and Arab Jews or Mizrahim that were encouraged to be fruitful and multiply.
Harvey (2005) has defined neoliberalism as a new capitalist mode of accumulation by dispossession that took shape in the late seventies as a way to resolve the Fordist-Keynesian crisis. According to Peck and Tickell (2002, p. 37) neoliberal projects consist of two phases. The roll-back phase refers to “the active destruction of Keynesian-welfarist and social-collectivist institutions through privatisation, deregulation, cutbacks in public services” while the roll-out phase refers to “the consolidation of neoliberalized state forms, modes of governance and new trade and financial regulations by international governance institutions in an attempt to create a competitive workfare state”.
Although I strongly sympathize with the critique of Birch and Tyfield (2012, p. 299) on the fetishization of everything ‘bio’ and the flawed interpretation of Marxist concepts such as surplus, bio-value, capital in some of the STS scholarship on the bio-economy, I do opt for the term bio-value as introduced by Waldby (2002) since her work puts strong gender emphasis on the role of women as reproductive laborers in the bio-economy.
Zondek mapped three human varieties of gonadotropins, one produced in the placenta during pregnancy and two extractable from the pituitary (Mashiach et al, 2010).
To extract gonadotropins the menopausal urine has to pass through a kaolin cake which absorbs the gonadotropins after which the crude gonadotropins can be extracted from the kaolin batch (Lunenfeld, 2013).
Israel State Archive, File 2, 40/15.
Some members of the Centre for Demographic Problems opposed the free distribution of Pergonal to all infertile women. A few doctors raised concerns about spending a big part of the Demographic Centre’s limited resources to an experimental drug such as Pergonal whose efficiency had not been tested properly. (Israel State Archive, File 2, GAL 2091/6, Centre for Demographic Problems, Letter from Professor Halpert 3 November 1969).
Israel State Archive, File 2: 40/15.
Personal archive Lunenfeld, Consulted on 28 August 2013 in Tel Aviv. Translated with the kind help of Tamar Novick and Bilal Dirbas.
This was not the first time in Israel’s history that experimental fertility research caused unforeseen side-effects, as was the case with the synthetic hormone diethylstilbestrol known as DES. This hormone was distributed to thousands of Israeli women between 1949 and 1975 in the erroneous belief that it would minimize the risk of pregnancy complications. However, investigative journalist Avi Valentine discovered that the drug manufacturers Teva and Assia, the Ministry of Health and the Health Fund were negligent in marketing a drug that was supposed to sustain pregnancies, contrary to the warnings in professional literature that it actually caused infertility and increased risk of cancer (Interview Avi Valentin, Herzliyya, 15 July 2013).
Spar (2006, p. 40) calculated that in 1991 Serono sold $260 million worth of fertility drugs and between 1992 and 2003 it doubled its sales. In 2003, the company’s sales rose by 31 per cent to $519 million, with a profit rate of 75 per cent, an astounding $390 million.
The Office of Chief Scientist in the Ministry of Economy is empowered by the Law for the Encouragement of Industrial Research and Development of 1984 to oversee all government-sponsored support of R&D within Israeli industry (www.economy.gov.il/madan last entry 7 February 2014)
Israeli biotech was given a boost by the establishment of a $222 million venture capital Life Sciences Fund which is being managed by OrbiMed Advisors, the largest healthcare investment fund in the world. The fund was initiated by an Israeli government tender and investment of $50 million. 13 companies are enjoying financial input from this venture capital fund (www.economy.gov.il/madan last entry 2 April 2014).
Yeda was rated first in the world in technology transfer revenues in 2006. In 2003, it has been reported yearly royalties income of $93 000 000. In 2003, more than three billion dollars worth of products licensed by Yeda were sold world wide, and at least 20 new companies were established in connection with technologies transferred from the Weizmann Institute (Messer-Yaron, 2011).
These institutional changes include the Bayh-Doyle Act, the ground-breaking case of Diamond versus Chakrabarty, TRIPS.
Parts of these paragraphs on the Law on Egg Cell Donations, and its close connection to stem cell research have already been described in earlier work (Vertommen, 2015a).
SCNT is a laboratory technique that attempts to create personalized stem cells for regenerative therapies.
Pre-implantation genetic testing is a technique used to identify genetic defects in embryos created through IVF before pregnancy. PGD refers specifically to when one or both genetic parents has a known genetic abnormality and testing is performed on an embryo to determine if it also carries a genetic abnormality (emedicine.medscape.com/ last entry 2 June 2014).
As explained by Pavone and Arias (2012, p. 252) in their research on the political economy of PGD/PGS in Spain, embryos discarded from PGD carry a broad range of different ‘defects’, varying from either recessive monogenic disorders to predispositions to multi-genetic, complex disorders. This has radically altered the definition of ‘life threatening’, ‘early-onset’ and ‘serious’ diseases and has lucratively broadened the actual scope of the technology.
Informed Consent Form for Genetic Research, Shaare Zedek Medical Center, dr Gheona Altarescu and dr Rachel Eiges (via personal communication 18 July 2012).
Quoted in Stockmarr Leila, Seeing Is Striking: Selling Israeli Warfare, Jadaliyya, 18 January 2014,www.jadaliyya.com/pages/index/16044/seeing-is-striking_selling-israeli-warfare
From a demographic-reproductive point of view the Law on Egg Cell Donations was also quite significant since it required the donor and the recipient of the egg cell to have the same religion, which inhibited Palestinian women from benefitting from the law since they hardly ever donate egg cells in the framework of the law (Vertommen, 2015a).
As one of the reviewers aptly remarked, there are also important differences between the two generations of Israeli tissue providers, despite their strong similarities. Although Labour Zionism was far from being socialist in its practical materialization in Israel/Palestine, it did serve a as powerful societal narrative until the late seventies. In this sense, the elderly women in the sixties were more prone to donate their urine than Israeli women today are willing to donate egg cells. Despite doubling the compensation fees for egg donors from 10 000 to 20 000 shekels ($5776) in 2013, Israel’s Egg Donation Law is not managing to attract many egg donors, neither for reproductive nor for therapeutic purposes. Between 2012 and 2014 only 42 egg donors had been registered by the Health Ministry www.haaretz.com/opinion/.premium-1.580728.
Drawing on the work of Birch and Tyfield (2012, p. 322) I agree that Israel’s reproductive-embryonic industry is mainly an asset-based enterprise rather than commodity-based one. Their current value is mostly derived from trade in intellectual property and financial investments, not yet from the production of bio-commodities, seen that up to now many Israeli biotech companies have simply not produced any therapies for sale.
Thanks to the anonymous reviewer for pointing out to this important nuance between demand -and supply-side state interventions in the bio-economy.
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Further Reading
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Acknowledgements
The author would like to thank Hedva Eyal, Sahera Dirbas, Bilal Dirbas, Tamar Novick and Lana Khaskia for helping with the translation of archival and policy documents, and Michal Nahman, Leila Stockmarr, Adam Hanieh, Koen Bogaert, Annemie Vermaelen, Sami Zemni and the anonymous reviewers for their valuable feedback and comments.
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Vertommen, S. From the pergonal project to Kadimastem: A genealogy of Israel’s reproductive-industrial complex. BioSocieties 12, 282–306 (2017). https://doi.org/10.1057/biosoc.2015.44
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DOI: https://doi.org/10.1057/biosoc.2015.44