 Now, Arthur, you will have to explain to us how you navigate in this kind of ethics on the fly that Daniel described to us in your day-to-day life, and then I will open for Curie, Goethe or Arthur. So, I would like to warmly thank Thierry and Patrick for the opportunity to speak on this particular panel. As a scientist by training, one of my deepest fascination is the unrelenting power of technological progress to transform human societies, in many cases, serendipitously, and regardless of our attempts to try to control or organize it. And I think in the 20th century has been the century of chemistry and physics. The 21st century will be the century of biology and medicine. With the promise of a flurry of medical innovation stemming from a better and deeper understanding of fundamental biological mechanisms underpinning the human body and mind. And to understand how these provide challenging use cases for ethicists and policymakers today, we can come back at the very birth of the century in 2003 with the completion of the human genome project and mapping of the entire human genome. And interestingly for this WPC health, this was actually a brilliant product of successful global scientific governance, with genome sequencing being performed across the US, Europe, Japan and China, and the resulting world being immediately published worldwide. And this global scientific effort was later deemed a public good. So to come back to Thierry's introductory words, this is one of the rare cases where I would argue we have a public good, the human genome. When in 2013, in the case association for molecular pathology versus myriad genetics incorporated, the US Supreme Court ruled that human gene could not be patented because DNA is a product of nature. In parallel, the rapid accumulation of technological breakthroughs further accelerated the field of cell and gene therapy. One, gene editing technologies such as mega-nucleases, Zincfinger nucleases, TALEN, and most recently and crowned by a Nobel Prize this year, CRISPR, allowed any research center to seamlessly copy, cut and paste human genes. Two, viral vector technologies allowed to reprogram cells of patients suffering from genetic disorders by making them express healthy genes. And three, reproductive medicine technologies drastically opened up the toolbox available to humans to operate on their own germline. Of course, the COVID-19 pandemic provides a fantastic use case of such paradigm with highly complex and innovative biotechnology such as Zincfinger RNA or engineered viral vectors being at the cornerstone of the most promising vaccines. But of course, and as usual, COVID-19 is just a currently visible tip of the iceberg. And the ethical questions raised by these technological evolutions are certainly not new, but the practical applications are. First, and this was mentioned in the previous session, while the initial use cases of cell and gene therapy are hardly debatable, we're talking treating certain forms of cancer or genetic disorders. The R&D and manufacturing costs of these extremely complex technologies lead to often unbearable price tags. The first gene therapy, Novorez Tysagen Lacluso, commercially known as Chemriah, was approved by the US FDA in 2017. It's a customized cancer treatment created using an individual patient's own white blood cells, which are genetically modified to target and kill leukemia cells. And it also carry a monster 475,000 price tag pre-discounts. Just two years later, in 2019, the US FDA approved a Vexis Ensameno gene, Apapavovec Zy, the name also has to be complicated, commercially known as Zorgansma, which is another gene therapy to treat spinal muscular trophy, a rare neuromuscular disorder in small children. And as Alexandra highlighted just before, with the bewildering price of $2.1 million, this became the world's most expensive drug and explained a Vexis future further acquisition by Novorez for $8.7 billion. And what are currently isolated cases are bound to become the norm for healthcare systems in the coming years, with close to 400 cell and gene therapies being in development in the US alone. As Jack pointed out, most of these development come from academic institution and biotechnology companies and are only taken at a very late stage by pharma companies. So the questions of access that are particularly acutely felt for vaccines and treatment during this COVID-19 crisis will continue to rise. So the first question is how can governments and payers better coordinate and negotiate to ensure that patients in need access those treatments while keeping healthy incentive systems for biotechnology innovation? But also from a manufacturing perspective, how can efficient technology platform and supply chains be built across the globe to further industrialize and make these highly complex technology truly accessible off the shelf to those in need? Second, we have profound societal changes to be expected from the rise of these technologies. And I'd like to take as an example the evolution of the concept of family and parenthood, which has been partly driven by technology, starting with the first in vitro fertilization baby in 1978. But today, the questions are already infinitely more complex. In 2016, the first three parent baby was born from mitochondrial transfer. This intervention involved the prospective mother with disease mitochondria, these are the structures that provide energy to cells, which were exchanged by mitochondria of a healthy unrelated donor. So the newborn thereby carry genetic information from three parents, the sperm donor, the egg donor, and the mitochondria donor. This came from a very ethically acceptable principle, offering mothers the ability to avoid passing on metabolic diseases caused by faulty mitochondria to their offspring. Yet, this technological prowess triggered the need to rethink once again our preconceived notions of parenthood, genetic transmission, and family structures. Today, countries across the world battle with the place to give to culturally complex situations rendered possible by modern reproductive technologies such as IVF or surrogate pregnancies. How can we ensure that such core cultural concepts are being regularly revisited and debated at the local and global level as scientific innovation will offer increasingly practical challenges to fundamental societal frameworks. Third, and most importantly, more debatable use cases are coming to life. And we've talked about the first genome-edited human embryos by Chinese scientist Hei Zhengui in 2018. Interestingly, this has led to a very rapid Chinese and international outcry. But one must remember that the original purpose of such intervention, at least on paper, was as much a medical one as the one of the others previously highlighted. Indeed, the purpose was to offer an HIV-positive father and an HIV-negative mother the possibility to have children that would be free of infection. To do so, the embryos were edited by CRISPR gene editing technology to inactivate the CCR5 gene, which encodes a protein that HIV uses to enter and infect human cells. The purpose of this was to reproduce a naturally occurring rare phenomenon seen on the so-called Berlin patient and London patient, where a mutation in CCR5 conferred innate resistance to HIV. But here, the world quickly asked a difficult question. Did this commendable end justify the mean of human germline editing? Thankfully, this led to a rapid global response through the creation of the International Commission on the Clinical Use of Human Germline Genome Editing, which provided guidance at a global level this September 2020. The key conclusion, I quote, no attempt to establish a pregnancy with a human embryo that has undergone genome editing should proceed unless and until it has been clearly established that it is possible to efficiently and reliably make precise genomic changes without undesired changes in human embryos. And importantly, they add, these criteria have not been yet met and further research will be necessary to meet them. Some of the key scientific concerns include the specificity of gene editing, that is the ability to avoid off-target undesired gene edits, mosaicism, which is what happens when not all cells continue to carry the genetic mutation during embryo development, as well as chromosomal abnormalities which can lead to severe genetic defects. The evolution of gene editing tools is very likely to reduce and eliminate these issues. But importantly, this review did not wish to conclude on whether these interventions should be permitted by countries once this technology matures. It calls to continue ongoing national and international conversations on ethical, moral and religious views for potential long-term societal implications without forgetting issues of cost and access as highlighted previously. This essentially aimed to provide a sound scientific foundation for ethics to be guided by action, confronted with cases and produced on the fly in the words of my co-panelist Daniel, in order to aim for global science-driven consensus while avoiding the dramatic pitfall of ethics dumping. So to conclude, it is evident that with the rapid progress of technology and absence of international consensus on ethics, such dilemmas are going to continue flourishing in the future and our societies will need to understand and address them. The risk otherwise is to fuel a rising tide of scientific defiance, misinformation and actual fake news, as we have seen for instance with anti-vaccine movements which were discussed in the previous panel and as panelists have aptly pointed out will be extremely damageable to healthcare system across the world. Instead I strongly believe the recipe for success is neither to hand over societal and ethical choices to scientists and technologists, but also not to shy away from the multiplication of such technological use cases. Instead, we should keep building bridges between scientific, medical and technological expertise together with political systems as this WPC health is offering an excellent example. So my overarching final question will be can we ensure that we put in place the appropriate global governance structure to promote a healthy dialogue between scientific progress and ethical guidance so that society can truly choose the medical and biological future they want to live in? Thank you Arthur for your presentation grounded on very practical examples and that was a good balance with Daniel's introduction more on the framework and what you're confronted or what we've been confronted in history.