Xiong Lei: Review of Harvard’s Genetic Hunt in Anhui
熊蕾:哈佛大学在安徽猎取基因事件再回顾
http://www.globalview.cn/html/global/info_36478.html
Following the SARS epidemic in 2003, another wave of new coronaviruses is once again raging across the land of China.
[dropcap]A[/dropcap]lthough many experts say that these two viruses are not directly related (although they have been traced to a bat), as a layman I can also see that these two viruses have one feature in common: they both target our lungs, targeting our respiratory system, making us suffocate.
This reminds me of the incident of Harvard University's gene hunting in Anhui, China in the mid-1990s.
As early as July 1996, the news section of "Science" magazine in the United States first reported that Harvard's population genetic research program would collect 200 million blood samples in China.
In January 2001, I investigated the violations of bioethics caused by the Harvard Project. We learned at the time that there were nine projects involving gene collection by Harvard University in Anhui, China in the 2000 fiscal year listed on the National Institutes of Health's NIH website, including hypertension, osteoporosis, and nicotine addiction. There were two genetic programs related to asthma and trachea and lung function. All of the nine projects were collecting samples in China, and the sampling site was basically in the Anqing area of Anhui Province.
However, as of January 2001, there were only three genetic research projects conducted by Harvard University in China approved by China's National Human Genetic Resources Management Office, which involved the ecology of hypertension, nicotine addiction, coronary heart disease, and osteoporosis.
Genetics research. There were no genetic programs for asthma and the respiratory tract.
In March 2002, Harvard University announced a total of 15 genetic research projects in Anhui, including asthma, hypertension, obesity, diabetes, and osteoporosis. How many blood samples have arrived in the United States are still unknown. For asthma alone, Xu Xiping (徐希平), the project leader and then an associate professor at the Harvard School of Public Health admitted that he had obtained more than 16,000 genetic samples from the United States.
In fact, at that time, many research institutions in Europe and the United States were collecting genetic samples in China, not only at Harvard University, and not only in Anhui. Among them, in March 1998, some research institutions in Europe and the United States at one time cooperated with a Chinese ministry to collect genetic samples of the elderly in various parts of China in an attempt to understand the secrets of longevity. This project was questioned by Tong Zeng (童增), a Chinese staff member at the time. Tong Zeng participated as a staff member in the training called China Longevity Elderly Health Survey. In the meantime, a European expert instructed them how to collect blood samples of the elderly, and taught them to soak the hands of those aged 80 years and older in hot water, and then rub the heat to promote blood circulation. blood. The first drop of blood can not be used. It is required that starting from the second drop of blood, the blood taken from each old man's finger must be able to fill 5 circles with a diameter of 12 mm or a penny. This project was funded by the National Institutes of Health, with the participation of Duke University in the United States and some European research institutions, with assistance from the China Aging Committee. This method of blood drawing caused suspicion of Tong Zeng. At first, he was concerned that such blood collection would be detrimental to the health and safety of the elderly. Later, he found that the Chinese materials and instructions in the training seemed to consciously avoid the word "gene" in the English materials. He believes that "this is hunting for China's genetic resources!" Therefore, Tong Zeng reported to the relevant departments on the one hand, and on the other hand, through the media, called for vigilance on the loss of Chinese genetic resources. As a result, the 4,000 blood samples collected were sealed by the Chinese government authorities and were not allowed to leave the country, but Tong Zeng was severely punished and dismissed for offending his boss.
At that time, none of the international projects that came to China to collect genetic samples publicly said that they were collecting genetic samples. Most of them were collecting blood samples under the banner of health surveys. Before and after Tong Zeng publicly questioned the health survey of longevity among elderly people, some experts also publicly questioned it, and the media issued a lot of reports alerting China to the loss of genetic resources. But soon, the voice of questioning was no longer seen in the media. Moreover, our country soon issued the Interim Measures for the Management of Human Genetic Resources. This is the first time that our country had formulated a do cument specifically for the management of human genetic resources.
So why did Harvard choose to collect genes in Anhui?
The earliest funding for Harvard's asthma project was the United States Millennium Pharmaceuticals. Millennium Corporation was founded in 1993. In December 1995, just five months after it agreed to fund Harvard's asthma project in Anhui, a major Swedish pharmaceutical company invested $ 53 million in research into the genetics of respiratory diseases. Both Millennium and Harvard officials believe that the Anhui project secured the investment. By 2002, Millennium's employees had grown from an initial 100 to more than a thousand, with assets reaching billions of dollars. At the end of 1994, the Millennium Company and Xu Xiping reached an agreement to phenotype 500 families (400 asthma families and 100 non-asthma families) in Anhui, China, and submit the DNA of 500 families to the Millennium Company for anonymous gene search to find asthma genes. The Millennium Corporation provided funding of $ 999,996 for this.
Our investigation of Harvard's genetic projects in Anhui only focused on whether they violated the rules, that is, whether they violated the provisions of our human genetic resources management measures, or whether they violated the bioethics guidelines.
Why choose this focus? Because issues such as gene loss and biosecurity were not only too professional, they also seemed to be listed as restricted areas at the time and were not easy to touch. However, bioethics norms are an international topic.
In January 2001, I started my investigation with Xinhua News Agency Anhui Branch reporter Wang Yan from Anhui Medical University, Xu Xiping's alma mater, and one of the Chinese partners of the Harvard project. A vice president in charge of scientific research at An Medical University said that when the emphasis was placed on cooperation "it must be approved by the state", "people can get approval in three months." After the introduction of the management measures, Xu Xiping set up an institute in Anqing because genetic materials were not allowed to leave the country. However, no one can tell exactly how much material he had taken before. According to his own paper, a hypertension project he did in Anqing in 1993 had to screen samples from more than 200,000 people. The vice-principal felt that there were too many units across these projects, and no unit could cooperate fully with him. Moreover, on these projects, the Chinese side was relatively weak, and the project was divided into several pieces. "Our interests are not easily protected." Chinese partners "cannot monitor the whole process."
The Vice-Chancellor had no knowledge of the US media's report that the United States Millennium Pharmaceuticals, which originally invested in the Harvard project, had invested more than $ 100 million in several genetic research projects such as asthma simply because it could access Anhui's DNA resources. He felt that cooperation was carried out under "asymmetric information."
We next investigate whether the farmers' right to informed consent is respected.
The UN General Assembly adopted the Human Genome Declaration in December 1998. The declaration clearly states that in international cooperation in the field of life sciences, especially in international cooperation with developing countries, the principles of life ethics must be observed. In all studies, informed consent is the most important principle.
When we drove from Hefei to Anqing to Yuexi, we just wanted to hear for ourselves whether the farmers who had given blood samples knew whether they were "contributing" to an international cooperation project.
Accompanied by the director of the Anqing Municipal Health Bureau and others, we arrived at Toto Town, Yuexi County, which is located in the west of Anhui. The town health center did not have any records on the physical examination for the year. We proposed to find a farmer who had blood samples taken at that time. They said that these farmers did not live in the town, and the nearest household had to go over a dozen miles of mountain roads where there was no traffic. The mountains are high and the roads are long, and the roads are slippery after snow. "You can't go up." I hesitated at that time, looking at Wang Yan. Wang Yan suffers from myocarditis. I think this mountain road will kill him! But Wang Yan said without hesitation, you find a guide and we go up. We don't listen to what farmers say. I was very moved. Finally, they found a guide, and we walked for two hours on the mountain road to the farmer's house in Songshan Village. At this time, we saw a wide lane leading directly to the village. Although it was a dirt road, it was not a problem to use a tractor. The guide said a little awkwardly that they could drive the tractor, but they would not let me tell anyone. Neither Wang Yan nor I said anything. I think I can understand the concerns of these grassroots cadres.
The farmer, his wife, and two daughters participated in two "medical examinations" in November 1996 and March 1997. Each of them had two health cards issued that year. One recorded the examination on November 5, 1996. The items included cardiopulmonary function, blood pressure, etc., and blood was drawn. The other one was recorded on March 10, 1997. The second check also took blood, more than the first, but "I don't know how much." He said, "The arm reached into the curtain through a small hole, and the doctor was behind the curtain and was invisible." Both times they were given a lost-time allowance, 10 yuan per person for the first time, and 20 yuan for the second time, plus two packs of instant noodles-the NIH's funding standard is $ 10 per blood draw. The second "physical examination" was optional. Only their family was picked in the village, and no son or granddaughter was required, as long as the old couple and two daughters went. They are willing to go, "because the older woman's condition is relatively serious, she coughs badly as soon as spring, hoping she can get treatment." But the treatment they were hoping for didn't come. Only a resident health checkup report issued by the Anqing US-China Institute of Biomedical Environmental Hygiene was given. In addition, the old man had high blood pressure and was given two bottles of antihypertensive drugs.
Their family all said very positively that no one had seen or read the informed consent form, nor did they know about the cooperation with Harvard. We took out the samples of informed consent given to us by the director of the county hospital office: "I know that the Harvard School of Public Health and Beijing Medical University, Anqing City Health Bureau, and Anqing US-China Institute of Biomedical Environmental Hygiene co-hosted the topic ' China Molecular Epidemiology of Diseases 'research project, the purpose of this project is to investigate Chinese (rural) residents' disease status, distribution characteristics, study its relationship with genetics, and study various environmental factors in the role played in the onset of the disease eventually leading to the development of new prevention and treatment methods for this disease. I hereby agree to participate in the project activities... I know that participating in this research will get related free medical examinations, tests, and consultations, It is possible to get further preferential health care services in the future ... "They listened and said," I don't know, I don't know. "They did not know where the blood samples were sent. The old man remembered signing it, but it was for the purpose of receiving compensation for missing work.
We asked the professor who funded the survey. He said that the money was given by the Ministry of Health and the World Bank for a rural health talent training project. I told him that the World Bank's projects are documented. The professor immediately changed his mind and said that he did not remember where the money came from, because "it did not cost much." How much is "not much spent"? He said, "I don't remember". Why does the investigation of cooperative medical treatment draw blood and draw twice, and the second time is to select families with respiratory diseases? He couldn't answer. What are the results of the two surveys, and are there any research reports? He still "doesn't remember", but repeatedly said, "That's a very small subject."
Back in Beijing, we asked the Beijing Representative Office of the World Bank. The answer is that the World Bank has never funded health projects in China that require blood tests.
In Hefei, Professor Xu Xiping of the Chinese Academy of Sciences (CAS) "Hundred Talents Program" (ed. a major project of CAS for recruiting outstanding talents overseas), talked with us for nearly 8 hours. He acknowledged that China is a developing country, and cooperation with foreign countries is definitely beneficial. But this kind of research "has a long time from publication to patent." He said that human genes have common parts and differences. Studying Chinese materials is good for studying the mechanisms of some diseases. He is very proud of getting the funding from NIH, because the project that takes it "is subject to the most rigorous review", so the project it finances "is the project with the highest honor." He believes that some scientists "sensationally" overstated the importance of genetic resources and attacked him. "A lot of people are jealous of me," he said. "The people who attacked me didn't know me."
For informed consent, Xu Xiping said, "My requirements are very clear. We have a responsibility as the sponsoring institute, but we do not bear the main responsibility. Execution is not my responsibility. My dean cannot be held responsible for my actions. We have an agreement. They have not implemented it and cannot blame me. "
However, we found on the Internet a paper signed by Xu Xiping, which did not match the above statement. Xu Xiping, the professor of An Medical University, and the eight directors of Anqing Health Bureau, published in December 1999, Volume 160, Issue 6, American Journal of Respiratory Health Medicine, entitled "Pulmonary Functional Groups in a Chinese Rural Community". In the paper, the location of the sampling of the Harvard School of Public Health's population genetic research project is clearly stated: "Asthma index families are in a multi-stage process in 8 counties (Zongyang, Huaining, Qianshan, Tongcheng, Taihu, Wangjiang , Susong, and Yue Xi). "Yue Xi is listed among them. And the paper was clearly written: the field investigation was completed from July 1, 1994 to January 26, 1998.
Can it be said that Yue Xi's "medical examination" has nothing to do with the Harvard project?
In addition, the NIH re-funded two Harvard asthma gene research projects in 2000. Because they did not have other investigation sites for asthma samples, we suspect they are still using blood samples collected in Anhui from 1994 to 1998. The National Genetic Resources Office has not approved these projects. In this case, they are still publishing papers on asthma. Can this be said to be legal?
Soon after we returned to Beijing, we received written letters from the leaders of the Chinese Academy of Sciences, the Ministry of Education, and the Chinese University of Science and Technology, and said that we were "anti-globalization", corrupted the reputation of Chinese scientists in the world, interfered with international cooperation, and "disclosure". Other issues are worth mentioning. What is going on with "disclosure"? The original so-called "secret" is that Xu Xiping is a member of the Chinese Academy of Sciences' Hundred Talents Program. He does not want the United States to know that he has a part in the hundred-people plan in China. In this regard, I specifically consulted the department in charge of the 100-person plan of the Chinese Academy of Sciences. They definitely said that the name of the 100-person plan project is not confidential and is public.
During the Anhui investigation, from An Medical University, Anqing Health Bureau to the Chinese University of Science and Technology, everyone we contacted praised Xu Xiping, praised him for donating education to his hometown, praised him for his long-term patriotism, and maintained his status as a Communist Party member. Wait. I acknowledge that this may all be true. However, I think that the status of patriotism and Communist Party members does not mean that doing scientific research can violate ethical principles?
In the end, this survey report by Wang Yan and I was published in the weekly issue of the 13th issue of the “Looking Out” weekly on March 26, 2001, under the title of “Questionable International Gene Cooperation Project”. In the article, we questioned some people in Anhui who spared no effort to deny that there were obvious mistakes in work that had a relationship with the leading foreign agency and main person in charge of a research project, and raised a question: a genetic research project conducted by Harvard University in a remote rural area in China without fully observing the principles of bioethics, why should we help them hide and deny them? If a scientific research project whose purpose is to benefit human beings is indifferent to the groups that contribute to it but lack the awareness of self-protection, such as the rights of farmers in the deep mountains of Anhui, it can also bring the weaker partners involved. What is the benefit? As a party to this cooperation, how can we guarantee China's due interests? In the cooperation with Harvard, China paid a unique genetic resource, which is the multi-level rural medical system established by the country over decades. In contrast, is the Harvard Project unique to us? Is China's income commensurate with China's contribution?
In the interview, we have a strong feeling that these genetic projects of Harvard would be impossible, from sample screening to collection, without the several levels of rural medical and health care networks that we have built for decades. This should be a huge investment from China. However, many people participating in the project in China think that "we have not invested much". With this view, can we uphold China's equality and mutual benefit in cooperation?
According to internationally accepted bioethical guidelines, participation in human biomedical research must be approved by the individual, and consent is based on knowledge. Informed content includes both the research purpose, method, and research project, such as who funds and benefits the research-related situation, as well as the interests and rights of the participants. It is particularly emphasized here that according to the "Clinical Practice Guidelines" adopted by an international conference jointly held by the United States, Europe, and other pharmaceutical regulatory agencies in 1996, "Informed consent is a process through which individuals learn about all relevant aspects of deciding to participate in experiments. After that, he or she voluntarily expressed his or her willingness to participate in the experiment. "That is to say, informed consent emphasizes the process of obtaining consent, rather than the process of obtaining documents in written, signed, and other forms. Informed consent cannot be replaced by a single form of proof. To check and judge whether a project has obtained informed consent, it is not only to look at the signatures of the participants, but also to see if the participants "fully understand the purpose, method, source of funds, any possible conflicts of interest, the institution to which the researcher belongs, expected benefits, potential risks, and possible discomfort caused by research, "depends on whether their consent was given with full knowledge and complete freedom from coercion, and whether they understand their participation in the process rights and interests.
After the announcement of the US investigation was published, Wang Yan and I again published an article in Hope Weekly entitled "Harvard's Genetic Research Violations in China". In this report, we once again raised some questions: Why were these research projects that ultimately proved to be violating regulations unimpeded on China's land for nearly a decade? What is the difference between the number of officially approved projects and the actual projects in China? How to protect our rights in genetic research?
Although the US investigation has reached these conclusions, it is still not without problems. The biggest problem is that the first director of the Office of Human Research and Protection responsible for the investigation originally served at Harvard University and led Harvard's internal investigation of the asthma research project. In fact, he didn't pay much attention to this investigation. When he was the director of the Office of Human Research and Protection, he proposed to the US government that there is no need to take further corrective action on asthma genetic research in China.
Therefore, I feel that the shortcomings of the US investigation are not enough to speak in the Chinese media. I have published a number of English comment articles in the English China Daily. It is suggested that such a wide range of violations cannot be investigated only by the project leader.
Personal responsibility.
The immorality of the US constitutional system should also be investigated. For example, the National Institutes of Health, known for its rigorous auditing, why would one person be responsible for so many projects? At Harvard University, where Xu Xiping is, the earliest millennium company that invested in the project, is there no responsibility? Some people blame the Chinese partners for not seriously implementing the relevant ethical rules. I propose that launching and funding these genetic projects are not these Chinese partners. This is a research project funded and led by the United States. The question is not whether these Chinese staffs perform poorly. The question is why US funding agencies allow these unqualified partners to participate in such research.
At the turn of the spring and summer of 2003, there was a sudden outbreak of SARS in our country. In the meantime, on May 30, the Harvard School of Public Health announced that the U.S. Office of Human Research and Protection's investigation into their genetic and environmental epidemic research projects in China had ended. The US government accepted Harvard's "corrective action" for violations. Two professors from Harvard School of Public Health went to Anhui to conduct an on-site investigation. The investigation showed that the Chinese farmers involved in the project "given voluntary informed consent." The Dean of the Harvard School of Public Health emphasized that "Harvard seeks to ensure the highest level of protection of human subjects in all its work" and "no participant has been harmed and there has been no incident of intentional violation of human subjects' procedures" .
I noticed that the people who came to Anhui to investigate in the United States were their own professors at the Harvard School of Public Health, who had organized violation programs, not third parties. And someone told me that it was Xu Xiping who led and accompanied them in the investigation. Since Beijing had not lifted the ban during the SARS period, I could not go out, so I sent an email to one of the Harvard investigators, the director of the ethics committee of the Harvard School of Public Health, and asked if he spoke Chinese? Can he communicate directly with Anhui farmers in Chinese? If not, who is his translator? Who arranged his visit to China? What sampling sites has he been to? How did he know that the informed consent was signed by the research subject at the time of the research? How independent is his investigation? However, instead of answering these questions, he forwarded my email to a spokesperson for the Harvard School of Public Health. The spokesperson only sent me a statement that Harvard School of Public Health issued on May 30 after the U.S. government investigation was over, and did not answer any questions I asked. So I wrote another English comment and published it in the China Daily, pointing out that the US investigation had masked the misconduct in their research.
After the end of SARS, in August 2003, my colleague Wen Chihua, and Wang Yan of the Anhui Branch, went to Anhui, straight to the rural area of Zongyang County, Anqing City, and interviewed a person who was injured when blood samples were taken. Farmer, and a village doctor. Later, the investigation report of the three of us was published in the 38th issue of the "Week" Weekly, published on September 26, 2003, entitled "Harvard Gene Project Investigation: A Poaching of Chinese Genes". At the same time, Wen Chihua and I co-authored an investigation report in English. The China Daily published this report in a full-page on September 25, 2003, entitled "Memory of a Farmer".
The farmer we looked for was a clue from insiders. He was 55 years old in 2003. He told us that one morning in the fall of 1995, the "come up" called him to the town health center for a "medical examination." They let go of their work and went because it was said that the "medical examination" was for farmers and "you don't need money to treat you if you are sick." This is a good thing for the peasant who usually "looks at no money to buy medicines" and has to wait until he can't bear to take a slice when he can't bear it. They have 4 sons and take two sons to a "medical examination" as required. Because they had no money to take a car, they walked more than ten miles and rushed to the town health center. After getting a free lunch, they started to check in the afternoon. They recalled that at the same time, there were 20 or 30 people from other villages. Among the 30-odd households in their village group, they were the only ones who were called to participate in the "medical examination". During the "checkup" they took their temperature and took blood. The inspector then asked the farmer to open his mouth and sprayed a "fog-like" thing into his mouth, making him say "ah". He didn't know what it was, and no one told them what the inhalation of this medicine would do and what risks it might pose. He remembered that the thing "was packed in a plastic bottle, like a mosquito repellent," "'Ah,' after three or four shots, he was out of breath, as if he were dead." Afraid, rush to rescue, "hang water (infusion)", "fill oxygen." None of the doctors who performed the examinations were local and spoke in different accents. But neither of them could tell where they came from. The peasant "received his anger" until the middle of the night. After that, no one cares about him anymore. The next day, the couple left without question and left the hospital. They found a free ride home because "there is no more money" and the 200 yuan given to them "was spent on rescue." During the rescue, a doctor promised to send them medicine later, but they "did not see the medicine to this day." Since then, they have never seen the doctors who performed the examinations, and no one has told them the results of the "medical examination." Both husbands and wives are illiterate. They said that they had never seen or heard the "informed consent" before or after the "medical examination", nor had they signed or pressed a fingerprint on such a document. They don't even know who their blood samples were given to.
The village doctor was random when we arrived at Zongyang. He was 52 years old and had been a village doctor for more than 30 years. He made it clear that he knew that the "checkup" was done "for a genetic study at Harvard University," but he couldn't say the name of the project. He said, "At that time, we were asked to inform the farmers to" check the body "to see what caused the asthma." He was certain that he "said for treatment, but then did not." He said he was not without doubt about the project. He said, "When I heard that this was an American project, I thought about it, and I was afraid there was something famous here." However, he "rejected this question because it was led by a government organization." So he didn't speak out the doubt in his heart. According to requirements, he registered the list and simple information of people with asthma in the village and their family members, about "a dozen". Then he accompanied the villagers who participated in the "medical examination" to the county epidemic prevention station. After the "transfer" list, he left, so he did not know the process of "medical examination". No one told him or any of the peasants inspected what procedures were in place, nor did they tell them the results of the "physical examination". He and these farmers have not seen or heard the "informed consent", let alone know that blood samples will be sent to the United States. No one mentioned it afterwards, he said. "It's nothing." But he hopes to "understand them" and "let us all know what is going on."
Of course, I don't expect any results from our investigation report. What I thought at the time was to keep a photo of it. We cannot count on the US government to uphold justice for Chinese farmers and seriously implement bioethics. I just want to show that we Chinese are not without doubt about the genetic projects that your American institutions have done in China. The kind of seemingly serious investigations you have done on the problems with these projects are actually cut-scene investigations, and we Chinese are not unnoticed. If you want to cover up these problems, then we will spread them to the whole world.
The fourth issue of the American Journal of Bioethics in 2004 published a letter from an internationally renowned biological and medical ethicist to the editor of the journal, condemning Harvard's human genetic research project in Anhui as contrary to bioethical principles. The seven well-known ethicists from Australia, Brazil, Mexico, South Africa and Switzerland said in their letter that Harvard's research in rural Anhui involves environmental and occupational diseases, genetic-environment interactions, genetic diseases, population genetics, reproduction Health, asthma, and chronic respiratory disorders. These studies have not been approved by ethical review, informed consent has not been obtained, and Chinese genetic sample providers are unlikely to benefit. They expressed deep concern that such a well-known institution and research of this nature, with funding from the National Institutes of Health, could escape rigorous ethical review. They hope to start an in-depth discussion of this type of research and urge the International Bioethics Association and the World Health Organization to issue a statement condemning these studies at Harvard and to show their willingness to stop research of this nature in the future. A German ethicist told me that this is the first time that the international ethics community has expressed public concern about the matter and condemned the relevant institutions.
After SARS, Tong Zeng published a book in October 2003: "The Last Line of Defense: Thoughts on the Loss of Chinese Genes." Based on the fact that some US scientific research institutions have hunted Chinese genetic samples since the 1990s, and combined with the phenomenon that Chinese are particularly susceptible to SARS virus, he put forward a hypothesis: SARS may be a genetic weapon against the Chinese. As a result, he was verbally abused. In response, Tong Zeng said: "I just proposed a possibility. I have the right to doubt."
I personally think that the questions raised by Tong Zeng are indeed very important. The Chinese should remain vigilant. Scientific research certainly needs evidence. However, problems like genetic weapons can only be doubted if evidence is available. It is too late.
China ’s first “Regulations on the Management of Human Genetic Resources”, which came into effect on July 1, 2019, clearly stipulates that the collection, preservation, utilization, and external provision of human genetic resources in China must not endanger China's public health, national security, and public interests. In line with ethical principles, protect the legitimate rights and interests of resource providers. The regulations specifically stipulate that foreign organizations, individuals, and institutions established or actually controlled by them shall not collect or deposit human genetic resources in China, or provide human genetic resources outside China.
According to this regulation, those Harvard projects can no longer be carried out in China. But think about how many genetic samples Harvard took away from us, especially samples of asthma genes, shouldn't we investigate: where did they end up? What's it for? Relevant research institutions in the United States should not explain to farmers in Anhui who provided blood samples to us? (PIB emphasis)
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