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-------------------------------- GENET-news --------------------------------

TITLE:  In rural China, a genetic mother lode
SOURCE: Washington Post, by John Pomfret & Deborah Nelson
        sent by the Indigenous Peoples Council on Biocolonialism
        Debra Harry,
DATE:   December 20, 2000

------------------ archive: ------------------

In rural China, a genetic mother lode

They came from distant farming villages and scattered rural shacks, 
trudging miles by foot across precipitous terrain and muddy green tea 
fields. Women left the open ditches where they washed the family clothes, 
dragging children along with them. The men joined in. Fifteen hundred 
people answered the call. Among them was Wang Guangpu, 26, who makes $36 a 
month cutting hair in a hut made out of reeds in the Toutuo town center, a 
100-meter strip of crumbling structures on a rutted dirt road. "We were 
told there would be free medical care," he said. "So of course everybody 
came out."

There was a catch, however: Residents had to give blood. Few in this 
impoverished community could afford a doctor otherwise, because economic 
reforms had gutted China's free health care system. So, one by one, they 
extended their arms.

This was no ordinary blood drive. It was genetic research, a pamphlet 
explained to participants. But many couldn't read, and few could have 
guessed at the tangle of scientific and business dreams that lay behind the 
project. DNA from this region was coveted in the West. Researchers at 
Harvard University and its corporate sponsor, Millennium Pharmaceuticals, 
Inc., of Cambridge, Mass., believed the isolated population here and 
elsewhere in the mountainous Anhui province held a treasure of unpolluted 
genetic material that could yield medical breakthroughs and perhaps 
millions in biotech profits.

Because it was unusually homogenous and made medical research easier, the 
DNA in the local population's blood "was more valuable than gold," the lead 
Harvard researcher reportedly told colleagues. Ounce for ounce, that would 
prove a sound estimate.

Harvard ultimately reaped millions of dollars in federal grants and private 
investment for the university and the project's lead researcher because of 
its access to Anhui DNA. And Millennium was able to raise tens of millions 
of dollars from corporate investors.

Along the way, Harvard allied itself with researchers in China who 
sometimes used the coercive levers of the country's government to help 
round up volunteers. They recruited women for one reproductive genetics 
study through the controversial Chinese bureaucracy charged with limiting 
births. To encourage blood donations, they sometimes mobilized local cadres 
for "thought work." Some Chinese who took part complain the bargain proved 
one-sided. In Toutuo and elsewhere in Anhui, people such as Wang Guangpu 
say promised medical treatment never materialized.

The story of Harvard's blood harvest in China highlights a question 
increasingly asked by medical ethicists as U.S. academic and corporate 
researchers turn to poor countries to find large pools of willing human 
subjects: Are some populations too vulnerable for all but the most 
essential medical research?

Harvard and Millennium officials say their research adhered to strict 
ethical guidelines. They say Chinese participants volunteered freely and 
Harvard kept its commitments. "We were very mindful of having the same 
standards applied to them as in the U.S.," said Harvard Provost Harvey V. 
Fineberg. "Every effort was made to assure that was the case." The same 
standards may not provide the same protections, though.

In November, spurred in part by complaints about the Harvard-sponsored work 
in Anhui, the U.S. Embassy in Beijing issued an unusual advisory warning 
U.S. medical researchers against working in impoverished, rural areas of 
China where "health care is poor and people are unable to protect their 

On the Chinese side, Yang Huanming, the director of sequencing work for the 
Chinese Human Genome Project, who has worked with the United Nations on 
genetic research ethics, offered scathing criticism. "I hope that Harvard 
and the School of Public Health will understand that the [recruiting] 
methods they used in China are unacceptable to the Chinese," he said in an 

An Attractive Target

The China project was hatched in the office of Geoffrey Duyk, a Harvard 
geneticist who had one foot out the door to industry. At the time, 1994, 
genetics seemed the next big thing in American medicine. Among those 
enamored was Scott Weiss, a prominent Harvard respiratory epidemiologist. 
Weiss had come to Duyk for help in launching a study into genetic causes of 
asthma and similar illnesses.

Duyk perked up when Weiss said he had a line on an unusually homogeneous 
population of 62 million people in Anhui province, a region isolated by 
geography and poverty for 2,000 years.

For researchers seeking genetic links to diseases and blockbuster drugs to 
treat them, DNA in such a place as Anhui offers a rare chance to study the 
human blueprint. Genetic deviations that may cause medical disorders are 
much easier to identify in a large DNA sample from a relatively uniform 
gene pool.

The research required thousands of volunteers, nearly impossible to obtain 
in such a remote place without an experienced guide. Weiss had just the 
person -- he had mentored a post-doctoral fellow, Xu Xiping, who came from 
Anhui and had conducted several public health studies there. Xu was an 
epidemiologist with no real expertise in genetics, but he had hometown 
connections and a proven aptitude for getting things done in China.

"Xiping had the skill to mobilize people," Duyk said. Duyk told Weiss that 
he was leaving Harvard to work for a biotech start-up, Millennium 
Pharmaceuticals, that might be interested in financing the Anhui project. 
They picked asthma as the disease to study. It was common enough in the 
West to make it an attractive target for Millennium. Duyk could provide the 
genetics know-how, Weiss the pulmonary disease expertise. And Xu could gain 
access to Anhui's population.

They began a pilot study in China, and within a year, Millennium agreed to 
pay $3 million for the DNA of thousands of Anhui residents to be collected 
through a collaborative effort among Harvard, Brigham and Women's Hospital -
- a Harvard affiliate -- and Xu's alma mater, Anhui Medical University.

Millennium announced the deal in July 1995, one month after a controversial 
eugenics law took effect in China. The law, which attracted international 
condemnation, promoted sterilization or lifelong birth control for citizens 
with an unspecified "genetic disease of a serious nature." With such a 
harsh law in place, some Western scientists thought genetic research should 
no longer be carried out on China's population, particularly given the 
history of forced sterilization of mentally retarded people in some 

Weiss and Duyk said the issue didn't come up in their discussions, and they 
plunged ahead. The Millennium-Harvard asthma deal provided Harvard with 
seed money to launch an ambitious genetics research program. The deal 
helped win a key early infusion of capital for Millennium. In December 
1995, just five months later, Astra AB, a large Swedish pharmaceutical 
company, agreed to invest $53 million in Millennium for genetic research 
into respiratory disease. Millennium and Harvard officials credited the 
Anhui project with securing the investment.

Millennium also received a $70 million commitment from pharmaceutical giant 
Hoffmann-LaRoche for obesity and diabetes research, and then added $500,000 
to its Harvard collaboration for the DNA of 400 obese families in Anhui.

Anhui, where millions starved in a 1960s famine, might seem a peculiar 
place to search for answers to the affluent West's battle of the bulge. Yet 
Anhui's poverty increased the likelihood the rare family with a serious 
weight problem had bad genes rather than just a bad diet, researchers 

"The Company believes that its access to these samples will facilitate the 
identification of the genetic components that underlie obesity," Millennium 
said in a document filed with the Securities and Exchange Commission in 
1996. The filing announced the company's first public sale of stock. A 
prospectus described research projects targeted at six major diseases and 
twice highlighted company access to DNA from the "large, homogeneous 
population" of Anhui. Millennium's public offering raised $54 million on 
Wall Street.

Combing the Countryside

In the high-tech harvest of Anhui DNA, Xu's job was reaper. Xu had spent 
the early 1970s in Anhui as a "barefoot doctor," one of the lay workers who 
provided medical care after the Cultural Revolution purged China of its 
professional classes. He earned a medical degree in 1982 at Anhui Medical 
University, a PhD in epidemiology in Japan in 1988 and a master's in 
biostatistics at Harvard in 1993, where he stayed on as a faculty member in 
the School of Public Health.

In the early 1990s, the slight, bespectacled native son returned to Anhui 
wearing the newly minted imprimatur of Harvard University. In a place where 
higher education is revered but access to it remains rare, Xu shone like a 
Dallas Cowboys quarterback returning to his Texas high school.

Xu said he wanted to study the causes of health problems common to Anhui 
and the West, with an eye toward prevention. He did non-genetic research 
into occupational and environmental ills and studied women working in 
textile mills.

When the opportunity arrived to work with Millennium, Xu said, he jumped at 
it. "I thought it would be a win-win situation," he recalled. "It would 
help give me a track record in genetic research and advance the cause of 
genetic epidemiology. . . . The population was ideal for gene mapping, 
because there are no trains or planes. People don't move." With the 
Millennium agreement in hand, Harvard established the Program for 
Population Genetics in 1996 for the China initiative. It named Xu director.

Xu proved able to operate with ease in China's authoritarian system, where 
the cooperation of government officials was essential and where volunteers 
lacked many of the freedoms and much of the information available to their 
Western counterparts.

His network of allies included provincial officials in the Chinese 
government; his alma mater, Anhui Medical University; and the regional 
Anqing Public Health Bureau, whose politically connected director was given 
co-investigator status on Xu's research. Xu helped set up genetic research 
centers at Anhui Medical University and in Anqing and became their 
director, his resume says. Local officials and health clinics were 
mobilized to comb the countryside for thousands of subjects who met the 
study criteria.

"It's different in a Communist state," said Karin Schmitt, who monitored 
the Anhui project for Millennium in 1997. "I think you always need to get 
in with the right groups. You need to see who can influence the people. We 
were working with the health minister of the province. He practically 
endorsed the study. Then he goes one level down, and the next one goes a 
level down."

In 1997, financial details about the Millennium-Harvard deal in Anhui 
leaked to the Chinese press and caused a storm of criticism. The idea of 
U.S. capitalists profiting from China's genetic heritage sparked such a 
fury that foreign genetic research stalled for a year as the Beijing 
government mulled new regulations. But during this period, Xu said he got 
permission to take DNA out of China with the help of Anhui officials. "They 
didn't listen to Beijing," he said.

Xu actually had support from Beijing, said Yang of the Chinese Genome 
Project. "We didn't agree with this decision but the Ministry of Health 
backed Xu," he said. "There was nothing we could do."

Yang said he and others in the Chinese genetics community had grown 
uncomfortable with the scale and speed of Xu's projects. He said he 
expressed doubts to Xu that such a sizable effort could produce good 
science or guarantee that the participants were making informed choices. 
Yang said Xu responded that he had the backing of Harvard and China's 
leadership, and that Yang couldn't stop him. Asked about the conversation, 
Xu said it never took place, and that he didn't receive special treatment.

Using the Millennium project as a foothold, Xu expanded into other 
collaborations with Chinese researchers. He applied for and received grants 
from the National Institutes of Health and the March of Dimes for $10 
million in research projects. In his grant applications, Xu emphasized his 
access to Anhui DNA.

He analyzed the samples from Anhui through a variety of projects that would 
eventually include studies of asthma, diabetes, hypertension, human 
reproduction, nicotine addiction, obesity, osteoporosis, schizophrenia and 
twins. Xu and his collaborators collected samples from thousands of people 
for Millennium and thousands more for his own research for Harvard and 
others. In all, by his count, 16,400 people gave DNA samples to the Harvard 
genetic bank, most from Anhui. Xu also collected DNA from 1,000 Beijing 
women working in petrochemical plants who had received government 
permission to get pregnant for a study of human reproduction.

But most of Xu's work took place in rural Chinese areas that few of his 
U.S. funders ever visited. He reported extraordinarily high volunteer 
rates, "exceeding 95 percent for all of our genetic studies in the Anqing 
area," as he wrote in one grant application.

Andy Kuo worked in Xu's lab in Boston and helped him set up projects in 
Anhui from 1996 until 1998, before leaving Harvard for an industry job in 
the United States. Kuo described Xu as a talented and committed 
epidemiologist, but said Xu felt pressure to move quickly. They were moving 
so fast that they couldn't keep close tabs on recruitment or testing, and 
the data suffered from mishandling and mix-ups, Kuo said.

"I kept saying, 'Why not do smaller projects and do them well?' But he was 
under pressure from everybody -- Harvard, the private sector, Millennium," 
Kuo said. "I don't think Harvard did right to foster this."

In 1998, Xu set up a company in Massachusetts to coordinate private 
research ventures with the Meizhong Institute, according to incorporation 
papers, although Xu says that company never got off the ground. "He was 
always saying that we were all going to be rich," Kuo recalled. He said Xu 
compared DNA to gold.

Other colleagues recalled similar statements. But in an interview, Xu said, 
"I never described DNA as 'more valuable than gold,' a very childish 
statement, nor have I ever reported that I hoped to get rich from these 
research efforts."

He acknowledged some quality control problems but said they had been 
addressed by a recent decision to centralize testing. "Throughout my 
scientific career and as a faculty member of Harvard University, I have 
always upheld myself to the highest standards," he said.

He said Harvard's collaborations in Anhui have provided valuable experience 
for Chinese researchers and may eventually yield important information 
about disease. For local hospitals and clinics, the collaborations were a 
"business opportunity" he said.

"An arrangement was made between the local hospital and the [Anhui] medical 
university. We gave a budget and we said this is the cost" for recruiting 
and examining study participants, he said. The clinics in turn used 
incentives like free exams and discounted health care to attract recruits 
and then hopefully retain their business, Xu said. The research projects 
were also an opportunity for Anhui residents, he said. "Very few of the 
people in the countryside ever get a health checkup," he said. "So when a 
team of doctors and researchers showed up there was a natural eagerness to 

Unkept Promises?

Toutuo Township is stranded in a mountainous region of Yuexi County, 
connected to the outside world by a lone dirt road. Families of ancient 
lineage are large and extremely poor. Illiteracy is high, particularly 
among women. One study by Xu put the illiteracy rate of his subjects at 
more than 70 percent.

Ten families from Toutuo (pronounced Toe-twaw)with a history of asthma took 
part in the Millennium study in 1996 and 1997, Xu said. During that time, 
Toutuo blood was also harvested from hundreds of residents for hypertension 
and pregnancy studies by Anhui Medical University and Xu. Toutuo and Yuexi 
health officials and doctors were recruited to help find study volunteers. 
One of their initiatives left a bitter taste.

English teacher Chen Hong said local health officials told villagers they 
were collecting health data "to study disease related to genetics" for an 
"American" research project. Those who participated were to get a free 
exam, test results, follow-up care and a "health card" for a discount 
health care program, she said. The card was attached to a booklet that 
explained the physical exams were intended to "find scientific evidence for 
the effective prevention and treatment of chronic diseases from both 
genetic and environmental perspectives."

Volunteers underwent a battery of tests and gave blood, but the test 
results, follow-up care and health program never materialized -- meaning 
many of the medical problems identified in the physicals went untreated.

Wang Mengfeng was among 1,500 people who turned out to give blood. He had 
been suffering from a worsening stomach ailment, according to his wife, Hu 
Nanxia. He volunteered with hopes of getting it diagnosed and treated, she 

The medical team told Wang he had gastritis, she said. They drew his blood 
and gave him a health card. Afterward, the local clinic wouldn't honor it, 
because the staff said they had not received the promised outside funding 
for the program, she said. So Hu and Wang borrowed money that soon ran out, 
and his condition deteriorated until he died last year at 34. "He was a 
good man," she said.

The director of the Toutuo Health Station was Zheng Guanghu, who is now the 
director of the Yuexi County Hospital administrative office. He said the 
health care initiative was a success. He described it as a joint effort to 
recruit volunteers for Xu's genetic research and drum up business for a low-
cost health care program promoted by Anhui Medical University. Zheng said 
he shipped 1,500 blood samples to Xu's Meizhong Institute, as did Baimao, a 
township in an isolated western valley of Anhui, and "every other county in 

But when Xu was asked about the failed initiative, he said he was not 
officially involved. He said he offered advice and reviewed the data they 
collected, but found it too unreliable to be useful for his research. He 
did not receive any blood from it, he said. "Maybe some people fell through 
the cracks. Maybe some promises were broken," Xu said. "I didn't have 
anything to do with that."

Zheng subsequently faxed a statement to The Post saying Xu wasn't involved. 
According to a second faxed statement, this one from Anhui Medical 
University, Toutuo residents were questioned about The Post's 
"unauthorized" visit and none complained about the research initiative. 
"All the subjects were satisfied about this project and were grateful to 
the local health agencies for their concern about their health," the second 
fax stated.

Huaining County is another remote, rural district that Xu and his Anhui 
collaborators targeted for genetic research into several diseases, 
including hypertension and asthma. Here, too, participants say promises 
were not kept.

In 1996, with Xu's permission, a team of social scientists interviewed 
asthma volunteers for a U.N.-funded public health study. Several refused to 
cooperate, because of bad experiences with Xu's project, according to the 
field researcher's study diary. "Had a refusal yesterday. . . . Complained 
had been subjected to a check-up and never told result. Felt used and 
tricked," one entry said. Said another: "The woman refused to have anything 
to do with us under any conditions, even if a gun was held to her head."

The field researcher, Leslyn Hall, recalled the encounter with the angry 
woman. "She was very, very upset," Hall said in an interview. "Her son was 
8 or 10. A minor. She had a disagreement with her husband over 
participation that she felt led to divorce. The boy passed out during their 
taking blood. He was with the asthma group. She sought follow-up care for 
him and never got it."

The study was canceled because Xu's database of volunteers turned out to be 
too problematic, said Robert Weller, a Boston University anthropologist 
involved in the study. According to grant documents, Xu and his research 
team gave differing accounts of how they recruited volunteers.

Xu said he wasn't aware of any complaints from asthma families. After 
learning of the issue from The Post, he said he dispatched two researchers 
to visit 10 participants. None recalled any promises of follow-up health 
care, he said.

However, Kuo said that recruits were told that they would get medical care. 
At one point, doctors at Haikou Hospital in Huaining County sought the lab 
results from Xu for thousands of study recruits so they could be treated, 
Kuo said. But none were provided, according to the hospital's medical 
staff. "Promises were made," said one doctor. "Participants were told they 
would get free medical care and reduced-cost care, but the research project 
never gave us the funds to do it."

The experience poisoned relations between local doctors and their 
community. "It used to be like this," said another doctor, clasping his two 
hands together. "Now it is very tense." Volunteers are recruited through 
township health stations, the doctors said, but now people are reluctant to 
participate. So the hospital has been tasked with working with Communist 
Party officials to find volunteers. "If they don't want to participate," 
said one doctor, "officials go down to the villages and do thought work and 
move them to participate."

"Thought work" involves meetings with local government and party officials 
and can involve both subtle and blatant forms of pressure. If officials are 
having trouble rounding up test subjects, residents said, thought work can 
become heavy-handed, even coercive. Residents rely on the Communist Party 
and local government for many favors involving taxes and the division of 
land. Families who are not cooperative could suffer, residents said.

When asked about the doctors' complaints last spring, Xu said, "I would be 
surprised if [the test results] were not returned."

He said the doctors did not know they were talking to a reporter, and 
Anhui's public security department has since issued a province-wide 
circular warning people involved in the research not to talk to outsiders. 
In a later e-mail, Xu said the hospital staff had been questioned about 
their complaints and confessed to lying about Xu promising medical care for 
volunteers. "These doctors now regret any untruthful answer they may have 
naively offered," Xu wrote.

Asked about the "thought work" allegation, Xu answered through Harvard 
spokeswoman Robin Herman. "Dr. Xu has never heard of authorities demanding 
'thought work' from recruited subjects," she said. "More importantly from 
Harvard's perspective, Dr. Xu or other Harvard researchers were never 
involved in such an effort."

Sponsors at Millennium said they didn't know how Xu recruited participants. 
"We left it up to [him]," said Schmitt, who oversaw the asthma study. "And 
we were happy with his progress." Duyk said he assumed residents 
participated for the medical attention and, along with local health 
workers, out of curiosity. "It was fun for people. It was a very isolated 
region. Just to participate in it was an interesting thing," he said.

A Federal Investigation

In March 1999, Harvard sent a six-person team to Anhui to make sure the 
research was ethically and scientifically sound. James H. Ware, the 
academic dean at the School of Public Health and a member of the site 
committee, said it was unusual to send overseers to such a remote location, 
but the scale and "sensitivity" of the genetic research warranted it.

The team included representatives of the School of Public Health, the 
Medical School and Brigham and Women's Hospital. Among the six designees 
were Xu himself, Weiss and one of their research collaborators. They spent 
just two days in Anqing at Xu's research headquarters. Ware said the 
Chinese they met were clean and well dressed. The notion of an oppressed, 
malnourished or illiterate population was at odds with what he saw, he 
said. "I came away extremely impressed." The program passed.

Five months later, regulators from the Department of Health and Human 
Services launched an investigation of Harvard's genetic research in China, 
based on the complaint of Gwendolyn Zahner, a former School of Public 
Health faculty member. She alleged violations of U.S. human subject 
protection regulations.

Zahner, now at the Research Triangle Institute in North Carolina, said she 
grew concerned about the project while on a Harvard committee assigned to 
review a proposal by Xu and his colleagues to conduct thousands of 
colonoscopies in Anhui. The study never received funding. But Zahner said 
she was surprised at Harvard's seeming lack of concern over patient 
protection. She investigated further and concluded that reviews of other 
studies hadn't adequately weighed the risks of the Chinese government 
misusing sensitive genetic information. Some of Xu's research appeared to 
have started ahead of any ethics review, she said.

Zahner visited Anhui four times to gather information for her complaint, 
and was twice questioned by police. "During my questioning, they knew every 
place I'd been and individual Chinese citizens to whom I'd spoken," Zahner 
said in an interview. "No one could conduct meaningful independent 
oversight of this research under those conditions."

Harvard officials said they took cultural differences into consideration 
and built protective measures into the studies to prevent the Chinese 
government from obtaining participants' genetic information.

And while grant documents and studies refer to at least four Harvard-Anhui 
Medical University studies that began prior to ethics committee approval, 
officials said those were "unofficial collaborations" in which Xu was 
helping the Chinese as a private consultant. "As the AMU-Harvard 
collaboration evolved and Dr. Xu became a principal investigator, studies 
then fell under the purview of our institutional review processes," said 
Harvard spokeswoman Herman.

However, records show thousands of vials of DNA were being shipped from 
Anhui to Harvard for analysis and storage under some of those informal 
arrangements. U.S. rules say ethics committee approval is needed before 
such analysis can proceed. Herman said Harvard officials now realize 
approval was needed, after reviewing regulations and a recent NIH advisory 
that clarified the rules.

In China, Xu's critics have attempted to stop or at least slow his 
expanding genetic research empire, but have had little success. "It is bad 
research, pure and simple," said Yang, of the Genome Project. "They cheated 
the patients. They came in for health checkups, they didn't know what their 
blood was being used for, and then they never gave them the results of the 

Yang sits on the national board appointed to review international 
collaborations. He said the board last year rejected two of Xu's most 
recent research applications and held up a third out of concern that he was 
overextended and couldn't meet China's newly enacted patient protection 
standards. Yang said Xu appealed to Chinese leaders and forced a compromise 
that would allow him to proceed with the projects if they received approval 
from the U.S. government.

Qiu Renzong, one of China's leading medical ethicists and a senior 
government adviser, called for a joint U.S.-Chinese review of Xu and the 
Harvard experiments. "There are so many questions about them," Qiu said. 
"As principal investigator, he is responsible for everything that happened."

The U.S. Embassy's November advisory about medical research in China 
concluded that while "good practices are widely understood by Chinese 
researchers, the lack of accountability and poor supervision can mean that 
good practices are not followed on the front lines of research projects."

As a result, "Research should be conducted primarily in the more prosperous 
parts of China, unless there is strong justification for doing otherwise," 
the advisory said. Beijing officials have a hard time overseeing research 
in remote areas, and local officials tend to cover up problems, it said. 
People lack freedom, making reliable informed consent a challenge.

"Local officials can sometimes have such great arbitrary power that a 
farmer may not want to say 'no' to them," the advisory said. The advisory 
said "good connections should not be a reason for choosing a research site 
in a "backward" area.

But Frank E. Speizer, co-director of Brigham and Women's Channing 
Laboratory, which oversaw the asthma research, challenged the notion that 
residents from Anhui needed special protection. "I find it hard to call 
China a developing country," he said. "It's a very sophisticated country."

Officials at the School of Public Health say they have provided adequate 
oversight and that the Anhui project meets the university's high standards 
for human research. Ware said he has tightened oversight in the past few 
months by requiring Xu to report all his research activities to the school, 
even the unofficial collaborations and consultant work that had not been 
reported previously.

At Millennium, chief business officer Steven H. Holtzman, a presidential 
appointee to the National Bioethics Advisory Commission, said he had no 
reason to believe that Harvard broke any rules in carrying out company-
sponsored research in China. But he said Millennium is "more sensitized" 
now to the need to keep a closer watch on such research, as is the research 
community as a whole. Holtzman said the embassy's concerns didn't apply to 
Millennium's research, because it was a well-run, low-risk operation "that 
could potentially shed light on the biological basis of a disease."

Millennium pulled out of Anhui last year, without a significant medical or 
business discovery to show for its $3.5 million investment. The DNA is 
still in the databank, and the company has hopes it will yield clues to 
disease in the future. Millennium has moved into a field of genetics that 
seeks to customize medical treatments for individual patients. The company 
has grown into a successful, billion-dollar enterprise that has made 
millions for top executives.

In March, Worth Magazine profiled Millennium Chairman and CEO Mark Levin 
after the company's stock more than doubled in three months. In April, he 
made the news again for paying a Rhode Island state-record $10.8 million 
for a 33-room vacation mansion with resident llama. Holtzman acknowledged 
Anhui's early supporting role in Millennium's success. "We're here now," he 
said. "But you don't get from there to here unless you do what's important 
at the time."

Xu continues on in Anhui. With grants from NIH, he is launching a $3.5 
million study of hypertension in 700 adults and teens and a $3.3 million 
nicotine study that will look for clues to cigarette addiction in the blood 
of 3,400 people.

Back in Toutuo, little has changed for Wang Guangpu, the barber. He said he 
still has the health cards his family received three years ago. He keeps 
them in a safe spot, just in case. "We Chinese are simple people," he said. 
"All we want is a little off the price of medical care. It would be better, 
say, if the price is 100, maybe we'd pay 60 or 70. We didn't even get that."

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