Can AI help create “smart borders” between countries?
A refugee in Uganda’s Oruchinga settlement uses an iris scan to claim food assistance.
In 2016, border patrols in Greece, Latvia and Hungary received a prototype for an AI-powered lie detector to help screen asylum seekers. The detector, called iBorderCtrl, was funded by the European Commission in hopes to eventually mitigate refugee crises like the one sparked by the Syrian civil war a year prior.
iBorderCtrl, which analyzes micro expressions in the face, received but one slice of the Commission’s €34.9 billion border control and migration management budget. Still in development is the more ambitious EuMigraTool, a predictive AI system that will process internet news and social media posts to estimate not only the number of migrants heading for a particular country, but also the “risks of tensions between migrants and EU citizens.”
Both iBorderCtrl and EuMigraTool are part of a broader trend: the growing digitization of migration-related technologies. Outside of the EU, in refugee camps in Jordan, the United Nations introduced iris scanning software to distribute humanitarian aid, including food and medicine. And in the United States, Customs and Border Protection has attempted to automate its services through an app called CBP One, which both travelers and asylum seekers can use to apply for I-94 forms, the arrival-departure record cards for people who are not U.S. citizens or permanent residents.
According to Koen Leurs, professor of gender, media and migration studies at Utrecht University in the Netherlands, we have arrived at a point where migration management has become so reliant on digital technology that the former can no longer be studied in isolation from the latter. Investigating this reliance for his new book, Digital Migration, Leurs came to the conclusion that applications like those mentioned above are more often than not a double-edged sword, presenting both benefits and drawbacks.
There has been “a huge acceleration” in the way digital technologies “dehumanize people,” says Koen Leurs, professor of gender, media and migration studies at Utrecht University in the Netherlands. Governments treat asylum seekers as test subjects for new inventions, all along the borders of the developed world.
On the one hand, digital technology can make migration management more efficient and less labor intensive, enabling countries to process larger numbers of people in a time when global movement is on the rise due to globalization and political instability. Leurs also discovered that informal knowledge networks such as Informed Immigrant, an online resource that connects migrants to social workers and community organizers, have positively impacted the lives of their users. The same, Leurs notes, is true of platforms like Twitter, Facebook, and WhatsApp, all of which migrants use to stay in touch with each other as well as their families back home. “The emotional support you receive through social media is something we all came to appreciate during the COVID pandemic,” Leurs says. “For refugees, this had already been common knowledge for years.”
On the flipside, automatization of migration management – particularly through the use of AI – has spawned extensive criticism from human rights activists. Sharing their sentiment, Leurs attests that many so-called innovations are making life harder for migrants, not easier. He also says there has been “a huge acceleration” in the way digital technologies “dehumanize people,” and that governments treat asylum seekers as test subjects for new inventions, all along the borders of the developed world.
In Jordan, for example, refugees had to scan their irises in order to collect aid, prompting the question of whether such measures are ethical. Speaking to Reuters, Petra Molnar, a fellow at Harvard University’s Berkman Klein Center for Internet and Society, said that she was troubled by the fact that this experiment was done on marginalized people. “The refugees are guinea pigs,” she said. “Imagine what would happen at your local grocery store if all of a sudden iris scanning became a thing,” she pointed out. “People would be up in arms. But somehow it is OK to do it in a refugee camp.”
Artificial intelligence programs have been scrutinized for their unreliability, their complex processing, thwarted by the race and gender biases picked up from training data. In 2019, a female reporter from The Intercept tested iBorderCtrl and, despite answering all questions truthfully, was accused by the machine of lying four out of 16 times. Had she been waiting at checkpoint on the Greek or Latvian border, she would have been flagged for additional screening – a measure that could jeopardize her chance of entry. Because of its biases, and the negative press that this attracted, iBorderCtrl did not move past its test phase.
While facial recognition caused problems on the European border, it was helpful in Ukraine, where programs like those developed by software company Clearview AI are used to spot Russian spies, identify dead soldiers, and check movement in and out of war zones.
In April 2021, not long after iBorderCtrl was shut down, the European Commission proposed the world’s first-ever legal framework for AI regulation: the Artificial Intelligence Act. The act, which is still being developed, promises to prevent potentially “harmful” AI practices from being used in migration management. In the most recent draft, approved by the European Parliament’s Liberties and Internal Market committees, the ban included emotion recognition systems (like iBorderCtrl), predictive policing systems (like EUMigraTool), and biometric categorization systems (like iris scanners). The act also stipulates that AI must be subject to strict oversight and accountability measures.
While some worry the AI Act is not comprehensive enough, others wonder if it is in fact going too far. Indeed, many proponents of machine learning argue that, by placing a categorical ban on certain systems, governments will thwart the development of potentially useful technology. While facial recognition caused problems on the European border, it was helpful in Ukraine, where programs like those developed by software company Clearview AI are used to spot Russian spies, identify dead soldiers, and check movement in and out of war zones.
Instead of flat-out banning AI, why not strive to make it more reliable? “One of the most compelling arguments against AI is that it is inherently biased,” says Vera Raposo, an assistant professor of law at NOVA University in Lisbon specializing in digital law. “In truth, AI itself is not biased; it becomes biased due to human influence. It seems that complete eradication of biases is unattainable, but mitigation is possible. We can strive to reduce biases by employing more comprehensive and unbiased data in AI training and encompassing a wider range of individuals. We can also work on developing less biased algorithms, although this is challenging given that coders, being human, inherently possess biases of their own.”
AI is most effective when it enhances human performance rather than replacing it.
Accessibility is another obstacle that needs to be overcome. Leurs points out that, in migration management, AI often functions as a “black box” because the migration officers operating it are unable to comprehend its complex decision-making process and thus unable to scrutinize its results. One solution to this problem is to have law enforcement work closely with AI experts. Alternatively, machine learning could be limited to gathering and summarizing information, leaving evaluation of that information to actual people.
Raposo agrees AI is most effective when it enhances human performance rather than replacing it. On the topic of transparency, she does note that making an AI that is both sophisticated and easy to understand is a little bit like having your cake and eating it too. “In numerous domains,” she explains, “we might need to accept a reduced level of explainability in exchange for a high degree of accuracy (assuming we cannot have both).” Using healthcare as an analogy, she adds that “some medications work in ways not fully understood by either doctors or pharma companies, yet persist due to demonstrated efficacy in clinical trials.”
Leurs believes digital technologies used in migration management can be improved through a push for more conscientious research. “Technology is a poison and a medicine for that poison,” he argues, which is why new tech should be developed with its potential applications in mind. “Ethics has become a major concern in recent years. Increasingly, and particularly in the study of forced migration, researchers are posing critical questions like ‘what happens with the data that is gathered?’ and ‘who will this harm?’” In some cases, Leurs thinks, that last question may need to be reversed: we should be thinking about how we can actively disarm oppressive structures. “After all, our work should align with the interests of the communities it is going to affect.”
Urinary tract infections account for more than 8 million trips to the doctor each year.
Few things are more painful than a urinary tract infection (UTI). Common in men and women, these infections account for more than 8 million trips to the doctor each year and can cause an array of uncomfortable symptoms, from a burning feeling during urination to fever, vomiting, and chills. For an unlucky few, UTIs can be chronic—meaning that, despite treatment, they just keep coming back.
But new research, presented at the European Association of Urology (EAU) Congress in Paris this week, brings some hope to people who suffer from UTIs.
Clinicians from the Royal Berkshire Hospital presented the results of a long-term, nine-year clinical trial where 89 men and women who suffered from recurrent UTIs were given an oral vaccine called MV140, designed to prevent the infections. Every day for three months, the participants were given two sprays of the vaccine (flavored to taste like pineapple) and then followed over the course of nine years. Clinicians analyzed medical records and asked the study participants about symptoms to check whether any experienced UTIs or had any adverse reactions from taking the vaccine.
The results showed that across nine years, 48 of the participants (about 54%) remained completely infection-free. On average, the study participants remained infection free for 54.7 months—four and a half years.
“While we need to be pragmatic, this vaccine is a potential breakthrough in preventing UTIs and could offer a safe and effective alternative to conventional treatments,” said Gernot Bonita, Professor of Urology at the Alta Bro Medical Centre for Urology in Switzerland, who is also the EAU Chairman of Guidelines on Urological Infections.
The news comes as a relief not only for people who suffer chronic UTIs, but also to doctors who have seen an uptick in antibiotic-resistant UTIs in the past several years. Because UTIs usually require antibiotics, patients run the risk of developing a resistance to the antibiotics, making infections more difficult to treat. A preventative vaccine could mean less infections, less antibiotics, and less drug resistance overall.
“Many of our participants told us that having the vaccine restored their quality of life,” said Dr. Bob Yang, Consultant Urologist at the Royal Berkshire NHS Foundation Trust, who helped lead the research. “While we’re yet to look at the effect of this vaccine in different patient groups, this follow-up data suggests it could be a game-changer for UTI prevention if it’s offered widely, reducing the need for antibiotic treatments.”
MILESTONE: Doctors have transplanted a pig organ into a human for the first time in history
A surgeon at Massachusetts General Hospital prepares a pig organ for transplant.
Surgeons at Massachusetts General Hospital made history last week when they successfully transplanted a pig kidney into a human patient for the first time ever.
The recipient was a 62-year-old man named Richard Slayman who had been living with end-stage kidney disease caused by diabetes. While Slayman had received a kidney transplant in 2018 from a human donor, his diabetes ultimately caused the kidney to fail less than five years after the transplant. Slayman had undergone dialysis ever since—a procedure that uses an artificial kidney to remove waste products from a person’s blood when the kidneys are unable to—but the dialysis frequently caused blood clots and other complications that landed him in the hospital multiple times.
As a last resort, Slayman’s kidney specialist suggested a transplant using a pig kidney provided by eGenesis, a pharmaceutical company based in Cambridge, Mass. The highly experimental surgery was made possible with the Food and Drug Administration’s “compassionate use” initiative, which allows patients with life-threatening medical conditions access to experimental treatments.
The new frontier of organ donation
Like Slayman, more than 100,000 people are currently on the national organ transplant waiting list, and roughly 17 people die every day waiting for an available organ. To make up for the shortage of human organs, scientists have been experimenting for the past several decades with using organs from animals such as pigs—a new field of medicine known as xenotransplantation. But putting an animal organ into a human body is much more complicated than it might appear, experts say.
“The human immune system reacts incredibly violently to a pig organ, much more so than a human organ,” said Dr. Joren Madsen, director of the Mass General Transplant Center. Even with immunosuppressant drugs that suppress the body’s ability to reject the transplant organ, Madsen said, a human body would reject an animal organ “within minutes.”
So scientists have had to use gene-editing technology to change the animal organs so that they would work inside a human body. The pig kidney in Slayman’s surgery, for instance, had been genetically altered using CRISPR-Cas9 technology to remove harmful pig genes and add human ones. The kidney was also edited to remove pig viruses that could potentially infect a human after transplant.
With CRISPR technology, scientists have been able to prove that interspecies organ transplants are not only possible, but may be able to successfully work long term, too. In the past several years, scientists were able to transplant a pig kidney into a monkey and have the monkey survive for more than two years. More recently, doctors have transplanted pig hearts into human beings—though each recipient of a pig heart only managed to live a couple of months after the transplant. In one of the patients, researchers noted evidence of a pig virus in the man’s heart that had not been identified before the surgery and could be a possible explanation for his heart failure.
So far, so good
Slayman and his medical team ultimately decided to pursue the surgery—and the risk paid off. When the pig organ started producing urine at the end of the four-hour surgery, the entire operating room erupted in applause.
Slayman is currently receiving an infusion of immunosuppressant drugs to prevent the kidney from being rejected, while his doctors monitor the kidney’s function with frequent ultrasounds. Slayman is reported to be “recovering well” at Massachusetts General Hospital and is expected to be discharged within the next several days.