The Emerging Neurobioeconomy: Implications for National Security

Abstract

Neuroscience and neurotechnology (neuroS/T) are techniques and tools used to assess or affect the nervous system. Current and near-future developments are enabling an expanding palette of capabilities to understand and influence brain functions that can foster wellbeing and economic growth. This “neurobioeconomy” is rapidly growing, attributable in large part to the global dissemination of knowledge that fosters and contributes to scientific innovation, invention, and commercialization. As a result, several countries have initiated programs in brain research and innovation. Not all brain sciences engender security concerns, but a predominance in global biomedical, bioengineering, wellness/lifestyle, and defense markets enables considerable power. Such power can be leveraged in nonkinetic or kinetic domains, and several countries have identified neuroS/T as viable and of growing value for use in warfare, intelligence, and national security operations. In addition to the current focus on biotechnology, the United States and its allies must acknowledge the significance of brain science and its projected impact on the economy, national security, and lifestyles. In this article, we examine growth of the neuroS/T market, discuss how the neurobioeconomy poses distinct ethical and security issues for the broader bioeconomy, provide examples of such issues that arise from specific nation-state activity and technological commercialization, and propose a risk assessment and mitigation approach that can be engaged by the economic, scientific, and security communities.

The neuroscience and neurotechnology market has grown considerably in recent years. This article discusses how the neurobioeconomy poses distinct ethical and security issues for the broader bioeconomy, provides examples of such issues that arise from specific nation-state activity and technological commercialization, and proposes a risk assessment and mitigation approach that can be engaged by the economic, scientific, and security communities.

Introduction

Neuroscience and neurotechnology (neuroS/T) are techniques and tools used to assess or affect the nervous system.¹ Current and near-future developments are enabling an expanding palette of capabilities to understand and influence brain functions, which “offer tremendous potential for the promotion of health, wellbeing, and economic growth.”² The inclusion of brain science as a business into the broader bioeconomy also creates ethical and security issues. In addition to the current focus on biotechnology, the United States and its allies must acknowledge the significance of brain science and its projected impact on the economy, national security, and lifestyles. In this article, we first examine how the neuroscientific market has grown and what further growth is projected for the following decades. Second, we discuss how this “neurobioeconomy” poses distinct ethical and security issues for the broader bioeconomy and emerging biotechnologies. Third, we provide examples of such issues that arise from specific nation-state activity, such as China's deliberate focus on brain science, and from technological commercialization, with a focus on recent innovations in brain–machine interfacing, highlighting Neuralink as an exemplar. Lastly, we propose a risk assessment and mitigation approach that can be engaged by the economic, scientific, and security communities.

Genomics scholars Rodrigo Martinez and Juan Enriquez popularized the term “bioeconomy” in the late 1990s.³ Since the mid-2000s, the bioeconomy has been the focus of increasing attention among scholars and governments, although there is little consensus about its definition or the fields that constitute the discipline.^4,5 Recently a working definition of bioeconomy, as “the economy built on biotechnology,” has been proposed, and there is general agreement that the bioeconomy includes the “energy, agricultural, medical, industrial, and defense sectors.”⁶

Bugge and colleagues described 3 visions of how published scholars perceive the bioeconomy: (1) a bioresource vision that focuses on research and development of raw biological materials; (2) a bioecology vision that examines the role of energy, nutrients, and sustainability in other processes and systems; and (3) a biotechnology vision that emphasizes the importance of biotechnological research and the application and commercialization of biotechnology in differing sectors.⁴ The primary aims and objectives of the biotechnology vision are particularly relevant to the economic growth and job creation engendered by the brain sciences. Fundamentally, such growth begins with initial investments in universities and other research institutions that spark innovation. This is followed by product development, manufacturing, and marketing. In the brain sciences, there are 3 primary reasons why market leaders will likely be limited to those countries and regions that possess and can exercise critical advantages.⁷ First, commercial firms must have, and maintain, synergistic collaboration with universities and institutions capable of high-quality research. In addition, public and private funding opportunities should be available to foster studies and projects that lead to iterative collaboration. Second, several productive pharmaceutical, biotechnical, and biomedical firms—and a viable, educated, and adept workforce—must be either in place or established to produce neuroscientific innovations on an industrial scale. Lastly, a capable market of zealous consumers must be identified and engaged in cultivating, encouraging, and sustaining expanding enterprises in research and production.

Brain Sciences as a Business

Much growth in the neurobioeconomy can be attributed to the global dissemination of knowledge that has fostered and continues to contribute to scientific innovation, invention, and commercialization. An aging international population, that provides both a viable target for innovative diagnostics and therapeutics and a market for their use, can also be regarded as a contributing factor. When taken together, there is an evident market opportunity for neuroS/T development and production. In a 2016 analysis of data from 195 countries, the Global Burden of Diseases, Injuries, and Risk Factors Study Group found that neurological disorders were the second leading cause of death worldwide (with approximately 9 million deaths, constituting 16.5% of global fatalities).⁸ Additionally, neurological disorders were the leading cause of disability, incurring approximately 276 million disability-adjusted life-years. Assessments by the group also illustrate the magnitude of neuropsychiatric illnesses, with 2016 estimates indicating that these disorders account for one-third of worldwide disabilities.⁹ A report by the Lancet Commission estimated that between 2010 and 2030, the fiscal productivity loss incurred by neuropsychiatric conditions could be as high as US$16 trillion.¹⁰ The increased prevalence of these diseases in an aging population is placing significant burdens on healthcare systems and generating substantial expenses in economic and social welfare.²

When considering recent demographic trends and continuity of aging populations, neurological disorders are likely to have a more significant impact in the near future. Estimates from 2017 projected that the global population of people over the age of 60 would increase from 800 million in 2017 to 2 billion in 2050—accounting for about 22% of the world population.¹¹ This percentage is disproportionately larger in higher-income countries. For example, dementing disorders—pathologies that present with a progressive decline in memory, emotion, and executive behavior—currently affect 50 million people, and it is projected that 152 million people will be affected by 2050. These disorders are, and are predicted to remain, a primary focus of global brain science.²

While the search for improved diagnostics, treatments, and potential prevention of neuropsychiatric disorders are principal drivers of brain research, there is a growing commercial interest in developing applications of neuroS/T in direct-to-consumer healthcare, education, information and communication technology, law enforcement, and military markets. For example, in the past 10 years, the number of patents for direct-to-consumer neurotechnologies has more than doubled; and the worldwide market for neurotechnology products is forecasted to increase from US$8.4 billion in 2018 to US$13.3 billion in 2022.¹² Illustrative of this increase is the number of health-related neurotechnology patents filed in the top innovative countries from 2008 to 2016² (Figure 1). Moreover, in 2019, several neurotechnology startups disclosed annual funding ranging from US$1 million to US$50 million (eg, Thync, Halo Neuroscience), US$50 million to US$100 million (eg, Dreem, Kernel), and more than US$100 million (eg, NeuroPace, MindMaze).¹³ Such financial success can be demonstrated by the size and relative growth of the global deep brain stimulation device market, which is projected to reach US$2.3 billion by 2025, increasing 16.1% in compound annual growth rate between 2019 and 2025.¹⁴

Figure 1.

Number of patents filed for health-related neurotechnology in the top 10 leading countries. It shows the total number of patents filed from 2008 to 2016 in the top 10 countries for health-related neurotechnology innovation: United States, People's Republic of China, South Korea, Germany, Australia, Israel, Canada, Switzerland, Japan, and France.²

Interactive developments in neuroS/T and computational biology have enabled the leveraging of neuropsychiatric data (ie, neurodata).¹⁵ The convergence of diverse approaches and disciplines, including the physical, social, and computational sciences, and intentional “technique and technology sharing,” has been crucial to the number and rapidity of recent advances in the brain sciences. Concerted efforts in neuroinformatics are producing new computational tools that can aggregate, organize, synthesize, and use neurodata in research and other applications, including clinical medicine, law, and national security and defense.¹⁶

Several countries have initiated programs in brain research and innovation (Table 1). These initiatives aim to (1) advance understanding of substrates and mechanisms of neuropsychiatric disorders; (2) improve knowledge of processes of cognition, emotion, and behavior; and (3) augment the methods for studying, assessing, and affecting the brain and its functions. New research efforts incorporate best practices for interdisciplinary approaches that can use advances in computer science, robotics, and artificial intelligence to fortify the scope and pace of neuroscientific capabilities and products. Such research efforts are strong drivers of innovation and development, both by organizing larger research goals and by shaping neuroS/T research to meet defined economic, public health, and security agendas.

Table 1.

Programs in Brain Research and Innovation

Brain Science Initiative	Overview
US Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative	The BRAIN Initiative aims to help researchers find new ways to treat, cure, and even prevent brain disorders, such as Alzheimer's disease, epilepsy, and traumatic brain injury. The initiative will accelerate the development and application of new technologies that will enable researchers to produce dynamic pictures of the brain that show how individual brain cells and complex neural circuits interact at the speed of thought.17
EU Human Brain Project	The Human Brain Project is building a research infrastructure to help advance neuroscience, medicine and computing. Six research platforms form the heart of its infrastructure: neuroinformatics, brain simulation, high-performance analytics and computing, medical informatics, neuromorphic computing, and neurorobotics.18
The China Brain Project: Brain Science and Brain-Inspired Intelligence	The China Brain Project covers basic research on neural mechanisms underlying cognition and translational research for the diagnosis and intervention of brain diseases, and for brain-inspired intelligence technology.19
Japanese Brain/MINDS Project	Brain/MINDS aims to map the structure and function of neuronal circuits to ultimately understand the vast complexity of the human brain and takes advantage of a unique nonhuman primate animal model, the common marmoset.20
Korea Brain Initiative	By accelerating brain research, the Korea Brain Initiative hopes to envision a comprehensive understanding of human behavior, open the road to treatments that can prevent and cure brain diseases, and develop innovative approaches and strategies to cope with a rapidly aging society.21
Australian Brain Initiative	The aim of the Australian Brain Initiative is to create advanced industries in neurotechnology, develop treatments for debilitating brain disorders, and produce high-impact transdisciplinary collaborations that will increase our understanding of the brain.22

In an attempt to coordinate goals and projects, the International Brain Initiative was established in 2017 with a specific intent toward “catalyzing and advancing ethical neuroscience research through international collaboration and knowledge sharing, by uniting diverse ambitions to expand scientific possibility, and disseminating discoveries for the benefit of humanity.”²³ Constituents of the initiative include Australia, Canada, China, the European Union, Japan, Korea, and the United States. While the intent is notable, it remains to be seen if and to what extent the International Brain Initiative will operate in partnership with other, extant organizations (eg, Organisation for Economic Cooperation and Development, Institute of Electrical and Electronics Engineers, World Health Organization) that are dedicated to similar, if not identical aims; and if the formation of another group may facilitate these means and ends, or merely become an example of “too many cooks ruining the broth.”^24-26

Ethical and Security Challenges

The US National Academies of Science, Engineering, and Medicine has called for the United States and its allies to recognize dual obligations to the emerging bioeconomy.⁵ First, they have a responsibility for prudent direction and oversight, as failure to promote progress among biological and technological industries could result in losing leadership of the international community. Meeting this obligation could include adequately funding research and development in key areas, implementing appropriate research oversight, and educating the research workforce. Second, they need to protect the bioeconomy from deliberate adversarial acts that could impede biotechnological progress and allow other international individuals, groups, or countries to gain power advantage. This responsibility could entail developing more rigorous methods of handling of biologicals and technologies, affording ample protection of biological data and digital infrastructures, and generating as well as implementing more effective, globally relevant intellectual property laws.

It is also important to note that although the US National Academies of Science, Engineering, and Medicine report⁵ briefly mentioned recent developments in brain-controlled robotics and brain–machine interface, it did not address neuroS/T on a larger scale. The majority of countries do not yet identify the brain sciences as a principal economic focus. Of the 41 nations that pursued specific political strategies to expand and promote their bioeconomies in 2018, only 10^* included neuroS/T research and development objectives.^27,28 There may be little doubt that neuropsychiatric disorders are a significant public health problem, but brain research is relatively costly; for countries that do not have substantial neuroepidemiological burdens, the perceived return on investment may be insufficient to justify pursuing dedicated neuroS/T initiatives.²⁹ Although the intranational human capital and sociopolitical agendas of a country may not prompt them to invest or engage in neurobioeconomics, the relative economic—and perhaps cultural and political—hegemony afforded by leveraging global neuroS/T (and overall biological) markets might prove influential to changing perspectives, postures, and participation.³⁰ Because of the current lack of emphasis on brain science in national bioeconomic strategies, countries that initiate policies and programs to invest in neuroS/T may achieve significant financial successes, economic power, and thereby influence future ethical, technical, and legal standards of research and use.³¹

As mentioned earlier, rapid advances in brain science represent an emerging domain that state and nonstate actors can leverage in warfare, intelligence, and national security (WINS) operations.^1,15,32 Not all brain sciences engender security concerns, but a predominance in global biomedical, bioengineering, wellness/lifestyle, and defense markets enables considerable power.³³ It is equally important to note that such power can be exercised in both nonkinetic and kinetic operational domains, and several countries have identified neuroS/T as viable, valuable, and useful in their WINS programs.^15,34 While extant treaties (eg, the Biological Toxin and Weapons Convention, the Chemical Weapons Convention) and laws have addressed particular products of the brain sciences (eg, chemicals, biological agents, toxins), other forms of neuroS/T, (eg, neurotechnologies, neuroinformatics) remain outside the focus, scope, and governance of these conventions.³⁵ Technology can influence and potentially shape the norms and conduct of warfare, and the future battlefield will depend on achieving not only biological dominance but also mental/cognitive dominance and intelligence dominance.³⁶ Without established standards and proper international oversight of research and potential use in practice, regulating and restricting WINS applications of neuroS/T will be ever more difficult.³⁷

Several aspects of the brain sciences make them particularly problematic for the biosecurity community. First, the field has become increasingly interdisciplinary, as it strives to integrate several sciences and technologies (eg, biology, chemistry, psychology, physics, computational sciences) to address neuroscientific questions and forge innovative discoveries and interventions. For instance, state and nonstate actors can use novel neurotechnologies (eg, brain–machine interfaces, transcranial neural stimulation devices), and advances in neuroinformatics (ie, analyzing neuroscientific data to better assess, access, and affect the nervous system) for WINS applications. The development and use of these devices are currently underregulated and not included in dual-use export safeguards, thus making effective oversight of potential dual-use research difficult. Second, these neurotechnologies have been underexplored for their augmentative and destructive capabilities and uses. In contrast to other conventional biological and chemical weapons (eg, microbes, toxins, chemicals), devices that affect the nervous system are relatively new and have only recently been engaged for their WINS potential. The unknown possibilities of neurotechnology creates difficulties in realistic biosecurity forecasting and preparedness.

Over the last 20 years, publications in the brain sciences have steadily increased (Figure 2). However, oversight of research remains a problem, as surveillance of potential WINS applications is complicated by persistent challenges in tracking and evaluating (any) neuroS/T research and product development.³⁸ Thus, the potential for dual- or direct-use of neuroS/T for disruptive or destructive purposes becomes increasingly viable.³⁹

Figure 2.

Number of publications in select brain science domains. It shows the number of publications per year from 2000 to 2019 in select brain science domains. The terms of neurogenetics, neuroproteomics (or “neuro” and “proteomics”), neuroimaging, TMS (ie, transcranial magnetic stimulation), DBS (ie, deep brain stimulation), and BMI (ie, brain machine interface) or BCI (ie, brain computer interface) were queried. To obtain information for this figure, the PubMed database (managed by the US National Center for Biotechnology Information, US Library of Medicine, and US National Institutes of Health) was searched, and the number of articles per year was retrieved using the search entry term(s) listed in the figure description. Although the PubMed database does not exclusively represent the total number of articles published on a given topic or category, this type of surveillance can be useful to demonstrate trends in research and publication volume.

Abbreviations: BCI, brain–computer interface; BMI, brain–machine interface; DBS, deep brain stimulation; TMS, transcranial magnetic stimulation.

Much of neuroS/T relies on computational approaches and the use of big data. It is important to note, however, that rapid advances in cybertechnology and data analytics often outpace security.⁴⁰ Peccoud and colleagues describe the term “cyberbiosecurity” as the intersection of computational systems, biological information, and the processes required to effectively mitigate, and/or prevent new and emerging risks and threats.⁴¹ We believe that neuroS/T data represent a specialized landscape of vulnerabilities, as such information could be misused to purloin medical records, and in this way, affect social, occupational, legal, and political regard and treatment of individuals and groups.^15,16 These data could also be used to acquire the “neuroprofiles” of individuals whom nefarious actors could target through the development and use of “precision pathologies.”^42-44

Brain science has clearly become a multinational enterprise. Although some countries have not committed investments and resources to escalate neuroS/T initiatives, several countries have showed an ardent intent to initiate brain science programs.^45,46 It is important to note that differing cultural and political values can affect the ethical codes that guide and govern the conduct of scientific research.⁴⁷ In some cases, these differing ethical standards may create opportunities to expedite neuroS/T research and advance outcomes and products to ultimately affect global markets.

Nation-State Case Study: China

As described in its 5-year plans for economic growth and other national strategies, China has identified and acknowledged the technical, economic, medical, military, and political value of the brain sciences and has initiated efforts to expand its current neuroS/T programs.⁴⁸ China uses broader strategic planning horizons than other countries and attempts to combine efforts from government, academic, and commercial sectors (ie, the “triple helix”) to accomplish cooperation and centralization of national agendas.^34,46,49 This coordination enables research projects and objectives to be used for a range of applications and outcomes (eg, medical, social, military).⁴⁸ As noted by Mu-ming Poo, director of the China Brain Project, China's growing aging population is contributing to an increasing incidence and prevalence of dementia and other neurological diseases.⁵⁰ In 2009, a brief study of elder healthcare facilities in Chengdu (the capital of China's Sichuan Province) found that 4.4% of individuals aged 60 to 69, 19.9% of individuals aged 70 to 79, and 65.5% of individuals aged 80 or older had dementia. The authors projected that these percentages would continue to increase as China's older population (ie, 60 years or older) grows to over 400 million by 2041.⁵¹ In their most recent 5-year plan, China addressed economic and productivity concerns fostered by an aging population and considerations for national economic stability, as resources and services required for elder care will stress their welfare programs and medical systems.⁵²

The current 5-year plan includes a call to develop medical approaches for neurological disorders and to expand research infrastructure in neuroS/T. This growing academic environment has been leveraged to attract and solicit multinational collaboration. In this way, China is affecting international neuroS/T through (1) research tourism, (2) control of intellectual property, (3) medical tourism, and (4) influence in global scientific thought. While these strategies are not exclusive to neuroS/T, they may be more opportunistic in the brain sciences because the field is new, expanding rapidly, and its markets are growing and being defined by both shareholders and stakeholder interests.⁵³

Research tourism in China involves strategically recruiting renowned, experienced scientists (mostly from Western countries) and junior scientists to contribute to and promote the growth, innovation, and prestige of Chinese scientific and technological enterprises. This is apparent by 2 primary efforts. First, initiatives such as the Thousand Talents Program (launched in 2008) and other programs (eg, Hundred Person Program, Spring Light Program, Youth Thousand Talents Program) aim to attract foreign researchers, nurture and sustain domestic talent, and bring back Chinese scientists who have studied or worked abroad.⁴⁶ China's ethical research guidelines are, in some domains, more permissive than in Western countries (eg, unrestricted human and/or nonhuman primate experimentation).⁵⁰ The director of the China Brain Project, Mu-ming Poo, has stated that this capability to engage research that may not be (ethically) viable elsewhere may (and should) explicitly attract international scientists to conduct research in China.^19,46,54

China leverages intellectual property policy and law to advance (and veil) neuroS/T and other biotechnologies in several ways.⁴⁸ First, it exploits the patent process by creating a “patent thicket.” The Chinese patent system focuses on the end utility of a product (eg, a specific neurological function in a device) rather than emphasizing the initial innovative idea, in contrast to the US system. This enables Chinese companies and institutions to copy or outrightly usurp foreign patents and products. Moreover, Chinese patent laws allow international research products and ideas to be used in China “for the benefit of public health,” or for “a major technological advancement.”⁴⁶ Second, the coordination of brain science institutions and the corporate sector establishes compulsory licensing under Chinese intellectual property and patent laws. This strategy (ie, “lawfare”) allows Chinese academic and corporate enterprises to have economic and legal support, while also enabling China to direct national research agendas and directives through these international neuroS/T collaborations.⁵⁵ China enforces its patent and intellectual property rights worldwide, which can create market saturation of significant and innovative products and could create international dependence upon Chinese neuroS/T.⁴⁸ Further, Chinese companies have been heavily investing in knowledge industries, including artificial intelligence enterprises and academic book and journal partnerships. For example, Tencent established a partnership with Springer Nature to engage in various educational products.⁵⁶ This will allow a significant stake in future narratives and dissemination of scientific and technological discoveries.

Medical tourism is the capability to explicitly or implicitly attract and solicit international individuals or groups to seek interventions that are either available only in a particular locale or that are more affordable to acquire in a certain locale. China certainly has a presence in this market, with available procedures ranging from the relatively sublime, such as using deep brain stimulation to treat drug addiction, to the seemingly science-fictional, such as the proposed body-to-head transplant to be conducted at Harbin Medical University in collaboration with Italian neurosurgeon Sergio Canavero.^54,57 China can advance and develop areas of neuroS/T in ways that other countries cannot or will not, through homogenizing a strong integrated “bench to bedside” capability and use of nonwestern ethical guidelines. China could specifically target treatments for diseases that may have a high global impact and could offer procedures that are not available in other countries (for either sociopolitical or ethical reasons). Such medical tourism could create global dependence on Chinese markets as individuals become reliant on products and services available only in China, in addition to those that are “made in China” for widespread use elsewhere.⁵⁸ China's growing biomedical industry, ongoing striving for innovation, and expanding manufacturing capabilities have positioned its pharmaceutical and technology companies to prominence in world markets. Such positioning—and the somewhat permissive ethics that enable particular aspects and types of experimentation—may be appealing to international scientists who choose to engage in research or commercial biomedical production within China's sovereign borders.^59,60

Through these tactics of economic infiltration and saturation, China can create power hierarchies and strategic biopolitical effects that influence real and perceived positional dominance of global markets. However, China is not the only country with differing ethical codes for governing research. The international community must, therefore, (1) recognize the reality of scientific and technological capabilities in countries; (2) evaluate what current and near-term trends indicate for global positions, influence, and power; and (3) decide how to address differing ethical views on innovation, research, and product development.⁵⁴ The research, development, and use of state-of-the-art brain sciences have arrived, and the world must be aptly prepared to manage its benefits and consequences.

Corporate Commercialization Case Study: Neuralink

A brain–machine interface is any device that acquires and translates brain activity for use or control by an external system. These interfaces are used to treat a growing number of neurological disorders (eg, deafness, Parkinson's disease, essential tremor, Tourette's syndrome) and have potential for broader use in both medical practice and occupational and lifestyle optimization.⁶¹ In 2019, Elon Musk announced that his company Neuralink would advance the clinical translation of a novel brain–machine interface that could restore sensory and motor function and treat neurological disorders.⁶² The interface involves implantation of microelectrodes in the brain to record neurological activity, which then conveys signals to sensors that can be detected by an external device, such as a smartphone. Due to the complex nature of this procedure, Neuralink plans to develop a robotic system for implanting electrodes. A neurosurgeon will monitor and manage the system and can manually adjust it as needed during the procedure. The company's efforts to develop such an interface have been underway for only 2 years, but it has already created an innovative, functioning application in an in vivo rat model. Neuralink plans to begin clinical trials in 2020 for treatments of certain neurological disorders, and Musk asserts that this technology could and should be available to any individual who wishes to achieve better access and better connections to “the world, each other, and ourselves.”⁶³

This emerging technology is significant and could further an understanding of the brain and neural pathways. However, there are several questions and considerations that the international community must address before Neuralink, or any related technology is offered to the public⁶⁴ (Table 2). For example, which patients—and under what conditions—will be treated using this approach? If only a select few can acquire a brain–machine interface, how will society regard such individuals versus those who do not have an implant?

Table 2.

Questions and Considerations When Offering Neurotechnology to the Public^a

^aAdapted from Giordano.⁶⁴

Abbreviation: neuroS/T, neuroscience and neurotechnology.

Presentations by Musk have asserted that a primary goal is to make the procedure as simple and automated as laser-assisted in-situ keratomileusis (LASIK).⁶³ However, until robotics, external devices, and neurosurgeons are available worldwide, there will be only a few places in the world that can offer this intervention. Given the current views of scientists throughout the United States, Europe, Japan, and Australia regarding medical interventions intended for nontherapeutic (ie, optimization or enhancement) purposes,^65,66 it seems unlikely that surgeons would want to perform the Neuralink brain–machine interface procedure. In this case, we would question where the procedures would be offered and how this technology and interventions would be funded. As noted earlier, some countries may be more inclined or even eager to adopt—and support, nurture, and further—brain–machine interfaces to offer to their citizens, healthcare system, and possibly WINS personnel.^50,67 The question then is whether and to what extent such enterprises would be viewed, solicited, and used to influence local and global bioeconomies and the relative balance of power yielded by position and prominence within these hierarchies.³⁰

The majority of these radical leveling and emerging developments are still at a relatively low technological readiness level. However, the use of brain–machine interfaces in WINS applications has been widely discussed in the literature, considered for various operational applications, and applied to assess and modify cognitive and motoric function in several tasks.^68,69 The extent of capabilities that brain–machine interfaces (or other devices) will have remains unclear. In the coming years, it is likely that such neurotechnologies will become more available, effective, and adopted. Using or modifying a brain–machine interface for WINS use, although requiring specific disciplinary expertise (eg, bioengineering, neurosurgery, and computational neuroscience), will not pose excessive difficulty for several countries that already have neuroS/T programs devoted to national security and defense efforts. Moreover, the differing cultural values and ethical norms in countries may enable more rapid research and broader translation and use in WINS operations.

Looking Ahead: A Potential Future

Addressing the complexities and issues generated by the influence of brain sciences on the global bioeconomy will become increasingly important. It is, therefore, necessary to understand the rapid pace, trajectories, and effects of neuroS/T developments as well as the interaction and reciprocity of these effects and economic, social, and political change on the world stage. If the United States and its allies seek to retain a leading role in the global bioeconomy, establishing and sustaining an iterative stake in the funding, guidance, and oversight of international brain sciences is essential.

First, it is important to acknowledge that other countries may use different ethical systems to govern neuroS/T research and development. This will lead to a more rigorous, granular, and dialectical approach to negotiating and resolving ethical dissonance in multinational bioeconomic discourses. Second, national intellectual property laws should be reviewed and evaluated both in relation to international law(s) and potential commercial veiling of dual-use enterprises.⁴⁴ And lastly, it is vital to recognize that state and nonstate actors can and will develop brain science for nonkinetic and kinetic WINS applications. Acknowledging this reality will maintain a stance of preparedness and sustain international efforts to regulate and govern dual-use and direct military use research and its operationalization. Failure to engage in these ways overlooks the conspicuity of neuroS/T influence on the global bioeconomy and could create opportunities for leveraging power in ways that threaten the position, capability, and security of the United States and its allies on the 21st century world stage.