Various proposals for an alternative international governance framework for genome editing focus on enhancing public and stakeholder engagement rather than merely establishing and enforcing rules. Almost every expert report on human genome editing emphasizes the need for continuous public involvement and discussion to achieve a broad social agreement before proceeding with different genome editing methods (30, 46, 54, 77, 82, 83, 97). Given the universal implications of this technology, public participation in the decision-making related to human genome editing is essential, albeit challenging to implement (2, 11, 82).
One major hurdle is the lack of effective precedents for global public engagement. A notable example is the UK's approval of mitochondrial DNA replacement after extensive public consultations (24, 56), but replicating such a process on a global scale poses significant difficulties (51). Additionally, achieving complete global consensus is unfeasible due to the vast cultural, ethical, historical, and legal disparities between nations (20, 46, 82) as well as differing public opinions on gene editing applications (74, 78).
Despite these challenges, numerous innovative proposals for stakeholder and public engagement in genome editing have emerged (10). One such initiative is the Association for Responsible Research and Innovation in Genome Editing, a global nonprofit that aims to foster responsible governance through diverse stakeholder engagement (81). Another suggestion involves forming a global consortium of 10–15 organizations to bridge the gap between people and the scientific and policy discussions regarding human genome editing (15). Additionally, a "global observatory" has been proposed, consisting of a network of scholars and organizations dedicated to collecting information from various sources and facilitating cross-disciplinary and cultural exchanges (61, p. 436). Furthermore, a "global citizens assembly" (42, p. 1435) made up of a representative sample of the global population has been suggested to provide insights on genome editing governance. A Governance Coordinating Committee has also been recommended as a means for stakeholders to communicate and coordinate (76). However, a significant aspect lacking in all these proposals is a dedicated institution to fund and host the initiatives.