Tara Acharya

Strengthening the Role of Genomics in Global Health

How genomics and related health biotechnologies can improve the health of the poor and contribute towards meeting the Millenium Development Goals

Harnessing genomics to improve health in the Eastern Mediterranean Region – an executive course in genomics policy

BackgroundWhile innovations in medicine, science and technology have resulted in improved health and quality of life for many people, the benefits of modern medicine continue to elude millions of people in many parts of the world. To assess the potential of genomics to address health needs in EMR, the World Health Organizations Eastern Mediterranean Regional Office and the University of Toronto Joint Centre for Bioethics jointly organized a Genomics and Public Health Policy Executive Course, held September 20th–23rd, 2003, in Muscat, Oman. The 4-day course was sponsored by WHO-EMRO with additional support from the Canadian Program in Genomics and Global Health. The overall objective of the course was to collectively explore how to best harness genomics to improve health in the region. This article presents the course findings and recommendations for genomics policy in EMR.MethodsThe course brought together senior representatives from academia, biotechnology companies, regulatory bodies, media, voluntary, and legal organizations to engage in discussion. Topics covered included scientific advances in genomics, followed by innovations in business models, public sector perspectives, ethics, legal issues and national innovation systems.ResultsA set of recommendations, summarized below, was formulated for the Regional Office, the Member States and for individuals.• Advocacy for genomics and biotechnology for political leadership;• Networking between member states to share information, expertise, training, and regional cooperation in biotechnology; coordination of national surveys for assessment of health biotechnology innovation systems, science capacity, government policies, legislation and regulations, intellectual property policies, private sector activity;• Creation in each member country of an effective National Body on genomics, biotechnology and health to:- formulate national biotechnology strategies- raise biotechnology awareness- encourage teaching and training of biotechnology- devise integration of biotechnology within national health systems.ConclusionThe recommendations provide the basis for a road map for EMR to take steps to harness biotechnology for better and more equitable health. As a result of these recommendations, health ministers from the region, at the 50th Regional Committee Meeting held in October 2003, have urged Member States to establish national bodies of biotechnology to formulate a strategic vision for developing biotechnology in the service of the regions health. These efforts promise to raise the profile of genomics in EMR and increase regional cooperation in this exciting new field.

Realising the promise of genomics: exploring governance

The tremendous potential of genomics to contribute to significant healthcare innovations in the developing world will not be realised without attention to governance. Governments, industries and citizens will encounter numerous ethical issues in achieving a balance between risk management and the promotion of the benefits of genomics. We need a governance mechanism that maintains a balance between the global public goods characteristics of genomics knowledge and the private goods nature of its application. Networks may well be an appropriate way of preventing a bleak future of increasing disparities between industrialised and developing countries. An informed debate that attempts to exchange the politics of polarisation with a truly participatory process would be worth pursuing. Consequently, this paper proposes a Global Genomics Initiative (GGI) that would provide such a forum.

Beyond GM Foods: Genomics, Biotechnology and Global Health Equity

The population of the world is expected to increase from the current 6 billion or so to 9 billion by the year 2050. Much of this increase will occur in developing countries. At the same time, 96% of arable land in the world today is already cultivated. Malnutrition affects nearly 800 million people in developing countries1 and several countries such as Ethiopia suffer from famines quite regularly. In some cases this is because of a real shortage of food, while in other cases the shortage is due to many other factors such as civil strife, poor distribution systems, etc. Even where there is no severe shortage, there are a number of micronutrient deficiencies in the staple foods consumed locally in developing countries. Micronutrient deficiencies such as iron deficiency and vitamin A deficiency are common, and they affect health negatively. Under these circumstances it is worth considering if staple food crops that have been genetically modified to enhance their nutritional value could make a difference, particularly in the long run. We discuss below some of the issues relevant to this debate, which we frame in the context of a foresight study that we recently performed to identify biotechnologies that are most likely to improve the health of people in developing countries. We highlight the need to let informed people in developing countries make their own choices. GM foods have been at the centre of much controversy in recent years, especially in Europe. It is often and widely questioned whether GM crops are safe to consume and environmentally safe to grow and release. A recent report from the UK by the GM Science Review Panel attempts to shed some light on these controversies.2 It concludes that recent attempts to create public anxiety about GM food safety, supported by sections of the media that are openly campaigning against GM, have been ignoring the scientific evidence.3 The World Health Organization (WHO) also