Béatrice Séguin and her colleagues at the McLaughlin-Rotman Centre for Global Health investigate how some developing countries are using genomic technologies to improve public health. Genome Technology's Ciara Curtin caught up with Séguin to discuss her studies of India, Mexico, and Thailand. What follows are excerpts of their conversation, edited for space.
Genome Technology: Why should developing countries invest in genomics?
Béatrice Séguin: With any technology that can improve health, if you don't invest in it, the divide between developed and developing countries will only get bigger. Ever since the sequencing of the human genome, [developed countries are] making steps towards personalizing medicine. But therapies developed in one population may not be applicable across the globe. So developing countries need to first understand the baseline variation in their own populations so that once they understand that and identify relevant variations, they can develop diagnostics and therapeutics that are suitable to their population. Secondly, by doing so, you are also building up scientific capacity, spurring innovation, encouraging spinoffs and the commercialization of products.
GT: How will individuals benefit?
BS: The most immediate benefit is building up scientific capacity: training local scientists who have an interest in research who hopefully have infrastructure now to support their interests, and perhaps prevent some of the brain drain. By not only creating programs to train genomicists, supporting disciplines like bioinformatics, and everything that is required to support a genomic platform, now you're training local talent. You're retaining that talent with infrastructure, and encouraging research and innovation and entrepreneurial spirits. The long term is the same hope that we have here in industrialized countries: that you do see the benefits reaching individuals through preventative screening and specific, preventative, personalized medicine.
GT: What are the challenges to genomic medicine becoming a reality in developing countries?
BS: Specifically when you think of India, it has such a large population, how is it going to deploy that technology? How will you make it reach the huge population there? You have to think of different ways of delivering the care, perhaps, than we have here.
When I think of Thailand, the challenge there is balancing their short-term needs versus a long-term, preventative approach to care. For example, Thailand does have a universal health care system which is unique in the developing world. That's definitely an advantage, but it's going to be a challenge in how you allocate your limited resources within that universal health care system. How do you balance between providing current medicines that are greatly needed versus bolstering an innovative sector that could, in the long run, help you detect disease, prevent them, and develop your own diagnostics and your own therapeutics?
One [challenge] that's common to developing countries is continuing political will within changing governments. Perhaps at the beginning, these initiatives were created with great political support, but how do you ensure it continues? That's going to be key for ongoing success of these initiatives.
GT: How do programs like these decide what diseases to focus on?
BS: In the West, we might think of developing countries as suffering from HIV, TB, malaria, but they are faced with the double burden of disease. The rate of chronic diseases is increasing at an alarming rate in developing countries. The genomic initiatives that we studied certainly have paid attention to things like cardiovascular disease, macular degeneration, and diabetes, for example.