What does the future hold? It is expected that genomics will lead to better diagnostics, vaccines, and therapeutics for the major infectious diseases, as well as control of disease vectors, such as the mosquito. It will also make possible surveillance tools that will allow countries to better monitor diseased populations and to determine when new strains of drug-resistant pathogens enter their areas. In addition, a better understanding of the genetic and environmental bases of chronic diseases should similarly lead to the development of new diagnostics and therapeutics. Though these promises will likely take many years to be fully realized, they are of immediate consequence to developing countries and the first potential successes are already in the early stages of development.

National Investment in Genetics Sectors

While the benefits of these technologies are clearly relevant to all countries, not all countries have the infrastructure and resources necessary to support new, emerging, and expensive technologies. For those countries that do, and are willing to make this commitment at the highest level, the potential rewards, both for economic activities and for relevant health outcomes, are very promising.

There are two major obstacles to full participation in genetics research by the South: the first is a lack of financial capital, and the second is a dearth of well-qualified, trained personnel. Although science and technology is seldom viewed as a high-priority, strategic sector by countries in the South, some governments have recognized the potential health, social, and economic benefits of investing in the genetic sciences during this critical window of opportunity.

China, for example, was the only developing country to participate in the Human Genome Project. The establishment of the Beijing Genomics Institute and the Chinese National Human Genome Center not only allowed a Chinese contribution to the physical sequencing of the human genome, but also created the capacity for Chinese researchers to fully engage in a range of genomics research. Recent projects include sequencing a subspecies of rice that is important in Chinese agriculture and taking part in other international genomic collaborations. According to a recent report from Li Zhenzhen and colleagues in Nature Biotechnology, China is taking advantage of their genomic sequencing capabilities to use its large population and more homogeneous population isolates to work towards the identification of disease-associated genes in China. This will leverage and enhance a burgeoning biotechnology and bioinformatics sector.

In 1997, scientists and policymakers in the state of São Paulo, Brazil had the foresight to invest in efforts to sequence the genome of Xylella fastidiosa, a bacterium that infects citrus plants, threatening orange cultivation. The State of São Paulo Research Foundation created a network to coordinate the work of over 200 scientists from 30 research laboratories. This consortium completely sequenced the first plant pathogen ever and the resultant information itself has been only one of the benefits—it has also created an awareness that state-of-the-art genetic technology now exists in Brazil. As a result, agencies both within the country and abroad are now eager to provide funding for further genetics research, both in agriculture and in human health.

The Mexican Institute of Genomic Medicine (INMEGEN) represents another example of investment in start-up funds for genetics research on the part of a country in the South. INMEGEN, which was formally initiated in July 2004, is currently being developed through the support of a consortium of private and public funding partners. It will sponsor a research program to promote domestic and global collaborations in genomic biomedical research, and among its top priorities are education and the development of human resources to perform genomic research. Interestingly, a feasibility study conducted prior to the establishment of INMEGEN showed the high costs of not making this investment, including a lack of competence for developing new diagnostic tools, scientific brain drain, increasing technological dependence, fewer investment and business opportunities, and higher health care costs.

Engaging at the Appropriate Level

The appropriate level at which countries should begin to engage in the genetic and genomic sciences will vary widely among the countries of the South, a subject that has engendered active debate and much confusion. As the WHO “Genomics and World Health Report” recommends, a serious cost-benefit analysis must be undertaken and the value of such an investment weighed against all the competing health needs of each country. Training a small core of scientists in genetic epidemiology and gene mapping to help better understand diseases within their own populations will likely serve national interests at modest cost.

On the other hand, sequencing and other genomic practices require expensive equipment that is continually being modified as the technology matures. As Eva Harris, President of the Sustainable Sciences Institute, has argued, the newest genomic technologies may soon be obsolete. Therefore, she contends, countries with limited resources should collaborate and outsource until the technologies stabilize, and should meanwhile invest in better computers, broadband access, and software to allow for efficient data analysis, bioinformatics, and data mining.

Collaborative Training Partnerships

Although a number of international funding agencies support training in the genetic and information sciences for scientists from developing countries, we briefly discuss two programs supported by the Fogarty International Center (FIC) of the National Institutes of Health (NIH) as examples of the needs perceived by institutions in the South and as models of how these training needs might begin to be addressed.

In response to international consultations with developing countries and US scientists, FIC, in partnership with six other NIH institutes and the WHO, launched a new US$11.5 million five-year program in 2002 for International Collaborative Genetics Research Training. Grants were awarded to build collaborative research training programs between US universities and institutions in India, China, Costa Rica, Thailand, and Venezuela. Most of these programs involve a mixture of short-term, in-country training for groups of scientists at the foreign institution and longer-term training in the United States for selected individuals who are expected to return to their home institutions and assume leadership positions in the genetic sciences.

The training in these programs focuses on disorders that are significant public health burdens in the individual countries and for which the infrastructure and expertise for research are weak. One example is a project in Venezuela, in which genetics research is being done on Alzheimer’s Disease, Parkinson’s Disease, and age-related dementias. An important goal of this particular project will be the development of low-cost diagnostics for common diseases of Venezuela. Meanwhile, the programs in India, Thailand, and Costa Rica will take advantage of “population isolates” within these countries to carry out epidemiological training and to perform genetic research related to cardiovascular disease, drug dependence, and psychiatric disorders such as bipolar disease, schizophrenia, and major depression. The importance of such research is only heightened by the WHO’s prediction that cardiovascular disease and major depression will be the two leading causes of global disease burden by 2020.