Oct. 9, 2001 World governments must ensure that the benefits of health genomics are available globally - and practical steps are needed to address this soon, say two University of Toronto bioethicists.
In a paper to appear in the Oct. 5 issue of Science, Drs. Peter Singer and Abdallah Daar of the University of Toronto's Joint Centre for Bioethics (JCB) suggest a five-point strategy to prevent a health genomics divide between industrialized and developing countries. Singer is also a professor in the medicine department at U of T and Daar is a professor in the departments of public health sciences and surgery.
"Everybody's talking about the digital divide where information technology is widely used in Western countries but unavailable in developing countries," says Singer, who is also director of JCB, holder of the Sun Life Chair in Bioethics, director of the Canadian Program in Genomics and Global Health - funded by Genome Canada - and a Canadian Institutes of Health Research investigator. "In health genomics, we're now at a situation where we can prevent that divide from developing in the first place. Those equity issues are some of the most important ethical questions facing the world today."
The five-point strategy focuses on more research into ethical, legal and social issues associated with biotechnology, training policy makers in developing countries who specialize in genomics, the establishment of a global commission on genomics and world health, greater public engagement and the creation of an investment fund in genomics and related biotechnology to improve health in poorer countries. The researchers would like to see genomics and global health equity as agenda items at next year's G-8 summit in Kananaskis, Alberta.
"By extending their discussion of health issues to genomics, G-8 leaders could signal their intention to prevent a health genomics divide from developing in the first place," write Singer and Daar. Currently, 90 per cent of health research expenditure is for the health problems of 10 per cent of the world's population. If that pattern continues to play itself out in genomics health research and genomics products, they are concerned that the equity gap will widen further.
Genomics research will completely transform health care in 10 years, says Daar, who is also director of JCB's Program in Applied Ethics and Biotechnology, which is funded by the Ontario Research and Development Challenge Fund. Industrialized countries are only now seeing the beginnings of the transformation. "The key question is whether that's only going to happen in the rich northern countries - leaving the south behind - or whether both the north and the south are going to benefit from the genomics revolution that's coming in health care."
Daar and Singer hope to link their proposal with the New African Initiative - a proposal for regeneration in Africa that deals with health, education and poverty reduction strategies - which will be a topic of discussion at the G-8 summit.
The benefits of genomics and biotechnology research must be extended globally, including to the global poor, they say. "Without some serious attention as to how to accomplish that, the benefits of genomics will accrue only to the developed countries and the gaps in global health equity will widen," Singer concludes.
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