Page 16 - Genomic Medicine in Emerging Economies

Why Should We Use Genomics in Developing Countries? 5

among healthcare providers. Moreover, there is occasionally misplaced skepti-
cism regarding the potential benefits that this new discipline has to offer, as
well as the many perceived challenges of applying and implementing these
new technologies in resource-limited health care systems (Forero et al., 2016).
The clinical implementation and general use of genomics technologies in the
developing world faces many different challenges, among these are the lack
of genomic laboratory infrastructure and the lack of a coordinated effort to
impart the necessary knowledge, skills, and attitudes on the part of the health-
care workforce to successfully implement genomic medicine. Despite these
barriers, there have been several notable examples of successful implementa-
tion of genomic medicine projects in resource-limited settings across different
continents (Mitropoulos et al., 2017, 2015; Tekola-Ayele and Rotimi, 2015).
Many of these examples are discussed in detail in the chapters that follow, and
some of these are summarized here by way of introduction.

Africa
Even though not covered in this volume, there are some good and encourag-
ing initiatives that indicate the potential impact medical genomics could have
in the African continent. Before, and even up to a decade after, the Human
Genome Project, genetic research in Africa has progressed very slowly with very
limited initiatives and limited capacity building. However, in recent years this
trend has been rapidly changing, with the advent of large-scale and interna-
tional initiatives such as the Human Heredity and Health in Africa (H3Africa)
initiative and other international initiatives (Coles and Mensah, 2017; Karikari
et al., 2015). The H3Africa initiative in particular aims to facilitate a contem-
porary research approach to the study of genomics and environmental deter-
minants of common diseases, with the goal of improving the health of African
populations. To accomplish this, the H3Africa initiative aims to contribute
to the development of the necessary expertise among African scientists, and
to establish networks of African investigators. The initiative is jointly funded
by the Wellcome Trust (the United Kingdom) and the National Institutes of
Health (the United States) and is addressing the following issues:

j Ensuring access to relevant genomic technologies for African scientists.
j Facilitating integration between genomic and clinical studies.
j Facilitating training at all levels and particularly in training research
leaders.
j Establishing necessary research infrastructure.
But to fulfill this vision, there is a clear need to perform more research on
African genomes and to develop local capacity (Mlotshwa et al., 2017). Most
genomic studies that have generated catalogs of whole genome sequences so
far have focused on white people of European descent. It is estimated that only