Page 20 - Genomic Medicine in Emerging Economies

Conclusions and Future Perspectives 9

but it also serves the unique needs of each country. In fact, some of the exam-
ples presented in this book are small illustrations of the “Fast-Second Winner”
model discussed here.

To implement this model widely, there is a need to promote the establishment
of innovation observatories, which can best identify a given country’s public
health needs, such as emerging candidate markers or drug-genomic marker
combinations. It would then be possible to make suggestions and provide rec-
ommendations to a given country.

CONCLUSIONS AND FUTURE PERSPECTIVES
Implementation of genomic medicine in developing countries and resource-
limited environments can be a rather cumbersome and lengthy process, which
can deprive population groups residing in these countries of the benefits that
genome-guided clinical interventions can offer. Given the scarcity or even lack
of resources in certain developing countries, genomic medicine interventions
can only be implemented in these environments under certain conditions.

There are different reasons for this. First, generation of primary research data in
research establishments of low-resource environments can be a rather daunt-
ing task. As such, and in order to advance genomics research in these coun-
tries, strategic partnerships should be sought with other research entities in
developed countries, which are likely to create benefits for all parties involved
(Cooper et al., 2014). In this case, not only will developing countries benefit
from the various training opportunities that will be created on top of knowl-
edge transfer, but developed countries may benefit too, through participation
in multicenter projects to study cases and individuals with unique clinical fea-
tures and/or rare diseases (Fig. 1.1) (Manolio et al., 2015).
Second, it would be highly beneficial for developing countries and low-
resource environments to prioritize their research efforts toward implementing
those actionable genomic medicine interventions that are relevant to their own
needs and that may differ from other parts of the world, including but not lim-
ited to pharmacogenomic tests, genetic testing for highly prevalent inherited
conditions, and application of genomics technologies to improve the care of
cancer patients. To a certain extent, all of these initiatives require the genera-
tion of country-, population-, or even region-specific data. As part of develop-
ing these local initiatives, it is also important to perform cost benefit analysis
and health economic studies that could then help demonstrate the concrete
benefits for local health care systems (see Chapter 8).
Third, it is reasonable that policymakers invest a significant amount of effort to
expanding the public health aspects of genomic medicine interventions, such