Page 26 - Genomic Medicine in Emerging Economies

Sri Lanka’s Initial Experience in Implementing Genomic Medicine 15

A special issue on genomic successes in the developing world in the Journal of
Applied and Translational Genomics in 2016 served to demonstrate that the need,
desire, and capacity to implement genomic medicine in developing countries
exist and that pockets of excellence exist where resources and manpower are
available (Dissanayake and Barash, 2016). A survey on unmet needs, con-
ducted on participants at the Asia Pacific Society of Human Genetics Meeting
in Hanoi in 2015, published in the same journal, provides insight into what
is needed to achieve widespread and equitable implementation of genomic
medicine (Isaacson Barash, 2016). The participants identified the lack of bio-
informatics and computational tools, absence of trained data scientists, lack
of access to datasets, and lack of funding as some of the reasons contributing
to the disparity between the developing world and the West. Areas identified
through the survey that need further attention include the following: (1) the
need to convince policy makers that genomics is important and that funding
genomics infrastructure and genomics education for health care workers is
the crucial first step in the path to implementing genomic medicine, (2) the
need for researchers to collaborate, (3) the need for different labs to share
their internal data, (4) the need for global help with basic clinical research,
(5) the need for affordable genetic and genomic tests, (6) the need to design
laws and regulations to ensure the existence of public genomic health pro-
grams, (7) and the need to train data scientists (Isaacson Barash, 2016).
Some of the research and clinical delivery needs that have become barriers
to implementing genomic medicine in developing countries are illustrated
in Fig. 2.1.
In view of the barriers identified above, specific measures need to be put in
place to establish viable translational and precision medicine initiatives in
developing countries (Isaacson Barash, 2016). These measures are summarized
in Fig. 2.2.

SRI LANKA’S INITIAL EXPERIENCE IN IMPLEMENTING
GENOMIC MEDICINE

As a result of increased access to information through the Internet and high
penetration of mobile technologies, news related to advances in genomics is
rapidly reaching the shores of developing countries like Sri Lanka faster than
ever before. In addition, expatriate communities from developing countries,
such as Sri Lanka, who live in the affluent West often share information of
such advances with their friends and relatives back home. In certain instances,
the health care of relatives left behind in home countries is paid for by their
relatives in the affluent West who demand a similar level of service in their
home countries. We experience this frequently in Sri Lanka. Most of the time
the local demand for genetic and genomic services that is created through such
influences is unmet in developing countries such as ours because our medical