Page 31 - Genomic Medicine in Emerging Economies

20 CHAPTER 2: Taking Genomics From the Bench to the Bedside in Developing Countries

are not affordable for most educational, research, and clinical institutions in
developing countries. This makes establishing such facilities beyond the bud-
get of most institutions in developing countries (Helmy et al., 2016) and thus
requires investment by governments.
In that regard, making the case for investment in genomic medicine with policy
makers is needed so that increased government funding can make it possible
for the establishment of such centers of excellence (Penchaszadeh, 2015). In
addition, governments should commit to developing well-funded and efficient
systems for the evaluation and regulation of the application of genomic tech-
nologies in health care. Academic and research institutes should provide the
leadership to overcome the challenges of financing by making strategic invest-
ments that promote genomics and by lobbying with governments to make
budgetary provisions for the establishment of such facilities.
To reduce financial requirements, institutions and governments can consider
adopting emerging low-cost technologies. Although such technologies are still
in their infancy, they are nevertheless promising in many ways, offering the
possibility of a wide range of genome sequencing applications that require
minimal laboratory and computational skills (Helmy et al., 2016).
j Provide adequate funding to train a genomics workforce with expertise
in integrating genomic data into clinical delivery services and provide
genomic education for both clinicians and patients.
Genome sequencing is an interdisciplinary field that requires knowledge in
molecular biology, biochemistry, and bioinformatics. In addition, when it
comes to using genomic information in a clinical setting, clinicians also need
to be trained in the use and interpretation of genomic information and in
genomic counseling. Developing countries lag behind in all these areas (De
Abrew et al., 2014). In the field of public health, public health professionals
need to become knowledgeable about genes as determinants of health, how
genomic testing will be used in screening, disease prevention, and health care,
and its potential in the control and treatment of infectious diseases (Burton
et al., 2014).
Since genomic testing is increasingly used in clinical practice (O’Daniel and
Berg, 2016), efficient means of integrating genomic data into existing health
records is needed, with consideration of appropriate clinical decision support
tools for prompting point of care use of genomic information and delivering
it to healthcare providers in an easily interpretable format. Novel biomedical
informatics infrastructure and tools are essential for developing individual-
ized patient treatment regimens based on specific genomic profiles (Madhavan
et al., 2009). Implementing such strategies will offer more intensive primary
or secondary prevention interventions to those at greater genomic risk. Such