Page 69 - Genomic Medicine in Emerging Economies

58 CHAPTER 4: Le v er aging Int ernational Collabor ations

CLINICAL GENETICS AND GENETIC COUNSELING IN
COLOMBIA

In Colombia there are very few trained clinical or medical geneticists (Jave-
riana, 2013). There are also wide gaps in access to genetic consultation and
genetic counseling according to the region, the type of insurance and insur-
ance company, and the socioeconomic level of the patient. Some cities, such
as Bogota and Medellin, have several genetic units mainly in academic institu-
tions, whereas other major cities do not have any genetic services.

One of the main reasons for the shortage of genetic specialists is the lack of
genetic training programs in the country for general and specialized medical doc-
tors. There is only one university in Colombia offering a formal clinical genetics
residency program, Pontificia Universidad Javeriana, in Bogota (PUJB, n.d.).

Some universities in different cities offer masters and doctoral programs in human
genetics or cancer genetics for physicians who also want to pursue a research
career. Colombia also has very few PhDs compared with other developing coun-
tries, and, specifically, there are very few medical doctors with a PhD degree.

Genetic counseling is an important part of a genetics consultation and is of
great support when ordering genetic tests in a clinical setting. In Latin America,
clinical geneticists and medical doctors with genetics training usually perform
the genetic counseling. The only country that developed genetic counseling as
a separate field is Cuba, through a 6-month training program for general phy-
sicians (Cruz, 2013; Penchaszadeh, 2004). In Colombia, there are no official
training programs for genetic counselors, and unlike in other countries, the
insurance companies do not pay the consultations with nonphysician genetic
counselors. Therefore only medical doctors are able to officially deliver genetic
counseling through the health care system. Sometimes nonphysicians partici-
pate in this process in a private practice setting.

There are many research groups across the country with great experience and inter-
national publications in different areas of genetics, but most research and train-
ing in genetics is in basic sciences (Colciencias, 2016; Corporación Ruta, 2016).
Translational and clinical research has only started developing in the last few
years, as evidenced by the recent growth of research units in clinics and hospitals
conducting clinical research studies financed by pharmaceutical companies or in
cooperation with national or international academic institutions.

GENETICS LAWS AND REGULATIONS IN COLOMBIA

Colombian law mainly addresses three aspects regarding genetics (The Código
Penal—Ley 599 del 2000) (Congreso de la República de Colombia, 2000):