Page 127 - Genomic Medicine in Emerging Economies

116 CHAPTER 6: Neuropsy chiatric Genomics in Latin Americ a

NPDs and for developing better treatment strategies for the affected patients.
Those collaborations might be between labs from Latin America and from
developed countries (North America and Europe, among others) and between
Latin American research groups. As global research into NPG is moving to large
interinstitutional and international consortia, there is the need for the creation
of Latin American networks for NPG, which could be for specific diseases or for
general research initiatives (Mitropoulos et al., 2015).
The strategic implementation of genomic technologies is a fundamental need
in Latin American countries, given the importance of the local development of
novel experimental methods (for diminishing the dependence on collabora-
tions with foreign groups), such as whole exome and genome sequencing, and
genome-wide expression and DNA methylation analyses (Forero et al., 2016d).
A collaboration of several research groups and institutions might be key for
these initiatives that need large funding from public or private agencies and a
strong bioinformatics structure (Forero et al., 2016d).
Given the complexity of the clinical diagnosis of NPD, particularly in Latin
American health institutions, there is an urgent need for the existence of an
adequate number of neurologists, psychiatrists, and psychologists with appro-
priate research training and experience (Forero et al., 2014). In this context,
there is the need for the local validation of additional psychosocial and clini-
cal scales and for the existence of neuroimaging and neurophysiological
platforms. More studies about the genetic basis of neuropsychiatric endophe-
notypes, in both healthy subjects and patients, are needed in Latin America. An
improvement of technological infrastructure applied to health care is essential,
considering that several Latin American countries have large territorial areas,
facilitating a broader availability of health assistance and a better quality of
health care.

In relation to pharmacogenetics, there is a need to continue the identification
of genetic variants that determine the response to drugs in Latin American
populations. An important step would be to join and establish working
groups and consortia (https://www.pharmgkb.org/page/collaborators and
www.ribef.com). With time, the costs of genetic lab tests and kits will come
down and they will become more affordable and common. Other countries
(Canada, Europe, and Japan) are including genetic information related to
neuropsychiatric disorders in drug labels. There are more than 30 psychiat-
ric drugs that contain genetic information on their labels, and several drugs
require testing before prescribing the medication (https://www.pharmgkb.
org/view/drug-labels.do). In Latin America, the need is for efforts aimed to
create detailed guidelines for the implementation of pharmacogenomics,
as well as for education on awareness about pharmacogenomics among