Genome Key to World Health

The decoding of the human genome and its potential to open the door to cures for AIDS, cancer, and many other conditions that today are incurable are likely to shapethe healthcare industry for decades to come.

According to a recent World Health Organization (WHO) report, "Genom-ics and World Health," the genome revolution also could hold the key to major public health advances in the developing world. The report looks at genomics' potential impact and genome research ethics and highlights the importance of ensuring that poorer countries also benefit from the medical advances to come.

Fourteen doctors from around the world, led by Sir David Weatherall of Oxford University, United Kingdom, compiled the report. Says Weather-all,"It anticipates how the global community could use genetics to attack infectious diseases such as malaria, tuberculosis, and AIDS that are still killing so many in the developing world."

Among the many genome research projects that could significantly benefit public health in poor countries, the report includes

• tuberculosis vaccine development

• vaccines incorporated into fruit and vegetables, using gene technology to protect against diseases such as cholera, hepatitis B, and the human papilloma virus

• a vaccine that maybe effective against Plasmodium vivax, the form of malaria most prevalent in India

• a DNA-based AIDS vaccine, specifically designed for use in Africa, in clinical trials in Kenya and the United Kingdom.

Because of high costs, most genomic research-which relies heavily on databases and automation-has been limited to the wealthier industrial nations. But there are exceptions, including India, China, Cuba, and Brazil, where various projects are under way.

The report also includes what claims to be the first global examination of the role of ethics in genetic research, particularly regarding access to large-scale genetic databases. According to the report, "The information will often have a far-reaching impact on the individuals and groups in question, and, if they are to cooperate freely in the development and use of this information, they should have assurance about how the information will be used, and who will have access to it."

The science of genomics will not change medicine overnight. But its long-term potential is enormous, making it essential that all countries, regardless of their ability to fund research, must be included. There is a danger that developing countries will be left behind, unless those involved find ways to ensure that all public health needs are taken into account.