Creating policy frameworks for public health genomics to benefit developing countries

Unprecedented advances in life sciences, as exemplified by the revolution in genomics, are yet to translate into effective public health interventions to benefit the health of populations living in the developing world. The developing countries continue to bear the major burden of disease globally, both infectious and chronic diseases, and they could clearly benefit from genomics being harnessed and used to address the greatest public health problems in addition to benefits for the health of individuals. For this to happen, we need to understand what are the major challenges or bottlenecks to be overcome and, informed by these priorities, create an effective, inclusive, equitable and sustainable policy framework within which knowledge translation into improved health outcomes of underprivileged populations can take place.

Mainstreaming sex and gender analysis in public health genomics

BACKGROUND

The integration of genome-based knowledge into public health or public health genomics (PHG) aims to contribute to disease prevention, health promotion, and risk reduction associated with genetic disease susceptibility. Men and women differ, for instance, in susceptibilities for heart disease, obesity, or depression due to biologic (sex) and sociocultural (gender) factors and their interaction. Genome-based knowledge is rapidly increasing, but sex and gender issues are often not explored.

OBJECTIVE

To explore the implications of a sex and gender analysis for PHG.

METHODS

We explore genome-based knowledge in relation to sex and gender aspects using depression as an example, gender equality, and the intersection of sex and gender with other social stratifiers such as ethnic background or socioeconomic status.

RESULTS

We advocate a sex- and gender-sensitive genomics research agenda alongside studies that provide sex-disaggregated data rather than controls based on sex. Such a research agenda is needed to guide research on how genomics is understood and perceived by men and women across groups, and for the equitable and responsible translation of such knowledge into the public health domain.

CONCLUSIONS

Including sex and gender analysis in PHG research will not only shed more light on phenomena such as diseases with a higher prevalence in either men or women, but will ultimately lead to gendered innovations by way of exploring how gendered and cultural environments increase or safeguard genetic predispositions.

Beyond base pairs to bedside: a population perspective on how genomics can improve health

A decade after the sequencing of the human genome, the National Human Genome Research Institute announced a strategic plan for genomic medicine. It calls for evaluating the structure and biology of genomes, understanding the biology of disease, advancing the science of medicine, and improving the effectiveness of health care. Fulfilling the promise of genomics urgently requires a population perspective to complement the bench-to-bedside model of translation. A population approach should assess the contribution of genomics to health in the context of social and environmental determinants of disease; evaluate genomic applications that may improve health care; design strategies for integrating genomics into practice; address ethical, legal, and social issues; and measure the population health impact of new technologies.