Inter Press Service - October 21, 2004
Stephen Leahy

New medical tools that quickly and accurately diagnose diseases like AIDS and malaria top a list of 10 biotech breakthroughs that could dramatically improve health in developing countries within a decade, according to 'Genomics and Global Health', commissioned by the U.N.'s Millennium Project and released Oct. 8.

However, a new global institute to share and promote the health benefits of new technologies will be needed to ensure that the current "genomics gap" between developed and developing countries does not dramatically widen, the report adds.

"Millions of people in developing countries die each year from diseases that could be prevented or treated cheaply and easily through the development and use of a handful of biotechnologies," said report co-author Peter Singer, director of the University of Toronto Joint Centre for Bioethics (JCB).

Genomics generally refers to the study of how genes function, and the use of this information to diagnose and treat disease in individuals. Biotechnology is a collection of technologies that manipulate or engineer biological cells to manufacture proteins for current uses, such as genetically-modified (GM) crops for agriculture and -- in the near future -- for new drugs, vaccines and diagnostic tools in health care.

Included in the top 10 list of biotechnologies are emerging diagnostic tools the report says may soon enable doctors in the poorest countries to detect tuberculosis, hepatitis C, HIV-AIDS, malaria and other diseases at a molecular level in blood or tissues.

Other top technologies of the future include recombinant vaccines produced through genetic engineering that promise to be safer, cheaper and possibly easier to store and transport than traditional vaccines.

Engineered micro-organisms that have the potential to reduce pollution and make water safe to drink, and microbicides for female-controlled protection against sexually transmitted diseases like HIV are among other future technologies the report suggests could improve health in developing countries.

The top 10 list represents a consensus of 28 eminent scientists canvassed separately in developing and developed countries regarding the technologies that are most important in achieving five of the U.N.'s eight Millennium Development Goals (MDGs).

The MDGs set targets for reducing under-five mortality and maternal mortality, reversing the spread of HIV/AIDS, and improving access to safe drinking water, among other goals, in developing countries by 2015.

"This report is about reaching the U.N.'s Millennium Development Goals, mobilising the developed countries of the world to share their wealth of information and know-how, and supporting the innovation of developing countries," Singer told IPS.

Prepared for the science, technology and innovation task force of the U.N. Millennium Project, the study is part of the six-million-dollar Canadian Programme on Genomics and Global Health. The programme is funded by Genome Canada, a Canadian government agency that promotes genomics, and two pharmaceutical companies, Merck & Co and GlaxoSmithKline.

However, many people working in the public health sector believe that while research in basic science is important, devoting money and effort to potential new technologies to aid development is unwise spending.

"There's a tendency to look for magic bullets that will solve all the problems," says Joe McCannon, who manages the global division of the Boston-based Institute for Healthcare Improvement (IHI), which focuses on efforts to rapidly scale-up AIDS treatment in countries of the South.

New research and technology has its place, but the focus ought to be on how to deliver health services on the ground, McCannon said in an interview.

"The biggest barrier to this is the lack of trained medical personnel."

Singer agrees that more work and more resources are needed for existing technologies, such as insecticide-treated bed nets for malaria prevention. But in that struggle, poor countries need to employ public health strategies that combine existing technologies with long-term programmes to develop new ones, he adds.

That was echoed by an official at the U.N. Millennium Project. "The world cannot make due on the money that's now going to aid, so everything needs to get bigger, including spending on biotechnology," said the official, who asked to not be named.

"We're saying you just have to come at this from many fronts. You need biotech solutions but you don't take them at the expense of (anti-malaria) bed nets and iron pills," added the official.

To help developing countries work on new technologies, the report calls for the creation of a Global Genomic Initiative (GGI), to promote the potential of genomics and to help transfer technology and basic science. "We envision a small institute that is light and nimble," it says.

The GGI would function as a node, linking various stakeholders and making information on the latest technologies freely available. Developing countries would use those resources to develop their own solutions to local problems along the lines of Cuba, which has created the world's only meningitis B vaccine, and may soon be exporting it, Singer said.

Biotechnology and pharmaceutical companies in the North are not interested in developing products for the South, says report co-author Abdallah S Daar, co-director of the Canadian Programme on Genomics and Global Health at the JCB.

"The biotechnology industries of China, Brazil, Cuba and others in the South is where future solutions will come from," he adds.

Daar believes that with an effective GGI in place, a vaccine for malaria and control of mosquitoes that cause the infection are possible within 10 years. "There is the potential for total eradication of malaria," he said in an interview.

Others working in the health field are not so enthusiastic about spending on biotech. "People are dying from preventable and treatable diseases as we speak on the phone right now," says Ted Constan of Partners In Health (PIH), a Boston-based body that works with community health groups in Latin America, the Caribbean and Russia.

Working at the grassroots with local health providers in the poorest neighbourhoods of Lima, Peru, PIH has helped to cure 80 percent of residents with multi-drug-resistant tuberculosis, previously thought to be untreatable in such a setting.

Lack of a public health infrastructure -- trained staff and basic equipment -- are by far the biggest hurdles to overcome in many parts of the South, Constan told IPS.

"Many people in the South are not benefiting from the medical breakthroughs of the 19th century, never mind those in the 20th century," he said.

*****

+University of Toronto Joint Centre for Bioethics (http://www.utoronto.ca/jcb/home/main.htm)

+Genome Canada (http://www.genomecanada.ca/GCprogrammesRecherche/projets/projectDetail.asp?id=c1p10&l=e)

+Partners In Health (http://www.pih.org/index.html)

+Special Coverage: Development Deadline 2015 (http://www.ipsnews.net/new_focus/devdeadline/index.asp)

041021
IP041011

Always watch for outdated information. This article first appeared in 2004. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2004. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .