WHO’s Science Council of experts has issued its first report, on accelerating access to genomics for global health. The report argues that it is not justifiable ethically or scientifically for less-resourced countries to gain access to such technologies long after rich countries do.
The field of genomics uses methods from biochemistry, genetics, and molecular biology to understand and use biological information in DNA and RNA, with benefits for medicine and public health – especially during the COVID-19 pandemic – as well as agriculture, biological research and more. The report calls for expanding access to genomic technologies, particularly in low- and middle-income countries (LMICs), by addressing shortfalls in financing, laboratory infrastructure, materials, and highly trained personnel.
While the costs of establishing and expanding genomic technologies are declining – making it increasingly feasible for all countries to pursue – they can and should be further lowered. A range of tools to make genomic technologies more affordable for LMICs have been developed, including tiered pricing; sharing of intellectual property rights for low-cost versions; and cross-subsidization, whereby profits in one area are used to fund another.
“Genomic technologies are driving some of the most ground-breaking research happening today. Yet the benefits of these tools will not be fully realized unless they are deployed worldwide. Only through equity can science reach its full potential impact and improve health for everyone, everywhere,” said Dr Soumya Swaminathan, WHO Chief Scientist. “Through convening and coordinating the world’s leading minds, as we do through our Science Council, WHO acts as a global engine for analysis to address the world’s most pressing health challenges.”
Comprised of 9 leading scientists and public health experts from around the world, the Science Council was established in April 2021 by WHO Director-General Dr Tedros Adhanom Ghebreyesus to advise him on high-priority issues and advances in science and technology that could directly improve global health. The Science Council identified genomics as the focus of its first study, given the significant implications for public health; its many successful uses in confronting infectious diseases, cancers, and other chronic diseases; and the new opportunities for implementing expensive technologies, even in LMICs.
“It is already clear that genomics can make enormous contributions to human health, from surveying populations for infectious agents, such as the virus that causes COVID-19, to predicting and treating a wide variety of diseases, such as cancers and developmental disorders. Attention to equity in deploying these technologies is essential for achieving the immense potential benefits to human health,” said the Council’s Chair, Professor Harold Varmus, a Nobel Laureate and former Director of the U.S. National Institutes of Health.
To promote the adoption or expanded use of genomics, the report’s recommendations address four themes: advocacy, implementation, collaboration, and associated ethical, legal and social issues:
Advocacy for genomics is needed to persuade governments, as well as commercial and non-commercial organizations, academic institutions, and others, of the medical, scientific, and economic benefits of genomic technologies.
Overcoming obstacles to implementation will require local planning, financing, expanded training of essential personnel, and the low-cost provision of instruments, materials, and computational infrastructure.
Government ministries, funding agencies, and scientific organizations in academia and industry should collaborate to establish plans on how to use genomics and build and expand technical capacity. They should also look to pool resources through regional programmes if appropriate.
Effective oversight – coupled with national and international rules and standards – is key to promoting ethical, legal, equitable use and responsible sharing of information obtained with genomic methods.
To take forward the recommendations and to monitor their applications across all four main areas, the report also recommends WHO create a Genomics Committee. A key responsibility proposed for the Genomics Committee is convening commercial organizations to develop and implement ways of making their products and technologies affordable in LMICs.
The report follows the release of WHO’s 10-year strategy for genomic surveillance of pathogens. Genomic surveillance has played a crucial role in the global COVID-19 response, with countries like South Africa able to make crucial contributions in detecting variants, due to their capacities in this area. Recent data from WHO shows that the percentage of countries able to conduct genomic surveillance increased from 54% to 68% between March 2021 and January 2022, due to major investments made during the COVID-19 pandemic.