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The science of biotechnology could save tens of millions of lives each year
in developing countries if the technology is shared equitably, says a new
report to the United Nations, October 2004 by 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.
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