Global Policy Forum

By Susan Okie

The flood of new knowledge from genetic research is likely to worsen inequalities in health between rich and poor countries unless money, training and technical assistance are provided to help developing countries benefit from new discoveries, according to a report issued yesterday by the World Health Organization.

"Frankly, in a time frame of three to five years, there can be quite considerable breakthroughs," said WHO Director-General Gro Harlem Brundtland. "And at that moment, it is important who is going to be able to benefit from those breakthroughs."

New vaccines and drugs for major killers such as malaria, AIDS and tuberculosis are being developed through genetic research, but mechanisms are needed to ensure that the victims of such diseases, most of whom live in poor countries, will have access to such treatments, according to the report, "Genomics and World Health."

Moreover, representatives of developing countries should be included in the global ethical and scientific debates over how personal genetic information should be used and how genetically engineered products should be developed and regulated, the report says.

"The risk is there that . . . people in poor countries could be used for doing research and really not benefit from the results of that research," Brundtland said.

The report, prepared by an international team of 14 physicians, researchers and ethicists, endorses an earlier recommendation by the WHO's Commission on Macroeconomics and Health urging the creation of a Global Health Research Fund, to be initially endowed with $1.5 billion that could be made available to all countries through peer-reviewed grant applications.

Although the United States and other donors are already contributing to a similar global fund to provide treatments for people infected with HIV, malaria and tuberculosis, "some funds have to go not just for existing pills, but for new products for developing countries," said Barry Bloom, dean of the Harvard School of Public Health and a coauthor of the new report.

Drug companies lack market incentives to develop treatments for many diseases that mainly affect people in poor countries. Without funding of such research by governments and nonprofit organizations, "the potential of genomics to combat these diseases will not be realized," the report predicts.

Among other recommendations, the report said that developing countries should seek to improve biotechnological capacity and establish programs in clinical genetics and genetics research, and establish partnerships between academic institutions, government and industry to use new genetic technologies to control communicable diseases.

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