By Mary Hearty

The World Health Organization’s (WHO) Science Council of experts has called for equitable access to genomic technology globally so that all member states, especially lower- and middle- income countries (LMICs) can adopt and expand the use of genomics for better health and other benefits.

This is because the costs of establishing and expanding genomic technologies are declining – making it increasingly feasible for all countries to pursue.  WHO advocates that they should be lowered further.

Genomic technologies are tools designed to describe and understand biological information that is stored in genomes using various methods arising from biochemistry, genetics, and molecular biology.

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.”

In its first report on accelerating access to genomics for global health, the science council notes that genomic methods are lacking in many LMICs, hence many of the member states have varying capacities for performing and interpreting genomic procedures. Additionally, their citizens are less likely to be included in international genomic initiatives.

“These inequities in access to genomic technology are majorly driven by shortfalls in financing, laboratory infrastructure, materials, as well as highly trained personnel, as they are limited in developing countries,” WHO’s Science Council states in the report.

Nevertheless, the Science Council notes these limiting factors can be addressed through assistance of long-term planning, support from other countries, and multi-sectoral collaboration.

“Successful implementation requires engagement of many sectors of society and attention to a wide variety of needs. Governments and funding organizations as well as the commercial and academic sectors, need to commit to the fundamental principle that investing in genomic technologies, even, in LMICs is a valuable enterprise,” the Science Council affirms.

More specifically, the Science Council requires commitments of financial resources; equipment and reagents for laboratory work; computational tools for data management and storage; the construction and maintenance of facilities; and the training and support of a workforce that serves all phases of genomics, from laboratory work to data analysis and management, to the use of data in public health and clinical care.

Notably, without such measures, the benefits of genomics are unlikely to be experienced broadly and unequal access to new genomic technologies is likely to persist.

WHO further explains that genomics presents unique opportunities to address public health issues, as analysis of genes helps to identify and diagnose infectious diseases, trace the spread of infection through human or animal host, and also evaluate an infectious agent’s sensitivity or resistance to drugs.

In South Africa for instance, since it has the highest burden of HIV and the largest AIDS Treatment programme in the world, it has built up substantial capacity, with government support, to undertake viral gene sequencing, principally to monitor the development of antiretroviral drug resistance and viral transmission patterns.

In March 2020, this capacity pivoted to monitoring mutations in the SARS-CoV-2 genome. Genomic surveillance was initiated in South Africa and then, in partnership with Africa CDC, played a key role in supporting the study of the mutation mechanism of SARS-CoV-2 in the whole of Africa. Consequently this enabled South Africa to make crucial contributions in detecting variants.

This support included helping build laboratory sequencing capabilities and bioinformatics analytic capabilities in several countries in Africa.

Furthermore, 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.

“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,” the Council’s Chair, Professor Harold Varmus, a Nobel Laureate and former Director of the U.S. National Institutes of Health says.

The WHO Science Council also emphasized on the need to execute plans to enhance the training of individuals capable of making effective use of genomic technologies, especially in countries that have previously had limited or no access to genomic technologies.

Such programs should include efforts both to recruit students early in their educations and to provide training in genomics for citizens already educated in general biology or computational sciences.

The Science Council also calls for promotion of international collaborations on genomics, noting that commitments at high levels to collaborative initiatives, with the involvement of governments, research funding agencies, and others, can reduce expenses and expedite the growth and use of new knowledge.

In addition, the council calls for promotion of ethical, legal, and equitable use and responsible sharing of information obtained with genomic methods through effective oversight and national and international rules and standards in the practice of genomics.

The ethical, legal, and social issues raised by genomics are often grounded in local practices and beliefs, yet they may need international solutions that are responsive to those local issues.

The Council notes that WHO should aspire to become the global authority on ethical, legal and social issues for health related genomic application.

“WHO should emphasize the roles and responsibilities of all those who are organizing, funding, and performing genomics and those who are delivering its products, by adhering to ethical and legal standards in genomics and by addressing issues pertaining to local and cultural sensitivities,” the Science Council explains.