2012 Panel Discussion - Questions and Answers

Impact of Genomics Globally

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What is the place for genetics and genomics in the developing world -- or the poorer population in the US?  How can we make genetics and genomics accessible in places without access to lots of expensive equipment?  What problems might the field of genetics/genomics address that would be most relevant to the developing world?

I am skeptical that genomics offers any shortcut to improved global health or economic development.  Information technology is starting to have significant effects in this arena, and we should probably concentrate on increasing IT’s reach rather than turning to other, less mature technologies such as genomics.  The biggest challenge in global health (and in poor communities in rich countries) is to improve access to existing health-care services with high cost/benefit ratios.  The next round of challenges relate to developing better, cheaper ways to diagnose and treat diseases that have disproportionate impact in poor countries, primarily infectious diseases.  Genomics is already playing a key role in this research, but the path from basic R&D to large-scale application in poor countries is tortuous.  Also, some of the research problems—for example, developing vaccines against malaria and HIV—are just plain hard even with all the tools at our disposal.

Agriculture offers some shorter-term opportunities.  The anti-GMO backlash has curtailed what might have been a developing-world success story, and anti-GMO ideologues bear some of the moral responsibility for this outcome.  GMO technology is actually relatively straightforward to implement in the types of agricultural-research facilities widely extant in developing countries.  It is not a panacea, but the technology could undoubtedly contribute to local efforts to engage local agricultural and nutritional problems.  Some activity of this type is going on, but knee-jerk opposition to GMO’s has not been helpful.  Neither have some of the activities of global-agribusiness enterprises.  This example illustrates the futility of looking for purely technocratic solutions to complex problems.  The technology is embedded in social, political, and economic contexts over which scientists have little influence.

Please comment on how the advances in medicine related to the human genome will affect longevity and world population, food supply, and resource demands.

This question is just too hard.  A few years ago, I met with a group of summer interns at the University of Washington who were working on biotech-related research projects.  Several of the students mentioned improving food productivity as a motivation for their work.  Just to see how they would respond, I asked them if they thought that it was possible, even in principle, to improve the global quality of life through agricultural technology given Malthus’s precepts.  None of these students knew what I was talking about—they had never heard of Malthus!  If our best university students are 200 years behind in grappling with the big questions of “longevity, world population, food supply, and resource demands” perhaps we should all increase our focus on improving the general education of scientists rather than trying to guess whether this or that well intentioned technical advance will help or hurt humanity.

Would you please address the global politics of the human genome?

This question could be interpreted in a variety of ways.  I will just address the global politics associated with the science itself rather than tackling such bigger questions as whether genomics is more likely to exacerbate or attenuate disparities in wealth and power around the world.  Within science, the Human Genome Project was a modestly successful instance of internationalization.  Most of the key technologies and actual data production originated in the U.S. or in the U.K.  Other European countries, particularly France and Germany, contributed significantly, as did Japan and China.  No serious effort was made to draw in the developing world.

A major success, seriously threatened in the late 1990’s and early 2000’s by privatization schemes, was that the data ended up in the public domain.  These data are freely available and widely used throughout the world, with the major costs of acquiring, maintaining, and distributing them borne by rich countries.

How many different human genomes must be sequenced to have a significant impact on disease and/or population control?

Arguments developed above suggest that we will need millions of sequenced genomes, embedded in accessible health records and tracked over a period of decades, to realize the potential of genomics in mainstream medicine.  I am not sure what to say about the impact on “population control,” although I raise the concern that Malthus may ultimately be proven right in my answer to an earlier question.