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Genetic research has the potential to lead to major medical advances within the coming years against such killer diseases as malaria, tuberculosis and HIV/AIDS, potentially saving millions of lives, especially in the developing world, the World Health Organisation (WHO) says in a major new report on the impact of genomics.

The WHO report, entitled Genomics and World Health, also makes a major contribution to the debate on the ethics of genome research, covering a wide array of themes, from using DNA tests to select the sex of children to the need to ensure that poor countries are not left out of the coming medical advances.

The report strongly endorses the recommendation of the Commission on Macroeconomics and Health to create of a Global Health Research Fund, a new central organisation for research and development with an initial US$ 1.5 billion, which would be available through peer-reviewed application, to every country.

It argues that a second US$ 1.5 billion should be made available to institutions which are working on new vaccine and drug development for HIV/AIDS, tuberculosis and malaria.

"Genome research, if we handle it correctly, can change the world for all health care," says Dr. Gro Harlem Brundtland, WHO Director-General. "In particular, it has the potential to allow developing countries to leap frog decades of medical development and bring their citizens greatly improved care and modern methods in the much more immediate future."

A team of 14 internationally prominent doctors, medical researchers and ethicists in both developed and developing countries, coordinated by Dr. Tikki Pang, WHO Director, Research Policy & Cooperation, developed the 241-page Genomics and World Health Report over a 12 months period.

The report was issued on behalf of WHO's Advisory Committee on Health Research (ACHR), the organisation's highest level scientific advisory body.

Based on a wide-ranging consultative process, the report details the latest advances in genome research, explains how this research could result in medical advances against many diseases, including those pandemic in poor countries, warns about potential risks of such research and makes recommendations on how the fruits of this research can be brought to the developing world."This is the first ever report to put genomic research in a global perspective," says Sir David Weatherall, lead writer of the report, Professor at Oxford University's Weatherall Institute of Molecular Medicine and a pioneering researcher in molecular genetics, haematology, pathology and clinical medicine.

"The report anticipates how the global community could use genetics to attack the unfinished agenda of infectious diseases such as malaria, TB and HIV/AIDS that are still killing so many in the developing world, and eventually the diseases that are crippling the health care systems of all countries, like heart disease, diabetes and cancer."

In recent years, scientists have succeeded in sequencing the entire human genome, which contains between 28,000 and 40,000 genes - lengths of DNA that carry the information required for every biological function of all living creatures. Researchers are also mapping the genomes of some important pathogens, disease vectors and plants. Such research involves large-scale creation and utilisation of databases through a high level of automation, and therefore requires major capital investment.

This has mostly limited research to the rich industrial nations, although Brazil, China, India and Cuba are notable exceptions. These achievements should allow other researchers to develop both preventative and treatment techniques that have pinpoint accuracy for a wide range of afflictions.

"Developing nations are in danger of being left out of the benefits of genomic research, like they were left behind in the computer revolution of the 1980s and 90s, resulting in the so-called 'digital divide'," Prof. Dan Brock of Brown University and another of the report's writers. "Genomics and related technologies should be used to narrow the existing unethical inequities in global health. The report is an important first step towards this goal."

"The whole trust of the report is that we will not change medical practice overnight by this new technology," Dr. Weatherall says. "However, the long-term possibilities are such that developing countries, as well as developed countries, must prepare themselves for this new technology and carefully explore its possibilities."- WHO release

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