WHO issues an urgent call to accelerate access to genomics in resource-poor countries

The World Health Organization (WHO) has issued an urgent call to accelerate access to genomics, especially in resource-poor countries, in a report that examines technology gaps and opportunities.

Genomics is the branch of science that uses methods from biochemistry, genetics, and molecular biology to understand and use biological information in DNA and RNA to benefit medicine and public health — but the technology can also be used in agricultural research.

“During the COVID-19 pandemic, genomics has been essential to detecting the virus initially — and new variants subsequently — and also integral to the development of tests, treatments and vaccines,” said WHO director-general Tedros Adhanom Ghebreyesus at a virtual press conference from Geneva on Tuesday (12 July).

Further, genomics has massive potential beyond pathogen surveillance for human health. It is timely for countries to invest in infrastructure and human resources in this area.”

Tedros Adhanom Ghebreyesus, WHO director-general

While genomics technology is driving some of the most ground-breaking research in medical science, including COVID-19 vaccine research and development, its full potential is yet to be realised globally, especially in low- and middle-income countries (LMICs), according to the WHO Science Council’s inaugural report.

“It’s not justifiable ethically or scientifically for less-resourced countries to gain access to such technologies long after rich countries do,” the authors argue.

American scientist Harold Varmus, chair of the council and a Nobel Laureate, said: “We’re encouraged by evidence we gathered that genomics has been adopted in many relatively poor countries, and that costs are going down.

“There are also incentives to encourage commercial providers of the essential ingredients such as machines, reagents and software to use a variety of economic incentives to further the expansion of the use of genomics.

“We are, however, concerned that the already widespread use of genomics in advanced countries should not leave LMICs behind, as has occurred in many other contexts.”

A raft of measures has been put in motion aimed at making the technology more accessible in LMICs, including modified pricing models, sharing of intellectual property rights for low-cost versions and cross-subsidization — where profits in one area are used to fund another.

But challenges remain in addressing shortfalls in financing, laboratory infrastructure, materials and highly trained personnel, according to the analysis.

The authors highlight four thematic areas to promote the adoption and expanded use of genomics: advocacy, implementation, collaboration and tackling legal and ethical concerns.

For this to happen, they say governments, academic institutions and businesses have to be convinced of the medical, scientific and commercial benefits of genomics.

The Science Council puts forward a number of recommendations to address ethical, legal and social issues associated with genomics and urges the WHO to become the authoritative source for mediation and guidance on these.

The council was formed following calls from the science world for a moratorium on human genome editing, after biophysicist He Jiankui announced in 2018 that he had used the CRISPR genome-editing technique to alter embryos that resulted in two births.

The Council was established in April 2021 to “provide guidance on the science and research strategy of the organization”. It is currently made up of nine members who serve in a personal capacity, rather than as representatives of institutions or countries.

“We’re optimistic about the future applications of genomics,” said Varmus. “We believe that … adoption of widespread use is feasible and with the help of the WHO and its leaders it can be achieved.”

Alessandro Marcello, head of the molecular virology laboratory at the International Centre for Genetic Engineering and Biotechnology in Italy, says the use of genomics in surveillance of viruses received a major boost during the COVID-19 pandemic.

“The new standard for molecular epidemiology is whole genome sequencing. WHO is right in highlighting disparity in different countries, not only in Africa,” he said, and added: “There are several efforts to fill this gap that need coordination and we are moving in the direction of enabling community labs to be able to sequence locally circulating viruses.”

As well as sharing of data, simple and affordable workflows for sequencing are needed, he said, not expensive, centralized facilities.