Abstract

At the turn of the millennium as the mapping of the human genome came to fruition and the potential of genomic science for improving health drew increasing optimism, global health policymakers and scientists voiced concern that the rise of genomics might ultimately deepen inequalities in global health (Pang, 2002; Singer and Daar, 2001; The Lancet, 2002; WHO, 2002). When he announced the completion of the first draft of the map of the human genome in June of 2000, US President Bill Clinton remarked that ‘humankind is on the verge of gaining immense new power to heal’, but at the same time, he cautioned, ‘we must ensure that new genome science and its benefits will be directed toward making life better for all citizens of the world, never just a privileged few’ (The White House, 2000). A year later, WHO released a report entitled Genomics and World Health in which it acknowledged that most advances in genomics were occurring in the world’s wealthiest nations and often in the private domain (WHO, 2002). That report pointed to a long history of neglect by northern pharmaceutical companies of the diseases most heavily burdening low- and middle-income countries. Would developing regions be left behind again by the ‘genomic revolution’? Beyond its applications for high-cost clinical care envisioned in the Euro-American West (i.e., ‘personalised medicine’), could genomic technology also be used to more broadly improve public health in the developing world?