The Genomic Revolution Implications for Treatment and Control of Infectious Disease: Working Group Summaries (2006) / Chapter Skim
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Explore the Emerging Role of Public Health in Integrating Genomics in Surveillance, Outbreak Investigations, and Control and Prevention of Infectious Diseases
Explore the Emerging Role of Public Health in Integrating Genomics in Surveillance, Outbreak Investigations, and Control and Prevention of Infectious Diseases
Pages 57-72
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From page 57... ...
Use this information to develop strategies to promote health and prevent disease in populations 3. Target and evaluate population-based interventions The "public health system," which includes federal agencies such as the Centers for Disease Control and Prevention, state health departments, and academic public health institutions, is beginning to work closely with basic scientists, professional organizations, consumer groups, and the private sector to "translate" advances in genomics into actions to prevent and control infectious diseases at the population level (Centers for Disease Control and Prevention, n.d.)
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From page 58... ...
. The Problem What should public health systems do to prepare and respond to the emergence of genomic tools in infectious diseases, in terms of surveillance, outbreak investigations, developing and deploying new interventions (e.g., vaccines)
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Tress. Public health surveillance of genetic information: ethical and legal responses to social risk (pp.
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60 THE GENOMIC REVOLUTION WORKING GROUP SUMMARY GROUP 1 Summary written by: Lenette Golding, Graduate Student, Grady College of Journalism and Mass Communication, University of Georgia Focus group members: · Benjamin Bates, Assistant Professor, Communication Studies, Ohio University · Sally Blower, Professor, Biomathematics, University of California, Los Angeles · Karen Burg, Hunter Chair and Professor, Bioengineering, Clemson University · Robert Cook-Deegan, Director, Center for Genome Ethics, Law and Policy, Institute for Genome Sciences and Policy, Duke University · Lenette Golding, Graduate Student, Grady College of Journalism and Mass Communication, University of Georgia · Isaac Mwase, Associate Professor of Philosophy and Bioethics, National Center for Bioethics in Research and Healthcare, Tuskegee University · Claire Panosian, Professor of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at the University of California, Los Angeles · Mary Reichler, Centers for Disease Control and Prevention · Charles Rotimi, Professor and Director, National Human Genome Center, Howard University · Daniel Salsbury, Managing Editor, Proceedings of the National Academy of Sciences · Todd Thorsen, Assistant Professor, Mechanical Engineering , Massachusetts Institute of Technology Summary This multidisciplinary group was given the task of exploring the interplay between public health and genomics. Recognizing the wealth of information and opportunities that genomics offers public health, the group discussed ways of bridging the gap between gene discovery and the applica
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In an article that appeared in Reason, a nonpartisan political magazine, in April 2003, Reason's science correspondent Ronald Bailey wrote, "Thank goodness that SARS broke out in the Genomics Age." Perhaps if the SARS epidemic had occurred in 1992 instead of 2002, many more would have perished. The group discussed the SARS epidemic in detail, because it illustrates classic public health issues, such as the fact that prompt identification and containment of any pathogen requires collaboration among government agencies and institutions and cooperation from the general public.
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From page 62... ...
Nonetheless, the group felt that the SARS epidemic of 2002-2003 increased awareness about the importance of good communication, coordination, infrastructure, and surveillance in running effective public health interventions. Universal issues in the use of genomic technologies: Strategies and solutions Whether the issue is an infectious disease outbreak or predictive testing for a heritable disease, the group identified five issues that genomic researchers and the public health community must face if genomic tools are to be used effectively.
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From page 63... ...
To be the most effective, genomic campaigns will need to address regional concerns, local health issues, and language differences; in fact, the individuals directing the campaign will first need to be educated about the campaign target regions in order to best serve the local public. "Buy in" from community leaders will be essential.
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Instead of being obsessed with relatively minor differences that set apart ethnic groups, the group felt that spreading the message of common origin would help the public understand the importance of global solidarity in the war against disease. But this is a tricky message to convey, because social definitions of race and ethnicity are often confused with genetic origin.
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There are apt to be population differences, particularly for pathogens that have co-adapted in particular regions over long periods of time, so there has been selection pressure on both pathogens and human hosts that may well map to geographic areas and environmental factors that influence the prevalence of specific infectious diseases. It would be sad, indeed, if the story stopped at "race" when in fact, the underlying story is specific environmental factors, host factors, or pathogen differences that could be illuminated by genomic tools.
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From page 66... ...
Jasny, Supervisory Senior Editor, Science · Rima F Khabbaz, Acting Deputy Director, National Center for Infectious Diseases · Hod Lipson, Assistant Professor, Mechanical and Aerospace Engineering, Cornell University · Daniel Oerther, Associate Professor, Civil and Environmental Engineering, University of Cincinnati · Anne W
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From page 67... ...
Thus, infectious disease control is now a shared burden -- as a growing threat in developed nations, and a clear and present danger in developing nations -- and it is therefore a perfect place for a new science like genomics to play an important role. The need to develop new approaches to fight infectious disease was evident in the sentiments of scientists, engineers, and medical researchers gathered in Irvine, California, at the Third Annual National Academies Keck Futures Initiative Conference.
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From page 68... ...
To help understand the etiology and pathogenesis of a disease, determining the genetic sequence of a pathogen might be a higher priority than sequencing the human hosts, because sequencing the human genome costs are enormous and may yield less information about the infectious disease. While resistance and susceptibility factors in the human genome will no doubt prove important in the future, the price of such discovery has to be balanced against more pressing public health needs.
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From page 69... ...
Programs for collecting samples and information for single diseases exist: preexisting HIV and malaria projects act as good starting points from which to develop a larger resource that covers multiple diseases. An excellent model is the Global AIDS Program, which partners with communities, scientists, and public officials to prioritize health concerns and direct prevention programs appropriately.
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From page 70... ...
However, it will likely be a challenge to articulate the message so as to compel a strong commitment to investing in this as a shared public health global resource. The International Human Genome and HapMap project exemplify the inherent challenges of equality in such ambitious global health initiatives.
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From page 71... ...
ROLE OF PUBLIC HEALTH IN INTEGRATING GENOMICS 71 knowing the health status of themselves and their families, especially in the cases of treatable diseases. With genomics still in its infancy, now is the perfect time to concentrate on the challenges and promises of this new science in winning the battle against common infectious diseases in their threat to human life and the public health.
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