The scientific community must make a concerted effort to build on advances in genomics research if it is to benefit people in resource-poor settings, says Stephen Baker, head of enteric infections at the Wellcome Trust's Major Overseas Programme at the Oxford University Clinical Research Unit, United Kingdom.
There are plenty of genome sequences, says Baker, but the value of such research is less easy to pinpoint. For example, although ten years ago the genome sequencing of the microorganism that causes typhoid fever made elimination a realistic target, promises of bespoke treatments, next-generation vaccines and low-cost diagnostics have failed to materialise.
The reasons for this are "depressingly obvious", writes Baker. The people and communities affected by typhoid do not have the power to influence the scientific community or decision-makers, who tend to come from a wealthier background where direct contact with the disease is limited. And there are no advocacy groups for typhoid or other diseases of poverty.
Major international donors, such as the Bill & Melinda Gates Foundation, prioritise diseases using metrics and tables — but because typhoid is difficult to detect, global prevalence is probably underestimated and the disease drops down the list of priorities in international assessments.
Much of the funding and technological expertise needed for genomics research and follow-up studies are found in countries removed from the realities of the disease. By contrast, sequencing the HIV virus, which affects wealthier countries, has led to remarkable progress in public health practice. This shows that strong scientific investment alongside political and community support is essential for reaping the benefits of genomics research.
Unless these issues are addressed, genomics research runs the risk of persisting as an exciting academic advance that does little to improve public health, argues Baker. He suggests that funding agencies give genomics researchers the opportunity to see how the infection affects endemic countries, and support collaborations "that aim to bridge the geographical and technological gap".