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[ADDIS ABABA] Africa should incorporate precision public health — an approach that targets diverse genetic and environmental characteristics of populations in preventing and treating diseases — to help the continent improve healthcare, a meeting has proposed.
At a round-table meeting in Ethiopia, this month (7 October) organised by the Bill and Melinda Gates Foundation, experts discussed that people respond differently to treatments and thus the concept of treating populations as if they have homogenous characteristics is outdated. 
Michele Ramsay, professor at the division of human genetics, University of Witwatersrand in South Africa, says there is need to understand how precision health can make a difference in managing non-communicable diseases in Africa.

“We need to understand gene-environment interaction against [the backdrop of] genetic diversity in Africa.”

Michele Ramsay, University of Witwatersrand


“Non-communicable diseases are complex and they have to do with genetic susceptibility and its combination with a given environment. We need to understand the gene-environment interaction against [the backdrop of] genetic diversity in Africa,” she says.
 Ramsay adds that knowledge to better understand how diversity and certain environments could predispose people to non-communicable diseases is crucial.
“In Africa we have diversity at many levels; genetic, sedentary lifestyles and at the cultural levels. We have to take all that into consideration when thinking about precision medicine for the future. It is about prevention and treatment,” she explains.
Ramsay tells SciDev.Net that precision health it is about quicker identification of individuals most at risk and implementing fast interventions for better outcomes, noting that often people do predictions in Africa based on very little data.  
She adds that the modules used currently to manage diseases need to adopt community-based approach because even within countries there is great heterogeneity and change.
Ramsay notes that genetic diversity and increasing urbanisation affecting lifestyles are catapulting non-communicable diseases such as hypertension, obesity and diabetes more than ever before.
“We need to understand the interaction between them,” she says, adding that there is a need to change people’s perceptions on sharing data and biospecimens between research groups.
Investing in human capacity and infrastructure for research could help boost precision medicine or public health in Africa, she explains.
Gabriel Anabwani, clinical professor of paediatrics and executive director of Botswana-Baylor Children’s Clinical Center of Excellence in Ethiopia, says precision public health is a new approach for generating evidence about what is known on genetics, epidemiology and ethnic groups in the best way possible to improve health.
“Africa is a huge continent with variable health infrastructure and thinking about precision [public health] is thinking about the future… and steering the continent in that direction,” Anabwani adds.
Peter Waiswa, associate professor at School of Public Health in Uganda’s University of Makarere, says knowing a defined demographic of a population is key in precision medicine because  it requires accurate, timely, quality and usable data and capacity to use that data for targeted interventions. “In Africa we have the problem of data in health and its determinants as most comes from health managements systems or through expensive exercises such as surveys,” Waiswa says.
Precision public health focuses on understanding populations at risk or where certain disease and conditions are clustering and what is causing these disease to occur.
“This will guide investment in resource-scarce areas like Africa and enable optimal use of interventions” Waiswa adds.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.

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