A colleague of mine, Steve Baker from Oxford Uni Clinical Research Unit in Ho Chi Minh City, has written an excellent but unsettling piece for Nature’s “World View” column on the impact of genomics on infectious disease in the developing world. Steve and I have worked together on several projects related to typhoid and diarrheal diseases, including our latest paper on typhoid in Nepal that I posted about a few days ago.
I’m generally optimistic about the great promise that genomics holds for infectious disease research and public health practice, and promote this whenever I can (and Steve does too). But as Steve points out in the article, the funding for these things is not directed at diseases that are common in developing countries, where the vast majority of the infectious disease burden occurs. He makes some very interesting points about how several factors – including local power structures and advocacy, well-meaning international donors like the Gates foundation, and a genuine lack of diagnostic field tests that are actually useable in the areas where the disease burden is – are resulting in very slow progress for diseases of poverty like typhoid.
The article is free to read here on the Nature site.
A general point that the article highlights, is that diseases and health issues need advocacy in order for change to happen. This is beginning to happen for typhoid, through the international consortium Coalition against Typhoid (see Wikipedia entry and the Sabin Institute). Their stated goal is “to define the barriers for adoption of typhoid vaccine and the key activities needed for the barriers to be overcome”, in short they aim to provide the advocacy much needed to get typhoid – which is essentially preventable through clean water and vaccination – onto the political & health agenda wherever the disease is endemic.