Daar

Avoiding the Health Genomics Divide : 

Avoiding the Health Genomics Divide Abdallah S Daar Peter A Singer Joint Centre for Bioethics University of Toronto June 8, 2002

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Medical Genetics and Biotechnology: Implications for Public Health   unedited draft report, version: 22 December 1999, by       Professor A.S. Daar and Professor J-F. Mattei       with the assistance and guidance of members of the WHO Working Group on Genetic Manipulations and incorporating modifications suggested at the meeting of the working group of independent and external experts held at WHO headquarters 12-14 October 1998             © World Health Organization    This report is not issued to the general public, and all rights are reserved by the World Health Organization. The report may not be reviewed, abstracted, quoted, reproduced or translated, in part or in whole, without the prior written permission of WHO. No part of this report may be stored in a retrieval system or transmitted in any form or by any means - electronic, mechanical or other - without the prior written permission of WHO.   The views expressed are solely the responsibility of the authors.

Human Development Report 2001: 

Human Development Report 2001 “moved in a new direction this year by challenging some cherished opinions about what the third world needs” Mark Malloch Brown, administrator of the United Nations Development Program looks at three areas - food, medicine and information systems - where high-technology can be made relevant and useful to poor countries, as long as risks are well managed

Bridging the genomics divide: 

Bridging the genomics divide

Rationale: 

Rationale Inequities in global health among greatest ethical challenges in world today Genomics may increase these inequities (”genomic divide”) Strategy needed to facilitate application of genomics to ameliorate inequities

What We Actually Mean By “Genomics”: 

What We Actually Mean By “Genomics” The powerful new wave of health related life sciences (biotechnologies) energized by the human genome project and the knowledge and tools it is spawning.

Examples of biotechnology in/for developing countries: 

Examples of biotechnology in/for developing countries Vaccines: Cuba meningitis B, Nairobi HIV, Indian Malaria Diagnostics: Latin America Dengue, Leishmaniasis using PCR Pharmacogenomics: HIV drugs in West Africa Bioinformatics/drug discovery: Fosmidomycin

Our Approach: 

Our Approach Large-scale problems require large-scale, sustained, long term interventions Critical examination of both risks and benefits Where benefits likely, pro-active engagement Interdisciplinary, multi-stakeholder approach Practical, down-to-earth, with emphasis on high-caliber research and capacity strengthening Dialogue not just with other ethicists-target policy makers and engage the public Global focus

CPGGH - Approach: 

CPGGH - Approach “…do we want ‘ethics as usual’ or should we in fact be defining a new bioethic that promises real world solutions to real world problems?” “Peter Singer and Abdullah Daar of the University of Toronto Joint Centre for Bioethics are tackling just these questions as they and their colleagues build the "Canadian Program on Genomics and Global Health", part of the C$300 million Genome Canada initiative…”

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Missing: Elettra Ronchi Tikki Pang Alan Wildeman Ross MacKenzie André La Prairie Elizabeth McPherson Betsy McGregor CPGGH/PAEB Advisory Board

Strategy: 

Strategy Research Capacity Strengthening Consensus Building Investment Fund Public Engagement

Partnerships: 

Partnerships OTHERS U of T JCB WHO (Collaborating Centre) ACTS,ICMR, PAHO Industry Harvard STI Program

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Which biotechnologies most likely to improve health of people in developing countries in 5-10 years? Top Ten Biotechnologies for Improving Global Health

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Why is Cuba so successful and its neighbours not? Genome Innovation Systems in Developing Countries India-Nandini Cuba-Halla Brazil-Marcella China-Fang Xin S.Africa-Marion S.Korea-?

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Examples of product, Cuba

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Chinese Academy of Sciences Fang Xin Li Zhenzhen Wenke

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What happened at Monsanto between Terminator seed and Golden Rice? Bioethics and Business Strategy

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Molecular Pharming: Ethical Guidelines Say goodbye to cholera?

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Genomics as a Global Public Good for Health (GPGH) Public Goods: Non-rivalrous Non-exclusive

Capacity strengthening initiatives: 

Capacity strengthening initiatives MHSc and PhD students Education for medical students Seminars for GELS researchers GELS consult service Theatrical productions for public Simulations for politicians Education for judges Genome Policy Exec. Courses

Genome Policy Executive Courses: 

Genome Policy Executive Courses Nairobi, March 4-8, 2002 Toronto, May 13-17, 2002 Delhi, Jan 27-31, 2003 Then China Latin America

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NIH Fogarty Fellows

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Public Engagement using Theatre Jeff Nisker Orchids Sarah’s daughters

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“Ethical” fund optimizes social returns, also provides economic ROI Social investment funds: US $2.3 TN; 12% of all assets under management Health/medical/ life sciences share of VC: US $2.2 BN (2001) ; 14% of total investment 1500 Genome companies in US; 400 have gone public Investment Fund-an Idea for Consideration

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Genomics & Global Health (Un-) Commission Elizabeth Dowdeswell

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evaluate need seek champions identify purpose and objectives select chair and commissioners consider methodology, approach and timing G8, G20, WHO, independent commission, global issues network Successful commissions have incubation phase

Launch of African S&T Commission (Now NePAD): 

Launch of African S&T Commission (Now NePAD)

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National Post & Mail CANADA WINS NOBEL PEACE PRIZE Genomic diplomacy lauded by world community By PAUL TAYLOR OSLO, Norway – Canada won its second Nobel Prize for Peace yesterday for its policy of “genomic diplomacy” that many developing countries praise as a revolution in global equity. “We see this as a continuation of the legacy of Lester Pearson ,” said Prime Minister Elizabeth Carlton. “The people of Canada are honoured to receive this prize, and encourage other nations of the world to continue working to reduce the burden of global inequality in the burgeoning field of genomics.” The Nobel Commi ttee lauded the concept of combining foreign aid with domestic research and economic development, seen as keys to providing a sustainable form of support for countries of the Third World. “Once again, Canada has taken a leadership role in advancing the cau se of global equity and charted a new course for the world community,” said King Harald of Norway, president of the committee. King Harald cited Canada’s first genomic aid project in southern Africa, a sequencing of the tobacco plant, as a prime example o f why the country is being recognized. Sequenced in 2004, the plant is now used to produce powdered insulin, malaria vaccine and valuable chemical assays. Tanzania, Zimbabwe and Malawi now export products made from the so - called “good - deed weed.” Makin g the project unique, said Madame Carlton, was the combination of private - public sector involvement, and the stringent ethical reviews put in place to avoid potential misuse of the technology, seen in the notorious U.S. xeno - eggplant experiments in Kentuck y. (Continued, page A14) Prim Minister Elizabeth Carlton Prime Minister Elizabeth Carlton November 1, 2010 By PAUL TAYLOR

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Program in Applied Ethics and Biotechnology: ORDCF, U of T, HSC, UHN, SWCHSC, Sun Life, Pfizer, Merck, GSK ($5.6 m) Canadian Program in Genomics and Global Health: Genome Canada, IDRC, ICMR, ACTS, FSBN, FBCN ($10 m) NIH / Fogarty Bioethics Research and Education Program ($1.8 m) Funding