Genomic Medicine Towards Affordable Health Care for All: A Case Study of Indian intitatives in Genomics in Collaboration with McLaughlin-Rotman Centre

In a six-paper supplement of the journal, Nature Reviews Genetics (NRG), the researchers from the McLaughlin-Rotman Centre for Global Health (MRC), Toronto along with collaborators from four countries with emerging economies, viz., Mexico, India, Thailand and South Africa have demonstrated the way for the others in similar economic circumstances that serious efforts in establishing domestic capabilities in the field of genomic medicine would help improve national health, slash medical costs through better resource allocation, and bolster their economies. The case studies have revealed six major cross-cutting themes underlying initiatives in all four countries studied, namely, political will, institutional leadership, the goal of producing local health benefits, protecting genomic sovereignty, and promoting economic benefits.

The insights chronicled will be of particular interest to developing world policy makers (especially in science and technology, industry and commerce, and health ministries); legislators considering research funding; leaders of research institutions; individual scientists; investors and small and medium private sector enterprises in both industrialized and developing countries, and international organizations interested in the use of science and technology to accelerate global health equity, health security and economic development.

Prof. Samir K Brahmachari, presently DG, CSIR and the then Director Institute of Genomics and Integrative Biology (IGIB) spearheaded the CSIR led Indian Genome Variation Inititative and Dr. Mitali Mukerji, IGIB, CSIR and the convener of the project have collaborated with MRC for the Indian chapter, From diversity to delivery: The case of the Indian Genome Variation Initiative. This Indian study details how it cannot emulate the West but needs to innovate in the field of genomics in human health for it to be useful for majority of the population. In this context, the scope of the Indian Genome Variation intitative, novel knowledge alliance of public-private enterprises as well as other genome intitatives in the country have been discussed. Some salient points highlighted are:

• The role of “The Indian Genome Variation (IGV)” towards scientific capacity building, developing and retaining valuable human resource and provided the Indian scientists and the growing private sector with a competitive edge in the global market through development of predictive medicine database at the population level.

• Emergence of India as a global hub for early stage clinical trials mainly due to the presence of a large population which is drug naïve and is readily accessible and genetically covers entire spectrum of global diversity.
• Members of IGV Consortium from other five CSIR institutes, namely, IICB, CCMB, CDRI, IMT, and ITRC and ISI Kolkata are also exploring innovative applications in niche markets. The idea of personalized therapeutics based on individual variation has existed for more than 4,000 years in India’s traditional practice of Ayurveda medicine. Individual variation has resonance with traditional medicine in India which is widely used by nearly 70% of the Indian population. Four millennia later, a new national databank containing genetic samples from about 15,000 unrelated individuals from India’s diverse geographic and linguistic subpopulations has been made available through IGV initiative. A new field of Ayurgenomics has been initiated which aims to explore this fundamental concept of individual medicine in conjunction with IGV for predicitive and personalised medicine.
• An Indian life-sciences company, Avesthagen Ltd, has announced a five-year, $32 million Avesthagenome project to genotype the country’s entire Parsi population -- about 69,000 people. IGVdb also contains a limited number of Persian population as sample. The Parsis, thought to be genetically homogenous, are feared to be at risk owing to their religious prohibition of marriage outside of the community. The aim is to determine linkages between genes, disease and environmental factors and develop new therapies and diagnostics, with a focus on chronic diseases, such as cancer and central nervous system disorders, that can be used to directly benefit the Parsi population, with an additional potential to be marketed globally where appropriate.
• The IGV has also begun to provide its researchers with commercialisation support in order to encourage translational research and also facilitated capacity to conduct proof of concept studies as well as technological expertise through the establishment of The Centre for Genomic Applications (TCGA) a not for profit public-private partenrship.

The article also highlights the challenges to adoption of genomic medicine in India and provides directions as to how these could be overcome through :

• Establishment of strong academic links like IGV consortium
• Public-private alliances for development and commercialisation of genomic knowledge
• Public engagements and public awareness
• Establishment of regulatory networks for clinical trials or threapeutics that rely on population difference, genomic science, population-based therapeutics or pharmacogenomics
• Innovative solutions through genomics for cheap diagnositics, retention of low cost drugs in the market
• Increase in physician’s understanding and acceptance for genomics and their potential applications
• Protection of genomic sovereignty while fostering international collaborations that can provide much needed financing and potentially contribute to local scientific capacity building.

The results under IGV Consortium have placed Indian genomics research in the world map and as a recognition of this, HUGO decided to hold its 13th Human Genome Meeting (HGM2008) at the Hyderabad International Convention Centre, druing 27-30 September 2008. During this meeting, IGV Consortium members would present nearly 100 papers covering the work of Phase II and disease gene assessment.

Source: Press Information Bureau
Date: 19 September, 2008