Biotechnology to improve health in developing countries: a review

The growing health disparities between the developing and the developed world call for urgent action from the scientific community. Science and technology have in the past played a vital role in improving public health. Today, with the tremendous potential of genomics and other advances in the life sciences, the contribution of science to improve public health and reduce global health disparities is more pertinent than ever before. Yet the benefits of modern medicine still have not reached millions of people in developing countries. It is crucial to recognize that science and technology can be used very effectively in partnership with public health practices in developing countries and can enhance their efficacy. The fight to improve global health needs, in addition to effective public health measures, requires rapid and efficient diagnostic tools; new vaccines and drugs, efficient delivery methods and novel approaches to therapeutics; and low-cost restoration of water, soil and other natural resources. In 2002, the University of Toronto published a report on the "Top 10 Biotechnologies for Improving Health in Developing Countries". Here we review these new and emerging biotechnologies and explore how they can be used to support the goals of developing countries in improving health.

Genomics, biotechnology and global health: the work of the University of Toronto Joint Centre for Bioethics

The new and rapidly advancing field of genomics and related biotechnologies has the ability to either improve or worsen global health inequities. In general, developing countries are left behind in the development of new technologies and advances in genomic medicine.In this view, the University of Toronto Joint Centre for Bioethics (JCB) through the Canadian Program on Genomics and Global Health has developed 25 research projects on capacity enhancement for developing countries for improving global health equity, including public health via genomics and related biotechnologies. One project with a great impact was the ÒTop Ten Biotechnologiesfor Improving Health in Developing CountriesÓ for its influence in the "Grand Challenges in Global Health Initiative" foster by the Melinda Gates Foundation.Additionally, the UN Millennium Development Project has asked JCB to become the genomics working group for improving global health through genomics biotechnology and JCB has started by studying applications of genomics/biotechnologies in seven developingcountries: Brazil, China, Cuba, Egypt, India, South Africa and South Korea, which may set examples for other developing nations.

Global health ethics: the rationale for mutual caring

Despite spectacular twentieth century scientific and technological progress, the world is more inequitable than it was fifty years ago. This is evident both in terms of access to health care for individuals, and in relation to the health of whole populations. Disparities in wealth and health within and between nations are widening inexorably and the rapidly expanding global economy has failed to reduce poverty among those with little if any access to health care. In this context the Universal Declaration of Human Rights remains an unrealized aspiration for the majority of the world's people. Given these realities, no single discipline, or body of knowledge is likely to make much difference. For example, approaches based only on neo­liberal economics, as exemplified by the structural adjustment programmes of the World Bank, have not been successful in promoting health equity. The authors believe that an interdisciplinary approach is required, and that bioethics, an interdisciplinary field, can make a contribution towards improving health globally. To do this, the scope of bioethics should be expanded towards a results­oriented global health ethics, based upon widely shared and foundational values that could be carried forward through five transformational approaches.