September 15, 2010 (Vol. 30, No. 16)

Winston Patrick Patrick Kuo, D.D.S., D.M.Sc.
Folarin Gbadebo-Smith

Developing Countries Evaluating Ability of Translational Technologies to Transform Status Quo

Governments in Sub-Saharan Africa, including Nigeria, are moving to integrate advances in science and technology into their countries’ service delivery offerings. Many have set up agencies to encourage the use of science and technology as a mechanism for accelerating economic growth and reducing poverty through the adoption of current global translational technologies.

Most of these initiatives, however, have been in the agriculture and telecommunications sectors. This is now changing. There are indications that the medical community plans to adopt biotechnology as a platform for better healthcare delivery in the subregion. An encouraging trend is the willingness of countries to collaborate with each other and partner with the private sector in addressing problems in sectors ranging from blood banking to clinical laboratory services at the community level.

Earlier this year, the Lagos State government of Nigeria, through the Ministry of Health, announced its intention to introduce biotechnology to enhance medical services and to invest in healthcare technology.

Lagos State Commissioner for Health, Jide Idris, M.D., and OGNOS Partners, a public policy consulting firm, recently hosted a meeting entitled “The Future of Medicine: Exploring the Impact of Technological Advancement on Health Policy,” in which we delivered the keynote speeches.

The lecture brought together key stakeholders in the health sector to better understand the role of advanced translational technologies in healthcare and also identified solutions toward addressing issues identified in a coordinated and comprehensive manner.

A variety of initiatives to use biotechnology in medicine and how these can assist in the diagnosis or prognosis of diseases, improve the prevention of diseases, and help conceive and execute new treatments in patients were discussed at the meeting.

In our addresses, we discussed how the holy grail of medical research is getting the latest discoveries translated into products that can treat patients at the bedside—and conversely, how observations made in the clinic can guide research at the bench and vice versa, what we call bench to bedside (and back).

We used the analogy that biotechnology is to medical science what cellular technology was to telecommunications. Advances in this field may create the quantum leap needed to overcome the major challenges of healthcare provision in poor and developing countries.


Developing countries are moving to incorporate biotechnology into their healthcare systems to enhance medical services and improve patient care. [Jason Kelvin/Photo Researchers]

Policies

In addition, we stressed the need to develop and implement the right policies for biotechnology to thrive in Nigeria. We also called on government to institute policies that would potentiate the capacity of the private medical sector to optimize its service outputs. This requires a review of the curriculum of Lagos State University, College of Medicine to create the appropriate departments to teach bioinformatics, genetics, patents and intellectual property law, and other related subjects in preparation of the personnel demands that will definitely arise from such major shifts in technology.

Effective health planning needs to anticipate future healthcare technology and take its impact into account. For health policy makers committed to improving national health systems, involvement of these new technological areas in the policy formulation process is essential to ensure that health policy, when implemented, is future-proof.

Appropriate studies of the medical value chain need to be undertaken to accurately determine the most effective mode of engagement with these new technologies. Policy makers need to ask, “Where and how in the healthcare delivery chain can developing country health systems intervene with biotech tools to deliver the most bang for their limited buck?”

Fortunately some of the infrastructure required for the functioning of such a biotechnology-driven healthcare platform is currently being implemented. The first of two privately operated subsea fiber-optic cables has arrived in Lagos, delivering sufficient bandwidth to make cloud computing, collaborations in computational biology, and collaboration between international research institutions a realistic possibility.

Dr. Idris promised that his ministry would “critically look into the recommendations from the symposium,” adding that there was the need to embrace technology in healthcare.

“Our current methods of organizing and delivering healthcare are unable to meet the expectations of patients and their families because the science and technologies involved in healthcare—the knowledge, skills, care interventions, devices, and drugs—have advanced more rapidly than our ability to deliver them safely, effectively, and efficiently,” he explained.

According to the former Minister for Science and Technology, Professor Turner Isoun, it is estimated that 15 years from now, 50% of the global economy will be bio-economies and knowledge economies.

“Hence, by 2020, any nation that does not align itself economically with biotechnology might miss out on the reward of yet another revolution. No doubt, Nigeria is endowed, but what matters most is how it uses the new information technology of bioinformatics to drive growth and development in the country.”

The Commissioner for Science and Technology, Kadiri Hamzat, Ph.D., said the theme of the symposium was appropriate since biotechnology allows quicker diagnosis for early treatment, thus saving more lives as well as allowing better treatments and higher success rates at curing or slowing progression of the disease process.

“Medicine today is characterized by the need to know more, manage more, watch more, do more, all with more people involved in doing it than at any other time in our history.”

Future Challenges

While stressing that the time to prepare to meet future health challenges is now, the Commissioner said that the current quarter of this century will be characterized by head-to-head competition in industries that offer high-paying jobs to their workers and bring prosperity and world prestige to their countries.

These new technologies present both major challenges and opportunities for developing countries; however, there is the potential for serious disruptions in the architecture of the health system by these new technologies. Consequently some confusion may arise in the way investments should be made in the near term in order to optimize the integration of biotechnology in Nigerian healthcare delivery.

The key to success will depend on cooperation between universities, hospitals, existing laboratories, private biotechnology companies, and research institutions both locally and abroad. The ability to create the necessary network of people and resources will be the final piece needed to complete this circle.

Winston Patrick Kuo, D.D.S., D.M.Sc. ([email protected]), is director of the laboratory for innovative translational technologies at the Harvard Clinical and Translational Science Center and instructor in the department of developmental biology, Harvard School of Dental Medicine. Folarin Gbadebo-Smith ([email protected]) is CEO of OGNOS Partners, a public policy consulting firm, and director of the Center for Public Policy Alternatives.

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