Penchaszadeh V B
Mailman School of Public Health, Columbia University, New York, N.Y., USA.
Public Health Genomics. 2009;12(1):59-65. doi: 10.1159/000153429. Epub 2008 Sep 3.
Argentina's population numbers about 40 million, with main genetic contributions from Europeans, Amerindians and, to a much lower extent, West Africans. There is a traditional health care system publicly funded coexisting with a social security system and a for-profit private sector. Clinical genetic services include about 40 units in public hospitals dealing mainly with pediatric genetics. The most conspicuous public policies in genetics are newborn screening and folic acid fortification of flour. Genetics/genomics research is funded by state agencies and is conducted in several institutes and centers. Clinical genetics research occurs in public hospitals and deals primarily with congenital syndromes. While there are no defined government policies in the public application of genomics, there have been initiatives to improve the provision of clinical genetic services countrywide. The main hurdles for applying genetics in health care are a fragmented, inefficient, and inequitable health system, facing large unmet needs in infectious diseases, malnutrition, prenatal and newborn care, deficient education in genetics, and lack of explicit public policies in genetic health care and governmental regulations. Overcoming these obstacles requires increase in government funding and improvement of the efficiency of the public health system and its genetic services. Further, there must be concerted efforts to ensure equitable access to the latter. Interactions should be promoted between clinical geneticists, public health officers, primary health care personnel and parent/patient organizations on the use of genetics/genomics in public health, as well as genetics education of health professionals, the public and decision makers, and development of the capacity of the state to regulate properly the application of genetic/genomic technologies to public health.
阿根廷人口约4000万,其主要基因贡献来自欧洲人、美洲印第安人,以及占比小得多的西非裔。该国存在由公共资金资助的传统医疗保健系统,与社会保障系统和营利性私营部门并存。临床遗传服务包括公立医院中的约40个科室,主要处理儿科遗传学问题。遗传学领域最显著的公共政策是新生儿筛查和面粉中叶酸强化。遗传学/基因组学研究由国家机构资助,并在多个研究所和中心开展。临床遗传学研究在公立医院进行,主要涉及先天性综合征。虽然在基因组学的公共应用方面没有明确的政府政策,但已经有旨在改善全国临床遗传服务提供情况的举措。在医疗保健中应用遗传学的主要障碍包括卫生系统分散、效率低下且不公平,在传染病、营养不良、产前和新生儿护理方面存在大量未满足的需求,遗传学教育不足,以及在遗传医疗保健方面缺乏明确的公共政策和政府监管。克服这些障碍需要增加政府资金投入,提高公共卫生系统及其遗传服务的效率。此外,必须共同努力确保公平获得这些服务。应促进临床遗传学家、公共卫生官员、初级卫生保健人员与家长/患者组织之间就遗传学/基因组学在公共卫生中的应用进行互动,以及开展针对卫生专业人员、公众和决策者的遗传学教育,并发展国家对遗传/基因组技术在公共卫生领域应用进行适当监管的能力。