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在非洲建立精准健康的基因组能力。

Building genomic capacity for precision health in Africa.

机构信息

The African Centre of Excellence for Genomics and Infectious Diseases, ACEGID, Ede, Nigeria.

出版信息

Nat Med. 2024 Jul;30(7):1856-1864. doi: 10.1038/s41591-024-03081-9. Epub 2024 Jul 3.

Abstract

The African continent is poised to have a pivotal role in the global population landscape, with the United Nations projecting a population of 2.5 billion (more than 25% of the global population) by 2050. Amid this demographic shift, Africa faces a unique healthcare challenge-navigating a complex landscape of infectious and non-communicable diseases. This necessitates a departure from the conventional 'one-size-fits-all' medical model toward precision approaches that are efficient and sustainable. Genomic capacity is a pillar of precision health; however, access to up-to-date genetic testing in African countries is limited, compounded by a startling lack of representation of data from populations of African descent in gene discovery studies. In this Review, we delve into the challenges impeding the development of genomic capacity in Africa, such as the lack of electronic clinical and epidemiological records, infrastructural challenges, high supply chain costs and the 'dependency trap' that jeopardizes long-term sustainability. We emphasize the need for strategies hinged on true partnerships, robust infrastructure, workforce development and well-crafted policies. Finally, we outline recent progress and existing initiatives that should be considered as role models for future capacity-building initiatives.

摘要

非洲大陆有望在全球人口格局中发挥关键作用,联合国预计到 2050 年,非洲人口将达到 25 亿(占全球人口的 25%以上)。在人口结构转变的背景下,非洲面临着独特的医疗保健挑战——需要应对传染病和非传染性疾病交织的复杂局面。这需要摒弃传统的“一刀切”医疗模式,转向高效、可持续的精准医疗方法。基因组能力是精准医疗的一个支柱;然而,非洲国家获取最新基因检测的机会有限,而且在基因发现研究中,来自非洲裔人群的数据代表性严重不足,这使得情况更加复杂。在这篇综述中,我们深入探讨了阻碍非洲基因组能力发展的挑战,例如缺乏电子临床和流行病学记录、基础设施挑战、高昂的供应链成本以及危及长期可持续性的“依赖陷阱”。我们强调需要制定基于真正伙伴关系、强大基础设施、劳动力发展和精心制定政策的战略。最后,我们概述了最近的进展和现有举措,这些进展和举措应被视为未来能力建设举措的典范。

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