Human embryonic stem cell research: ethical and legal issues

The use of human embryonic stem cells to replace damaged cells and tissues promises future hope for the treatment of many diseases. However, many countries now face complex ethical and legal questions as a result of the research needed to develop these cell-replacement therapies. The challenge that must be met is how to permit research on human embryonic tissue to occur while maintaining respect for human life generally.     

Treating lysosomal storage disorders: current practice and future prospects

There are over 40 human disease states that are caused by defects in various aspects of lysosomal function. Over the past two decades there has been dramatic progress in the development and evaluation of therapies for lysosomal storage disorders, several of which are now in routine clinical use or in clinical trials. The greatest current challenge is in developing effective therapies for treating the CNS manifestations of these complex disorders. In this article, we will review the current therapies/approaches being considered for treating lysosomal storage diseases and give a perspective on the scientific, medical, social and ethical issues they raise.     

Agricultural policy and sustainable livestock development

Future agricultural and rural development is, to a large extent, influenced by the projected food needs of 2.5 billion people expected to swell the world population by 2020. This increase will require more food in general and, in view of recent experience in East Asia, more animal products. To achieve this increase will require judicious use of resources, and trade, especially in those countries where natural resources are insufficient to support food production. Achieving food sufficiency in a sustainable manner is a major challenge for farmers, agro-industries, researchers and governments. The latter play an important role as many of the farmers' choices are, to a large extent, directed by government or supra-government, often through macro- and micro-economic policy. In many countries the economic, environmental, trade and agricultural policies have not been conducive to an agricultural development that is risk-free with respect to the environment, animal welfare or public health. The recent decline of government support in agriculture forced farmers in Western countries to think about more risk adverse agricultural practices and more efficient production systems. On the other hand, many countries in Eastern Europe and the former Soviet Union, as well as other developing countries, are still going through a painful process of adjustment to new market conditions. International banks and development agencies have a mandate to help developing countries, but are somewhat restricted both by needing to work directly with governments and by their perceived dogmatic approach to development. Changing policies do, now and in the future, also affect the development of animal disease control programmes, including the control of parasitic diseases. On the one hand there is an increasing interest in risk-free control practices, and on the other hand a demand for greater regulatory control over the production process. As parasitic diseases of animals are closely linked to the environment (i.e. grazing and waste management) and public health (i.e. parasitic zoonoses), the new interest in sustainable agriculture provides a challenge for those concerned with the control and prevention of animal parasitism.     

Tropical medicine for the 21st century.

The specialty of tropical medicine originated from the needs of the colonial era and is removed from many of the health care requirements of tropical countries today. Tropical medicine concentrates on parasitic diseases of warm climates, although other infections and diseases related to poverty rather than climate dominate medicine in developing countries challenged by population pressure, civil strife, and migration. In the new century, tropical medicine would best be absorbed into the specialty of infectious diseases, which should incorporate parasitic diseases, travel medicine, and sexually transmitted diseases. Pressing questions for health care and research in developing countries concern the provision of appropriate services for problems such as HIV/AIDS, tuberculosis, sexually transmitted diseases, and injuries. The question of how to provide appropriate clinical care in resource poor settings for the major causes of morbidity and premature mortality has been neglected by donors, academic institutions, and traditional tropical medicine.     

Global capture of crop biotechnology in developing world over a decade

There is an urgent need for the advancement of agricultural technology (e.g. crop biotechnology or genetic modification (GM) technology), particularly, to address food security problem, to fight against hunger and poverty crisis and to ensure sustainable agricultural production in developing countries. Over the past decade, the adoption of GM technology on a commercial basis has increased steadily around the world with a significant impact in terms of socio-economic, environment and human health benefits. However, GM technology is still surrounded by controversial debates with several factors hindering the adoption of GM crops. This paper reviews current literatures on commercial production of GM crops, and assesses the benefits and constraints associated with adoption of GM crops in developing countries in the last 15 years. This article provides policy implication towards advancing the development and adoption of GM technology in developing countries and concludes with summary of key points discussed.     

In search of self‐reliance: Problems of marine technology transfer to the developing countries: The case of West Africa

Abstract

This study presents some of the main features of the marine technology transfer process and identifies the key factors determining the particular transfer arrangements available for developing countries of West Africa under different circumstances. Emphasis is made on the fisheries sector because of its economic importance in that region. It examines the principal characteristics of suppliers and recipients of fisheries technology and their prevailing attitudes with regard to transfers. It draws on empirical research covering several international cooperative fisheries arrangements in Mauritania, Guinea‐Bissau, and Guinea‐Conakry that have high potential to function as a technology transfer mechanism from developed to developing coastal countries.     

Inhibitors of dihydrofolate reductase in Leishmania and trypanosomes

The protozoan diseases leishmaniasis, Chagas' disease and African trypanosomiasis are major health problems in many countries, particularly developing countries, and there are few drugs available to treat these diseases. Dihydrofolate reductase (DHFR) inhibitors have been used successfully in the treatment of a number of other diseases such as cancer, malaria and bacterial infections; however they have not been used for the treatment of these diseases. This article summarises studies on leishmanial and trypanosomal DHFR inhibitor development and evaluation. Possible mechanisms of resistance to DHFR inhibitors are also discussed.     

The mosquito genome: organization, evolution and manipulation

Apart from the genetic flexibility of the vectors, impediments to the control of vector-borne diseases include the rapid spread of drug resistance throughout parasite populations, the increasing movement of people to and from disease-endemic regions and the limited funds and public health infrastructures of most developing countries. The widely used residual insecticides and antiparasitic drugs have been inadequate solutions to the problem of vector-borne disease control. New approaches are needed. The enormous impact of recent developments in molecular genetics on the understanding of basic biology and human disease has stimulated a re-examination of the prospects for genetic manipulation of vector populations as a means for reducing or eliminating vector-borne diseases, especially malarial. Although control scenarios that exploit this technology may never be realized, Nora Besansky and Frank Collins emphasize that the increase in knowledge of basic mosquito biology on which these ideas depend will inevitably stimulate novel approaches to the control of mosquito-borne diseases.     

Hemoglobinopathies worldwide: present and future

The genetic disorders of hemoglobin, the commonest monogenic diseases, occur at some of their highest frequencies in the developing countries, particularly those of Sub-Saharan Africa and Asia. Although progress towards their control and management continues to be made, the prospects for curing them, apart from marrow transplantation, remain uncertain. In many countries expertise and facilities for their control are extremely limited. Although a great deal can be done to help the situation by developing further North/South and South/South partnerships for disseminating better practice, the major problem for the future lies in the unwillingness of governments and international health agencies to accept that the hemoglobinopathies represent a health burden comparative to that of communicable and other major diseases. However, preliminary analyses suggest that, at least in the case of Asia, this may not be true. Further work of this type, together with more detailed frequency and economic data, is required to provide solid evidence for the health burden posed by the hemoglobin disorders, particularly in the developing world. Unless this is done, the increasingly large populations of patients with these diseases will continue to be neglected.     

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.     

Obesity is a common soil for premature cardiac aging and heart diseases - Role of autophagy

The advance in medical technology and healthcare has dramatically improved the average human lifespan. One of the consequences for longevity is the high prevalence of aging-related chronic disorders such as cardiovascular diseases, cancer and metabolic abnormalities. As the composition of aging population is raising in western countries, heart failure remains the number one cause of death with a more severe impact in the elderly. Obesity and aging are the most critical risk factors for increased susceptibility to heart failure in developing and developed countries. Numerous population-based and experimental data have depicted a close relationship between the age-related diseases and obesity. There is an overall agreement that obesity is causally linked to the development of cardiovascular disorders and severe premature cardiac aging. Accumulating evidence indicates that autophagy plays an important role in obesity, cardiac aging and diseases. In this review, we will focus on the role of autophagy in obesity-related cardiac aging and diseases, and how it regulates age-dependent changes in the heart.     

Genomic medicine and developing countries: creating a room of their own

The notion that developing countries must wait for the developed world to make advances in science and technology that they later import at great cost is being challenged. We have previously argued that developing countries can harness human genetic variation to benefit their populations and economies. Based on our empirical studies of large-scale population genotyping projects in Mexico, India and Thailand, we describe how these resources are being adopted to improve public health and create knowledge-based economies. A significant additional benefit is building the capacity for scientific research and internalizing advances in technology, whatever their source.     

Science and society: promoting the learning of immunology in developing countries

In 2005, the economic gap between developing and developed countries is bigger than ever, and this has consequences for public health. So, to sustain education and research in the most resource-constrained regions, it is necessary to promote local teaching of the immunology of infectious diseases. This Perspective article reviews the use and expected efficiency of current Internet-based tools for higher education in the biomedical sciences in developing countries. We also discuss other approaches to improve access to updated training in immunology for students in the poorest countries.     

Navigation in Marine Protected Areas: National and International Law

Abstract

World fish resources, fishing methods, and processing operations in the seafood industry are described. The fishery situation in developing countries (LDCs) is discussed, with particular reference to artisanal and other local fisheries, and examples are cited to illustrate the structure of the industry. Technology transfer from developed countries to LDCs is discussed and recommendations are presented for future technology transfer programs. It is concluded that an integrated complex of small projects with defined, attainable objectives and immediate impact on income and food supply of the LDC populations is likely to be more successful than large‐scale programs with little immediate payoff. A case study of fisheries in two developing countries, Thailand and Peru, and extensive tabulation of statistical data on catches, value of catch, and unit value of fish species groups for selected countries, with a discussion of the significance of the data, are presented in an appendix.     

Development of health biotechnology in developing countries: Can private-sector players be the prime movers?

Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor.     

Demographic shifts and medical training

The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professionals worldwide such that curriculums in developing countries may not meet the needs of those who practice in industrialized countries. Chronic and degenerative diseases as well as problems of multiple pathology are likely to increase with an aging population. Consequently, multiple pathology makes current medical training so likely to lead to inappropriate and poor quality of care. In addition, increasing subspecialization in medicine provides doctors who are unable to deal with the complexity of multiple pathology. Undergraduate medical education reforms are also forcing specific training in geriatric medicine out of the curriculums.     

The effect of aging on brain barriers and the consequences for Alzheimer’s disease development

Life expectancy has increased in most developed countries, which has led to an increase in the proportion of elderly people in the world’s population. However, this increase in life expectancy is not accompanied by a lengthening of the health span since aging is characterized with progressive deterioration in cellular and organ functions. The brain is particularly vulnerable to disease, and this is reflected in the onset of age-related neurodegenerative diseases such as Alzheimer’s disease. Research shows that dysfunction of two barriers in the central nervous system (CNS), the blood–brain barrier (BBB) and the blood–cerebrospinal fluid (CSF) barrier (BCSFB), plays an important role in the progression of these neurodegenerative diseases. The BBB is formed by the endothelial cells of the blood capillaries, whereas the BCSFB is formed by the epithelial cells of the choroid plexus (CP), both of which are affected during aging. Here, we give an overview of how these barriers undergo changes during aging and in Alzheimer’s disease, thereby disturbing brain homeostasis. Studying these changes is needed in order to gain a better understanding of the mechanisms of aging at the brain barriers, which might lead to the development of new therapies to lengthen the health span (including mental health) and reduce the chances of developing Alzheimer’s disease.     

Affordable assisted reproductive technologies in developing countries: pros and cons

¹ Correspondence address. E-mail: akandewole{at}yahoo.com Infertility in developing countries is pervasive and a seriousconcern. In addition to the personal grief and suffering itcauses, the inability to have children especially in poor communitiescan create broader problems, particularly for the woman. Infertilityservices in developing countries span the spectrum from preventionto treatment. From a societal and public health standpoint,prevention is cost–effective and is considered by manygovernments and public health care providers to be a priorityfor service delivery. While prevention remains paramount, takenalone it ignores the plight of infertile couples, includingthose with non-infectious causes of infertility. Two key argumentsare frequently used to challenge the development of new reproductivetechnologies in developing countries: overpopulation and limitedresources. Evidence supports the conclusion that there is acompelling need for infertility treatment beyond prevention.In many instances, assisted reproductive technologies (ART)are the last hope or the only means to achieve a child for couples.In an effort to make much needed ART to developing countriesaccessible and affordable, developing countries should lookto public–private partnerships. Governments have a responsibilityto ensure safe and effective services including the controlof standards for clinical procedures and the regulation of professionalpractice.     

Thinking big about global health

The Gates Foundation is funding high-risk research into new ways to improve health in developing countries, but ensuring that the fruits of these studies reach the people who need them most may be the biggest challenge of all.