Although the potential for genomics to contribute to clinical care has long been anticipated, the pace of defining the risks and benefits of incorporating genomic findings into medical practice has been relatively slow. Several institutions have recently begun genomic medicine programs, encountering many of the same obstacles and developing the same solutions, often independently. Recognizing that successful early experiences can inform subsequent efforts, the National Human Genome Research Institute brought together a number of these groups to describe their ongoing projects and challenges, identify common infrastructure and research needs, and outline an implementation framework for investigating and introducing similar programs elsewhere. Chief among the challenges were limited evidence and consensus on which genomic variants were medically relevant; lack of reimbursement for genomically driven interventions; and burden to patients and clinicians of assaying, reporting, intervening, and following up genomic findings. Key infrastructure needs included an openly accessible knowledge base capturing sequence variants and their phenotypic associations and a framework for defining and cataloging clinically actionable variants. Multiple institutions are actively engaged in using genomic information in clinical care. Much of this work is being done in isolation and would benefit from more structured collaboration and sharing of best practices.Genet Med 2013:15(4):258–267

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The development pathway for tropical livestock production for many years in the twentieth century was to upgrade or replace indigenous stock with exotics of supposedly higher genetic merit. Early indications that this might not be the most appropriate approach were largely ignored. Later there was a reverse movement towards locally developed species and breeds. These were seen as pools of irreplaceable genetic material of unacknowledged merit and value that must not be lost but must be conserved for possible unknown unseen future use. This paper examines the use of various native species and breeds. It goes on to describe some attempts at the introduction of genetically engineered highly productive (at least in their areas of origin) stock. Examples of attempts to produce cross or synthetic breeds are then provided. In a last section the case for the right animal in the right place--and these may be unconventional species and breeds--is provided.

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