Argentina: Public Health Genomics

Abstract

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.

Clinical Cancer Genetics Disparities among Latinos

“…In Argentina, the health care system is composed of coexisting systems of social security and for- profit or private clinics (Penchaszadeh 2009). Public insurance in Argentina covers 48% of the population, 47% is covered by social security, and around 5% is covered by the private sector (Penchaszadeh 2013).…”

“…Many barriers to widespread genetic services are cited, including: fragmented and inefficient health systems, deficient education in genetics for physicians, and lack of explicit policies to include genetics in health care (Penchaszadeh 2009). Barriers for genetic testing identified in Latin American cancer patients are similar to those identified in US Hispanics (Palmero et al 2007).…”

Genetic testing and services in Argentina

“…Research in clinical genetics is concentrated in dysmorphology-cytogenetics, selected single-gene disorders such as skeletal dysplasias, muscular dystrophies, fragile X syndrome, cystic fibrosis, thalassemia, congenital deafness, and cancer (Penchaszadeh 2008).…”

Ethical health technology assessment in Latin America: lessons from Canada and Argentina

“…Unfortunately, chronic understaffing and a lack of sufficient fiIn Argentina, the medical application for PGT in the public health care and social security system 9 is still quite limited, nor are there well developed public policies or regulations governing the use of these technologies (19,20). Nonetheless, private access to such services and other reproductive technologies is relatively easy (through private clinics) and Argentinean professionals employ the same techniques as their colleagues in developed countries (20,21) 10 .…”

“…Better collaboration with the medical genetics community is needed, as well as more fluid communication between practitioners and policy makers, to avoid any misunderstandings. For instance, in Argentina, the field of genetics is still closely associated in the public mind with eugenic practices, and this is arguably one of the principal reasons why PGT has not been included in public services (19,30,31). Promoting education and dialogue among the different stakeholders -including patients and health professionalswould help enormously to eliminate such misperceptions and misinformation.…”