Contents -- Executive Summary -- 1. Introduction -- 2. Genomics and the Genome Projects -- 2.1 Introduction -- 2.2 What are genes and how do they function? -- 2.3 The development of molecular genetics -- 2.3.1 Classical genetics -- 2.3.2 Molecular genetics -- 2.4 Characterizing the human genome -- 2.4.1 The identification of human disease genes -- 2.4.2 The Human Genome Project -- 2.4.3 Mapping the human genome -- 2.5 Functional genomics -- 2.5.1 Annotation of the human genome -- 2.5.2 Proteomics -- 2.5.3 Transcriptomics -- 2.5.4 Gene regulation -- 2.5.5 Bioinformatics -- 2.6 The genomes of other organisms -- 2.6.1 Introduction -- 2.6.2 The pathogen genome project -- 2.6.3 The genomics of disease vectors -- 2.6.4 The genomes of the worm, fruitfly, yeast and various animals -- 2.6.5 The central importance of the mouse genome project -- 2.6.6 Plant genomics -- 2.7 Summary -- 3. The Potential of Genomics for Health Care -- 3.1 Introduction -- 3.2 Monogenic disease -- 3.3 Communicable disease -- 3.4 Cancer -- 3.5 Complex multifactorial disease -- 3.6 Developmental abnormalities and mental retardation -- 3.7 Ageing -- 3.8 Pharmacogenomics -- 3.9 Gene therapy -- 3.10 Stem cell therapy -- 3.11 Plant genomics and human health -- 3.12 Forensic medicine -- 3.13 Biotechnology -- 3.14 Broader issues of biology -- 3.15 Summary -- 4. Relevance and Time-Scale of Advances in Genomics for Global Health -- 4.1 Genomics in the context of current world health problems -- 4.2 When will the medical promises of genomics be fulfilled? -- 4.3 Maintaining the balance of research planning and health care -- 4.4 Will the medical applications of genome research be affordable? -- 4.5 Summary -- 5. The Potential of Genomics for the Health of the Developing Countries -- 5.1 Introduction -- 5.2 Examples of what is feasible now -- 5.2.1 The inherited disorders of hæmoglobin.

5.2.2 Genetic resistance to communicable disease -- 5.2.3 The introduction of DNA diagnostics for communicable disease -- 5.2.4 Drug-resistant organisms -- 5.2.5 Pharmacogenomics -- 5.2.6 Non-communicable disease -- 5.3 The development and provision of services in clinical genetics and DNA technology -- 5.4 Genomics for the control of communicable disease: future directions -- 5.5 Forging international partnerships in academia -- 5.6 Regional collaboration -- 5.7 Information technology and bioinformatics -- 5.8 Summary and future possibilities -- 6. Potential Risks and Hazards of the Applications of Genomics and Their Control -- 6.1 Introduction -- 6.2 Genetic manipulation -- 6.3 Risks in non-human genomics -- 6.3.1 Animals and insects -- 6.3.2 Plants -- 6.4 Changing the genetic constitution of individuals or populations -- 6.5 Genetic databases -- 6.6 Biological warfare and other political misuses -- 6.7 Stem cell gene therapy -- 6.8 Summary -- 7. Justice and Resource Allocation: Implications for the Post-Genomic Era -- 7.1 Introduction -- 7.2 Current inequities in the provision of health care -- 7.2.1 Inequities in health status and disease burden -- 7.2.2 Issues of development and poverty alleviation -- 7.3 Research priorities and access to the benefits of research -- 7.3.1 The gap between developed and developing countries in health research -- 7.3.2 Redressing the developed-developing country gap -- 7.3.3 Developing research capabilities -- 7.4 Intellectual property and sharing the benefits of research -- 7.4.1 Patents -- 7.4.2 Patenting genetic material -- 7.4.3 The TRIPS agreement -- 7.4.4 Biological resources and benefit sharing -- 7.5 Ownership and access to genetic databases -- 7.6 Summary -- 8. Ethical Issues in Genetic Research, Screening, and Testing, with Particular Reference to Developing Countries -- 8.1 Introduction.

8.2 Informed consent -- 8.2.1 Principles -- 8.2.2 Genetic testing in health care and research -- 8.2.3 Other approaches to regulating genetic testing, screening and research -- 8.2.4 Genetic databases -- 8.3 Confidentiality of genetic information to prevent discrimination and stigmatization -- 8.3.1 Confidentiality and its appropriate limits -- 8.3.2 Discrimination and stigmatization -- 8.4 Gender issues -- 8.5 Eugenics -- 8.6 The disability rights movement's challenge to genetic screening and testing -- 8.7 Nontherapeutic genetic interventions: genetic enhancements -- 8.8 Gene therapy, stem cell therapy and human cloning -- 8.9 Summary -- 9.Education and Public Policy -- 9.1 Introduction -- 9.2 Level of knowledge about genetics -- 9.3 Public perceptions of biotechnology and genetic engineering -- 9.4 Lack of organizations for setting public policy and ethical standards for genomics -- 9.5 Requirements for education and policy-making in the genomics era -- 9.5.1 Public education -- 9.5.2 Health care professionals -- 9.5.3 The educational role of clinical genetics services -- 9.6 Summary -- 10. Recommendations for WHO and Its Member States -- 10.1 Introduction -- 10.2 Recommendations -- 10.2.1 Technical cooperation between WHO and its Members States -- 10.2.2 WHO's normative function -- 10.2.3 An advocacy role for WHO -- 10.3 Closing Summary and Key Messages -- Annex A: Glossary of Technical Terms -- A -- B -- C -- D -- E -- F -- G -- H -- I -- K -- L -- M -- N -- O -- P -- R -- S -- T -- V -- Y -- Annex B: Consultation Process -- Annex B1: Outline of consultation process and timeline -- Annex B2: Consultations -- B2.1 Consultation on the ACHR Report on Genomics and Health -- B2.2 Brasilia Regional Consultation on Genomics and World Health -- B2.3 The Bangkok Multiregional Consultation on Genomics and World Health.

Annex B3: List of contributing WHO staff -- Annex B4: List of relevant background WHO work on genetics, genomics and biotechnology -- Annex B5: Profiles of Report writers -- Annex C: References and Further Reading.