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EDITORIAL
Year : 2013  |  Volume : 2  |  Issue : 3  |  Page : 143-144

Public health genetics in India: An unexplored evolving specialty


1 Department of Community Medicine, JSS Medical College, JSS University, Mysore, India
2 Department of Biochemistry, JSS Medical College, JSS University, Mysore, India

Date of Web Publication25-Oct-2013

Correspondence Address:
Kulkarni Praveen
Department of Community Medicine, JSS Medical College, JSS University, Mysore
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.120581

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How to cite this article:
Praveen K, Prashant V. Public health genetics in India: An unexplored evolving specialty . Int J Health Allied Sci 2013;2:143-4

How to cite this URL:
Praveen K, Prashant V. Public health genetics in India: An unexplored evolving specialty . Int J Health Allied Sci [serial online] 2013 [cited 2019 Oct 20];2:143-4. Available from: http://www.ijhas.in/text.asp?2013/2/3/143/120581

The concept of public health is to deliver health care services based on the principles of preventive, promotive, curative, and rehabilitative approaches to all the individuals in a sustained and uninterrupted manner. Specialty of public health in India has drawn much attention in 21 st century than any time in the past due to the fact that it has explored a novel way for solving most of the age old unsolved mysteries related to health and health care. Genetics has been heralded by some as the new "revolution" in health care, suggesting a rapid overthrow of existing health paradigms. However, the reality is that the advances in genetics are integrated into medicine and public health, in a considered and gradual way, accompanied by the necessary social and ethical debate. In other words, the convergence of public health and genetics holds the possibility of improved understanding of the etiology, prevention, and management of diseases with multi-factorial inheritance such as diabetes, hypertension, dementia, heart disease, and cancer. [1]

There has been a historic association between public health and genetics, beginning in 19 th century, when public health and the eugenics movement shared common ground in values and ideas, programs, and personnel. The term "public health genetics" has been introduced to denote the interface between genetics and public health. It reflects attempts of the public health profession to cope with, and make best use of, the rapid advances in genetics. Genetic tests can, for example, be used in screening programs for disease or for targeting health promotion interventions. [2]

India is in the verge of its demographic and epidemiologic transition, the communicable diseases, which were taking the major toll of lives at once are gradually getting replaced by non-communicable diseases, which are complex in their inheritance, need more intense efforts for prevention and control. Apart from them, problems associated with maternal and child health including congenital malformations are the serious concerns. In order to combat these problems and cope with Millennium Development Goals, government of India launched National Rural Health Mission in 2005, which has brought down all the major indicators related to above mentioned problems. There has been a shift of focus to the genetic disorders as well as to the genetic signature of a person, which renders him susceptible for various disorders. Now is the time to think on genetic disorders, which were not given the attention they deserve.

Genetic diseases like hemoglobinopathies, congenital malformations, mental retardation, and muscular dystrophies result in considerable burden not only to the affected persons but to their families and society at large as the treatment of such conditions are complex and economically less feasible. Thus, there is a need to shift from treatment to prevention of such births in future by blending the principles of public health and genetics. This can be achieved by population education, prospective genetic counseling, mass screening of at risk communities, and prenatal diagnostic tests. [2]

In India, specialties of public health and genetics have remained as two separate fields without much integration. The probable reason for this could be that the experts working in these fields have not explored the importance of mutual collaboration. Public health with its wider scope and resources can contribute in mapping of genetic disorders at community level, mobilize the community to access services of medical genetics, provide genetic counseling, conducting screening for mass as well as 'at risk' populations and health education on genetic disorders. On the other hand, specialty of medical genetics can contribute in identification of 'at risk' communities, prenatal diagnosis, gene therapy, molecular characterization of genetic disorders etc., Thus, these two fields can complement the activities of each other in order to successfully prevent and control the genetic disorders.

Some successful multi-stage diagnostic and therapeutic models in public health genetics involving detection of cases and carries of genetic disorders by simple cost-effective creening tests (e.g. NESTROF test for Beta thalassemia and Sickling test for sickle cell anemia) followed by confirmatory diagnosis among those found positive

(e.g. Electrophoresis) and further subjecting them to gene typing by molecular characterization techniques (e.g. PCR) finally providing curative services (e.g. Gene therapy) or preventive services (e.g. Genetic counseling) have been tried and tested at different parts of the country. [3] There is a need for nationwide replication of such models in order to build the confidence between these two specialties.

Thus, in India, not only is there a wider scope for integration of public health and genetics for the prevention and control various health-related problems, there are facilities also being made available at centers in private and governmental institutions. There is a need for the experts working in these fields to give a serious thought regarding collaborative efforts in exploring this evolving specialty and also the Government of India in allowing the private partners to participate in use of genetic tools for the wider use in community.

 
  References Top

1.Halliday JL, Collins VR, Aitken MA, Richards MP, Olsson CA. Genetics and public health-evolution, or revolution?. J Epidemiol Community Health 2004;58:894-9. Available from: http://www.jech.com. [Last accessed on 2013 Aug 14].  Back to cited text no. 1
    
2.Aswini YB, Varun S. Genetics in public health: Rarely explored . Indian J Hum Genet 2010;16:47-54.  Back to cited text no. 2
    
3.Human Genetics Extension Programme-Anthropological Survey of India. Available from: http://www.ansi.gov.in/human_genetics_extention.htm[Last accessed on 2013 Aug 13].  Back to cited text no. 3
    




 

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