Affiliation: Department of Genetics, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa.
Sequencing the human genome, more than a decade ago, initiated the genomics era and the promise of truly personalized medicine. However, much is still unknown about the genetic factors that affect drug efficacy and toxicity, and there are currently very few clinically useful pharmacogenetic tests available. Of these, even fewer are potentially of benefit to developing countries in Africa because pharmacogenetic screening tests are often not applicable to African populations with their unique genetic profiles. Yet, pharmacogenetic tests that accurately predict drug response and toxicity can have a major impact on efficient and effective healthcare in Africa, where the burden of disease is greatest. HIV/AIDS, malaria, and tuberculosis are responsible for approximately 2.5 million deaths in Africa annually, and improving medical care for just these three infectious diseases would save millions of lives. A number of potential biomarkers have been reported that purportedly influence the efficacy and/or toxicity of antiretroviral, antimalarial, and antituberculosis drugs, but more research is required to completely understand the pharmacogenetic applications associated with these treatments. Another 2 million people, however, are dying of preventable and easily curable diseases, such as diarrhoeal and lower respiratory tract diseases. Although pharmacogenetics can play a pivotal role in combating the disease and therapeutic burden in Africa in the future, a multifaceted approach is required to provide effective, affordable and personalized healthcare while also addressing the extreme poverty and other related problems of the people in Africa.