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Oman’s Move Toward Personalized Medicine

MUSCAT—Arab scientists should start solving Arab health problems, say a number of experts in the region. Sultan Qaboos University in Muscat is taking this idea to heart by actively pursuing a medical research agenda that uses information collected from Omani patients in Omani hospitals, instead of relying on European and American datasets (a common practice in the Arab world).

While there are enthusiastic researchers in other parts of the region who are keen to follow suit, they say it’s hard to convince funders of the merits.

There is a widespread lack of data in the Middle East, which forces academics in all fields of research to use Western data. But when it comes to medical research, this means the region is missing out on the personalized medicine movement, through which treatments and screenings are tailored to specific populations based on their genetics.

Arab populations are more likely to suffer from genetic diseases and illnesses influenced by their genes—such as diabetes—than their European counterparts. “That’s what makes it important to treat according to the genetic setup of the patient—and to do that you need to understand your population, so you can personalize treatment,” says Moiz Bakhiet, director of the Princess al-Jawhara Center for Molecular Medicine, Genetics and Inherited Disorders in Bahrain.

But if scientists are largely failing to use data taken from Arab patients then that understanding is unlikely to ever materialize, and the important role of the Arab genome is neglected in the development of treatments.

Meanwhile, researchers in the West continue to hunt for cancer cures, HIV therapies and fertility treatments based mainly on data collected from European patients, which means any drugs that may result from their work will essentially be designed to work best with European DNA.

The Arab world should do the same, says Fahad Al-Zadjali, assistant dean of academic affairs at Sultan Qaboos University College of Medicine. “We cannot trust that what works best for other populations will also automatically work best for us.”

But for the moment, many of the most noteworthy and cutting-edge research projects in the region are simply adding to the efforts of Western scientists by using data collected from beyond the Arab world. For example, a recent study from Qatar University showed that thyroid cancer is over-treated to the point that it very often doesn’t extend the lives of patients yet still inflicts a number of unpleasant side effects—but the researchers had to use data from Australian autopsies because the relevant database doesn’t exist in the Arab world.

That’s not to say medical research in the region that relies on foreign data does not help Arab patients. Undoubtedly it does—human genomes are not so different that drugs and treatments will only work for certain ethnicities. But it does mean that the research doesn’t help as much as it could if data from Arab patients was readily available.

Bakhiet says this has to change. The Arab world has to get better at collecting data from Arab patients and making that data more accessible to researchers.

Others agree. Mohammed al-Buloshi, an associate researcher at Sultan Qaboos University’s Department of Immunology and Microbiology, says his university is making an effort to promote personalized medicine in Oman through research.

“There isn’t much investigation going on in the Arab world, especially in Oman, and the reason is known to be a lack of funds. But now Arab governments are starting to focus on this research,” he says.

Sultan Qaboos University, based on the outskirts of Muscat, is now more likely to allocate funding to medical research that collects and analyzes data locally, says Al-Zadjali.

“The government gives priority to research that has relevance to Oman,” he explains. “The ministry of health is pushing this focus.” The university has followed the ministry’s lead and now pursues a research agenda to satisfy the ministry’s aims.

“The aim of our research at SQU is to find solutions for problems in our community,” al-Buloshi says. “So many diseases affect Omanis differently, and so the standard procedures may need to differ from other countries. That’s why SQU focuses on personalized medicine.”

Al-Buloshi is currently investigating what may cause fertility problems and miscarriages, also known as spontaneous abortions, in Omani women.

He’s been taking blood samples to screen for immune responses to certain strains of bacteria in women who have miscarried compared to women who experience a healthy pregnancy. He has found that a number of bacteria are significantly associated with miscarriages. He hopes to eventually screen pregnant women in Oman to see if they have a large number of these bacteria and if so to offer antibiotics or dietary advice.

Al-Buloshi says others in the region could look to Sultan Qaboos University as an example of how to encourage personalized medicine. To further the progress of this field, he says it’s important to stress the tangible results that can come from the research. “It’s something that can directly benefit the Arab world. We want to apply what we find for the benefit of our population.”

That is useful information to people like Bakhiet who are trying to push personalized medicine in their own countries. “I’m trying to convince the authorities that we should establish a Bahrain Genome Project,” he says. The idea would be to eventually decode the sequence to every Bahraini’s DNA, but starting with just 1,000 people. He estimates it will cost about $5 million to get the ball rolling.

“It sounds expensive, but it could really change lives,” he says.

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