Abstract:
Clinical research in high-income countries is increasingly demonstrating the coste
ectiveness of clinical pharmacogenetic (PGx) testing in reducing the incidence of adverse drug
reactions and improving overall patient care. Medications are prescribed based on an individual’s
genotype (pharmacogenes), which underlies a specific phenotypic drug response. The advent
of cost-e ective high-throughput genotyping techniques coupled with the existence of Clinical
Pharmacogenetics Implementation Consortium (CPIC) dosing guidelines for pharmacogenetic
“actionable variants” have increased the clinical applicability of PGx testing. The implementation
of clinical PGx testing in sub-Saharan African (SSA) countries can significantly improve health
care delivery, considering the high incidence of communicable diseases, the increasing incidence of
non-communicable diseases, and the high degree of genetic diversity in these populations. However,
the implementation of PGx testing has been sluggish in SSA, prompting this review, the aim of which
is to document the existing barriers. These include under-resourced clinical care logistics, a paucity of
pharmacogenetics clinical trials, scientific and technical barriers to genotyping pharmacogene variants,
and socio-cultural as well as ethical issues regarding health-care stakeholders, among other barriers.
Investing in large-scale SSA PGx research and governance, establishing biobanks/bio-databases
coupled with clinical electronic health systems, and encouraging the uptake of PGx knowledge by
health-care stakeholders, will ensure the successful implementation of pharmacogenetically guided
treatment in SSA.
