[Genetics and public health]

In order to draw attention to the need for public health action in genetics in Latin America, the author begins by giving a brief review of congenital anomalies, including hereditary diseases and chromosomal anomalies. He notes that these defects affect at least 5% of live births in the different regions of the world, regardless of the development status or ethnic make-up of their populations. In the Region of the Americas, birth defects rank somewhere between second and fifth place among causes of death in children under 1 year of age, and account for 2% to 27% of infant mortality. It is logical to expect that these disorders will take on more relative importance as the general indicators of child health improve, as has been the case in industrialized countries. The fact that pathologies of genetic origin affect a wide range of organs and systems, are chronic, and require expensive therapy and rehabilitation means that they demand services that countries must be prepared to provide. The author proposes three general objectives for health activities regarding genetics: to minimize clinical manifestations in individuals who are born with congenital anomalies by means of adequate care at all service levels; to improve the quality of life for those individuals and their families by helping them to become involved in the normal life of their communities; and to ensure that people at high risk of conceiving children with genetic diseases receive counseling and support services so that they can exercise their right to informed reproduction. Finally, he recommends eight strategies for setting up genetic health programs with the resources available in each country.