Metagenomics and Social Inclusion in Peru

Abstract

Metagenomics is the study of all the genetic material found in an ecosystem. Each part of the human body is an ecosystem with a distinct bacterial profile or microbiota whose metagenomic signature is called a human microbiome. The study of human microbiomes is a promising new area of biomedical research. Certain bacterial species are directly associated to specific diseases, suggesting their potential as biomarkers or even as therapeutic alternatives. As it has happened with genetics and genomics applications, most microbiome research is focused on urban human populations, thus providing a very biased set of study populations, both human and bacterial.

The developing world harbors biological phenomena absent in the developed world. The study of traditional communities from developing countries provides unique opportunities for scientific advancement. At the same time, the knowledge obtained might impact public health programs and help to build research capacity in these countries. However, including traditional communities from developing countries in research has proved to be a sensitive matter.

Research with indigenous populations carries the stigma of being exploitative, neocolonialist, and imperialist. Engaging communities in research can reduce the risk of exploitation and increase protection for these vulnerable populations. The biggest challenge to establishing meaningful partnerships with indigenous populations is distrust. The history of marginalization and constant friction between indigenous communities and outsiders has eroded any potential predisposition to trust. In absence of trust, any attempt to engage a community will be futile, superficial or pretendcommunity engagements without any real participation from the community. Real community engagement requires open dialog that results in real partnership which is impossible without a relationship of trust.

Developing a relationship of trust with indigenous communities and the authorities that represent them is a demanding venture. Some unsuccessful research initiatives in the developing world have been credited to obstacles resulting from inefficient systems of research governance. Barriers that complicate inclusion of indigenous populations in biomedical research will contribute to the existing health disparities.

Here, I discuss these topics from my own field experience and my efforts of implementing metagenomic research in Peru. Chapter 1 presents a case- study of the human gut microbiota of a hunter-gatherer community from the Peruvian Amazon region. The findings challenge some of the early conclusions of the study of human gut microbiome, highlighting the need to diversify the populations examined. Chapter 2 discusses distrust as the main barrier to effectively engage indigenous populations from developing countries in biomedical research. Chapter 3 offers the concept of intermediate research organizations as an alternative to overcome some of the barriers related to the implementation of international research with indigenous populations. The necessary process that researchers must undertake can be streamlined, while enhancing protection for human subjects within a system that lacks clear regulations for research.