As the world’s 8th largest country, Argentina (officially the Argentine Republic) was once among the world’s wealthiest nations. The country’s name is derived from the Latin word for silver and it is famous for its abundance of natural resources, iconic footballing history and the Argentine tango. Read on to learn more about healthcare and genomic medicine in Argentina.
The population of Argentina
Argentina is the second largest country in South America, providing the continent with a diverse geography – from tundra and forests to vast deserts and miles of ocean shoreline. It also claims a portion of Antarctica and the British-ruled Falkland Islands (Islas Malvinas) in the Atlantic. The country is bordered by Chile, Bolivia, Paraguay, Brazil and Uruguay. Argentina’s diverse geography is often grouped into four main regions: the Andes, the North, the Pampas, and Patagonia.
In 1816, Argentina declared independence after three centuries of Spanish rule, sparking moves towards independence throughout the continent. Different political factions fought for either provincial autonomy or central authority, meaning the country tended towards strongman leadership. Democratic rule was established in the country following the Falkland’s War of 1982.
Overall, Argentina has fewer native people compared to other South American countries such as Peru and Ecuador, with large numbers of the population coming from Europe. As much as 95% of the population is descended from Europe, mostly from Italy, Spain and Germany. Nearly half of the population lives in the capital, Buenos Aires, or the surrounding area.
Geographic and demographic information
- Land area: 309,500 sq km
- Gross domestic product (GDP):
- Total: $88.19 billion (2021)
- Per capita: $19,509.5 (2021)
- Population size: 46,621,847 (2023 est.)
- Birth rate: 15.38 births per 1000 people (2023 est.)
- Death rate: 7.28 deaths per 1000 people (2023 est.)
- Infant mortality rate: 9.14 per 1,000 live births (2023)
- Life expectancy: 78.55 (2023)
- Male 2020 estimate: 75.49
- Female 2020 estimate: 81.81
- Ethnicities: 86.4% European, 6.5% Mestizo (mixed European and Amerindian ancestry), 3.4% Amerindian, 3.3% Arab, 0.4% Other (2000).
Argentina is widely considered to have one of the best healthcare systems in Latin America. Argentine healthcare spending usually accounts for between 9-10% of GDP, which is among the highest in South America. There are four subsections of the healthcare system in Argentina – public hospitals, a social security-based health insurance system, a private sector, and PAMI, a scheme similar to the USA’s Medicare, on which over 3 million individuals rely. Around 35% of the population obtain healthcare through public hospitals, whilst around 61% use the social security-based scheme and a further 13% use the private system.
The country has a high doctor-to-patient ratio, with an average of 4 doctors per 1,000 inhabitants. However, there are large discrepancies between the level of healthcare available across different regions in the country. For example, in Buenos Aires there are more than 10 physicians per 1,000 inhabitants, whilst in Misiones the ratio is only 1.2 per 1,000.
To combat health inequalities, governmental programmes exist for those who do not benefit from private or social security-based health insurance, such as Incluir Salud and Remediar. These programmes ensure that those who rely on the public health system have access to quality care and medicines.
Noncommunicable diseases are responsible for the majority of deaths in Argentina, and the leading causes of death are ischemic heart disease and cancer.
Obesity levels are relatively high in Argentina, rising to around 20% of the adult population in 2013. To combat this health issue, the government have introduced regulations around food labelling, and this year businesses have had to start publishing warnings on food products.
HIV is a prominent health concern in Argentina, with around 140,000 individuals thought to be living with the condition. One organization, called Mundo Sano, is working on strategies to interrupt the transmission of congenital HIV/AIDS between mother and child. HIV/AIDS treatment is available to every Argentinian free-of-charge, a move that is thought to have saved over 4,000 people from the disease.
In 2018, over a third of the population were estimated to suffer from mental health disorders, notably anxiety and depression.
Genomic medicine capabilities
Around 90% of newborns undergo mandatory genetic screening at birth in Argentina, but not all babies are tested for the same disorders or undergo the same procedures. Birth defects are a leading cause of infant death in Argentina – causing around 30% of infant deaths in 2016. To address birth defects and other genetic conditions, a law was passed in 2011 relating to genetic medicine, rare disease and the training of medical professionals.
The idea of implementing precision medicine strategies is becoming more of a focus in Argentina. However, several barriers currently exist including a lack of education and data-sharing capabilities. Nonetheless, some of the ongoing initiatives to help develop precision medicine in the country include building a biobank, implementing exome sequencing in the healthcare system and more. Fears over the use of genomic data are being handled via the enactment of a new data law, which specially addresses this issue.
Improving access to certain therapies is also a key focus for the country. Currently, many targeted cancer treatments are not covered by the public health system, meaning patients are unable to access them.
In 2016, Bitgenia and the University of Buenos Aires launched the campaign “100 exomas”. This initiative aimed to sequence the exomes of rare disease patients. The initial campaign analysed over 100 cases and proved that this type of treatment could be implemented in Argentina.
- The National Genomics Data System of Argentina (SNDG): The SNDG emerged as a natural consequence of different initiatives and the establishment of several local bioinformatics and genomics research groups. The main objective is to establish a unified national database of genomic information derived from research and surveys funded by the country. Parallel objectives also include training local researchers in how to generate and analyse genomic data, generating a local interdisciplinary and cooperative community of laboratory scientists and bioinformaticians, promoting and facilitating the generation of genomic information, generating quality standards both for generation and analysis of genomic data, and promoting the development of bioinformatic tools locally. Since its creation, the SNDG has incorporated more than 20 centres around the country, provided grants to more than 10 projects related to genomics, and generated the pipeline and web portal to upload and analyse genomic data.
- The National Network of Congenital Anomalies of Argentina (RENAC): RENAC aims to reduce the frequency of birth defects. RENAC is a hospital‐based surveillance system, which includes 134 public and 26 non-public hospitals from the 24 provinces of the country. Annual coverage is approximately 300,000 births, which accounts for 65% from the public health sector and 38% of all births in the country.
- “100 exomas”: In 2016, Genomics company Bitgenia and the University of Buenos Aires launched the campaign “100 exomas” for the sequencing and analysis of exons of patients diagnosed with rare diseases. The group processed and analysed 129 exons that represented 100 cases analysed in more than ten provinces in Argentina. The exomes were sequenced at no cost for the patients and their families, and all downstream analysis was performed free of charge. Results were provided to the physician in charge, so they could offer proper genetic counselling to the patients involved in the project.
- Mapa de la Accionabilidad Genómica Tumoral de Argentina (MAGenTA): A public–private partnership. It was launched in 2017 in collaboration with Conicet, Hospital Italiano and Instituto Multidisciplinario de Biología Celular (IMBICE). It is a massive sequencing platform for the development of a panel of precision genomic oncology. It comprises a new sequencing methodology that allows one to simultaneously study many molecular alterations in the same sample, with greater efficiency. The objective is to generate a database of incidence and frequency regarding molecular variations that are related to common types of tumours.
Notable organisations and companies
- The National Center of Medical Genetics (CENAGEM): Under the National Ministry of Health, CENAGEM was established in 1969, followed by other genetic services located in the main paediatric hospitals.
- Héritas: A genomics company focused on treatment and prevention for oncologic, cardiologic and rare diseases, among others. The objective of Héritas is to develop a platform to generate a database of diseases based on genetics. Though the initiative is a collaboration of two actors in the private sector, the investment is done through the Program for the Promotion of Entrepreneurial Investment in Technology of the Ministry of Science, Technology and Productive Innovation.
- PoblAr: Known as the Argentinian population’s reference and genomics biobank program, PoblAr was established in 2014 and consists of an initiative to implement precision medicine. The core objective is to create an open biobank that should be the reference for any genomics research related to the population in Argentina. In addition, PoblAr aims to establish a link between the public and private sectors concerning the development of drugs and precision medicine therapies based on genomic. Unfortunately, due to lack of funding and lack of political will, this initiative has been slow to materialise. However, there is now ministerial support to finance the implementation of units to perform collection at a federal level so that the units may be equipped to extract and evaluate the quality of the DNA collected. Also, they are seeking a physical location for the biobank and qualified staff to work with data.
- Victor Penchaszadeh: Argentine geneticist who’s 40-year career has spanned pediatrics, epidemiology and bioethics. In 1996 he teamed up with the Pan American Health Organization and the World Health Organization to establish the PAHO/WHO Collaborating Center on Community Genetics at the Mailman School of Public Health at Columbia University in New York. He also helped pioneer the use of genetic testing in recovering lost identity through his efforts to identify children illegally taken from captive birth mothers during Argentina’s period of military dictatorship.
- Luis Federico Leloir: An Argentine physician and biochemist who received the 1970 Nobel Prize in Chemistry for his discovery of the metabolic pathways by which carbohydrates are synthesized and converted into energy in the body. Although born in France, Leloir received the majority of his education at the University of Buenos Aires and was director of the private research group Fundación Instituto Campomar until his death in 1987. His research into sugar nucleotides, carbohydrate metabolism, and renal hypertension garnered international attention and led to significant progress in understanding, diagnosing and treating the congenital disease galactosemia.
- Alberto Granado Jiménez: An Argentine–Cuban biochemist, doctor, writer, and scientist. He was also the youthful friend and traveling companion of Che Guevara during their 1952 motorcycle tour in Latin America. Granado later founded the University of Santiago de Cuba School of Medicine.
- César Milstein: An Argentine-born British biochemist in the field of antibody research. Milstein shared the Nobel Prize in Physiology or Medicine in 1984 with Niels K. Jerne and Georges Köhler. A major part of Milstein’s research career was devoted to studying the structure of antibodies and the mechanism by which antibody diversity is generated. It was as part of this quest that in 1975 he, together with Georges Köhler (a postdoctoral fellow in his laboratory), developed the hybridoma technique for the production of monoclonal antibodies – a discovery recognised by the award of the 1984 Nobel Prize for Physiology or Medicine. This discovery led to an enormous expansion in the exploitation of antibodies in science and medicine.
The future genomics landscape
The next decade will no doubt usher in a period of significant development in terms of genomics and precision medicine in Argentina. Dr Ricardo Mastai, health economics professor at the San Andres University, believes genome-guided treatments will reduce healthcare expenditure in the country and bring enormous benefits: “Precision medicine will directly impact the quality of health systems in a very positive way. It can improve the cost-efficiency of every process in the future”. A key part of implementing precision medicine in the country is educational reforms – improving public, and professional, knowledge of genomic medicine. The integration of patient advocacy groups into the health system is also a key focus. Improving collaboration among the highly fragmented healthcare system in Argentina is also going to be a significant challenge in the coming years. There is also an opportunity for the country to redirect resources developed during the COVID-19 pandemic to tackle problems such as a rise in cancer cases.
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