Medical genetic services in the new South Africa
Prior to 1990 medical genetics in South Africa was an academic pursuit, with medical genetic services available at university medical genetic departments accessible mainly to those in the middle and upper socioeconomic class. In the 1990s outreach clinical genetic programmes into rural and black communities began to define the country’s epidemiology and the resources, principles and practice needed to manage the burden of birth defects. With the election of the democratic government in 1994 the political approach to the development of accessible, equitable medical genetic services changed. National guidelines for the management and prevention of genetic disorders, birth defects and disability were developed and accepted. Currently, efforts to implement these are in progress. These include a modernisation of tertiary services plan to ensure by 2010 South Africa has 5 staffed and equipped academic medical genetic departments. Medical genetic education programmes for primary care practitioners- nursing staff and doctors- are being developed and implemented with assistance from the March of Dimes. Public medical genetic laboratory services have been coalesced in a single national server. Progress in the development of medical genetic services is being made, despite competing priorities, particularly HIV/AIDS.