It is now a little more than ten years since leaders of the United States and England, together with research team leaders from public and private fields announced that a draft sequence of the human genome had been completed.1 The way this amazing project will change the world as we know it is taking place in front of our very own eyes at different speeds, in different places, as different nations implement advances in genome science and medical technology. The decoding of the sequence of human genome and the resulting improvement in genotyping technologies have made it possible for the field of pharmacogenetics (the study of genetic variability in individual responses to drugs and drug metabolism) to arise and assume its place of importance in medical research. As we will read in the accompanying article, the main goal of pharmacogenetics is to identify individual genetic differences (polymorphisms) in drug absorption, metabolism, distribution and excretion and the effects of these polymorphisms on the activity of a particular drug in terms of efficacy and toxicity. Pharmacogenetics has evolved during this last decade into pharmacogenomics (the study of the roles of inherited and acquired genetic variations in drug responses) with a shift from a focus on individual candidate genes to a more comprehensive approach using genome-wide association studies.2,3 Nonetheless, the availability of these new data and their application into medical practice has not as fast as one might imagine and there are still major impediments to a complete integration of genomic knowledge into patient care. As an example, genome-wide association studies (GWAS) have identified genetic variations (single-nucleotide polymorphisms in the region of the IL28B gene on chromosome 19) that play a critical role in predicting treatment response in patients infected with hepatitis C virus and are strongly associated with treatment response to pegylated IFN and ribavirin. The relative frequencies of these variations explain a large proportion of the observed differences in response to HCV treatment in populations around the world, with Asians having high response rates, Europeans intermediate response rates, and Africans low response rates.4 It is important to note however, that in general, although the population frequencies of genetic variations differ geographically, genetic variations are not exclusive to any race or people group. Consequently, it cannot be assumed that individuals within a particular group will have a specific phenotype. In other words, there is a danger of group labeling of genetic variation and we cannot tell how any particular individual will respond based on group data. We are stepping into the era of personalized medicine and the day may soon arrive when before making any medical decision each individual will be studied for relevant genetic variants to decide the best treatment options. A perhaps even more radical thought is that an individual may be genotyped at birth or in early childhood to allow customization of all medical therapies to their unique genetic characteristics. In developed countries, major research efforts are underway to increase our knowledge in the genomic fields and the translation of this growing body of knowledge into clinical practice and day-to-day patient care. It is a huge contrast to note that while there are substantial investments in funding from both government and private organizations to support research in pharmacogenetics in industrialized countries, bringing new drug discoveries and allowing the development of targeted therapy for specific diseases using genome information, in developing countries where government health policy is focused on meeting the basic needs of the population, it is not easy to designate major resources to this important area. As we will read in this paper, Ghana is one of the few countries in Africa in which substantial genotype information is being accumulated, at least at the population level, and it is ahead of where many developing countries are in this field. Nonetheless the article highlights the still rudimentary stage of knowledge and application of genomic information in the country and the urgent need to increase pharmacogenetic research and integrate genetic information into both public health decision-making and clinical practice in all nations still remains a goal to aspire toward. Jairo A. Garcia A., MD. Clinical Gastroenterologist, Fundacion Valle Del Lili. Cali, Colombia. Lewis R. Roberts, MB ChB, PhD, FACP* Professor of Medicine and Director, Hepatobiliary Neoplasia Clinic, College of Medicine, Mayo Clinic, Rochester, MN, USA.