Population Health Genomics in Member Countries of the Cooperation Council for the Arab States of the Gulf

The member countries of the Cooperation Council for the Arab States of the Gulf, also known as the Gulf Cooperation Council (GCC), have a diverse population of 35.1 million people and an overall population growth rate of over half a million people a year. The GCC countries have fast-growing economies based mainly on revenues from petroleum and related industrial products. Health services are provided by the government and the private sector, and GCC citizens have no mandatory health insurance plan. Patients incur no cost for government-provided health services at the point of care. Among the distinctive socio-cultural characteristics of GCC countries are marriage at a young age (sometimes at less than 15 years of age), child-bearing until menopause, a high birth rate (16 - 43 births/1000 population), large family size resulting from a high fertility rate (2 - 7 children per woman), and a high rate of inbreeding or consanguineous marriage (up to 58% of marriages in some areas). The prevalence of genetic diseases in the GCC countries is high in comparison with rates in Europe and North America. Hemoglobinopathies, G6PD deficiency, inborn errors of metabolism, congenital hypothyroidism, deafness, and Down's syndrome represent the most prevalent genetic diseases in the GCC countries and have been discussed frequently in the literature. Public health activities are resourced by government. Premarital medical counselling is obligatory in Bahrain and Saudi Arabia, while it is encouraged in the rest of the GCC countries. Prenatal screening is offered as part of routine clinical prenatal services. Newborn screening programs vary between GCC countries with respect to organization and the conditions screened for. The many gaps that remain in current screening programs reflect gaps in effective surveillance and a resulting lack of national incidence and prevalence data for certain genetic diseases. The GCC countries as a whole would benefit from the adoption of a comprehensive screening and surveillance framework for genetic diseases. Adequate stakeholder engagement and good communication between medical and public health disciplines is needed for such a framework to be effective. Regular evaluation, dissemination of information, and the application of evidence-based knowledge to the specific needs of the region will be essential to improvements in genetic services.