Why genomic medicine in Africa cannot simply be imported

Pipelines are opinions

A diagnostic pipeline looks like plumbing: data in, answer out. It is really a stack of assumptions: about which reference genome counts as normal, whose ancestry the variant databases represent, and what infrastructure the clinic can rely on.

Import the pipeline wholesale and you import its assumptions too. The blind spots come free.

Building for where the work happens

Equitable genomic medicine is not the same tools, shipped further. It is methods designed, from the start, to be true in the setting that uses them.

This note is still forming. I will keep returning to it as the practice and the reading deepen.