The complex promise of newborn screening.

Newborn screening has been practised as a form of preventive medicine since the 1960s, and has attracted increased attention in recent years as technological capacities expand. Like other emerging economies, India faces pressure to expand infant screening, though developments have been halting. The promise of newborn screening is the reduction of infant mortality and morbidity from a host of rare, typically genetic, disorders. Deciding what priority should be placed on the realisation of this promise, together with the practical challenge of coordinating the screening enterprise, requires the use of decision making frameworks that address both clinical criteria and values conflicts. Frameworks for public health ethics can aid sound policy development in India, and help to inform the larger international debate about the expansion and benefits of NBS.