genomics

We need to start a conversation now about how to prepare our systems and societies for the changes on the horizon. In the second of a two-part mini-series on predictive genomics, Francesco Floridini examines how Europe can accelerate the transition. I believe technology is no longer the key barrier to unlocking the potential of predictive genomics. Most large European countries, including France, Germany, Spain, Italy, the UK and the Nordic countries, have made large investments in genomics and have the necessary infrastructures to get predictive genomics to the clinic in the next 5 years. The challenge now is to move from running academic research projects towards making this approach the norm in a clinical setting. What’s missing is: efficient and safe health data sharing; genetic counsellings and awareness among health professionals; pathways to market and reimbursement models that recognise the economic value of predictive genomics. First: health data. Potential harms could arise if personal health risk data is not kept in a safe, private environment. Yet, predictive genomics cannot happen without robust and comprehensive health data sharing. There is a need for a new social contract between citizens, governments (as healthcare providers) and industry on health data sharing. The hope is that the forthcoming European Health Data Space would provide a framework within which to integrate predictive genomics in a safe and effective way. Second: awareness. While predictive genomics is not new (the technology on which it is based, microarrays, is very well established), it has not entered doctors’ curricula or treatment guidelines, apart from a few examples [1] . It is necessary to inform practitioners about the state of the art of predictive genomics and prepare them for the upcoming uptake of PG solutions in the market. There are plenty of genetic tests available to patients, and genetic counsellors...
Predictive genomics can transform healthcare, shifting the focus towards prevention and getting better value for the money we spend. In the first of a two-part mini-series , Francesco Floridini explores this new paradigm in healthcare. Healthcare today is all about treating people who are ill. They experience symptoms, engage with the health system, and receive an intervention ‒ perhaps a drug, a device, surgery or recommendations for lifestyle change. This works well for some. For others, diagnosis comes too late or the intervention doesn’t work as had been hoped, and doctors must try something else. Outcomes vary and, more often than not, there is no way to tell which treatment will work best in a given patient. This is not only inefficient, but costly. Many healthcare systems across the world are perilously approaching the point of no return in terms of sustainability. Ageing, sedentary lifestyles and unhealthy nutrition are driving the rising prevalence of non-communicable diseases (NCDs) such as certain types of cancer, cardiovascular diseases and diabetes. At the same time, the young healthy and productive population (which shoulders the socio-economic burden of older generations) is getting smaller, while economic crises are driving inequalities. The result is a potentially catastrophic scenario, where healthcare and social insurance systems can’t cope with the load of sick people, leading to less healthcare services and even greater inequalities. Focus on prevention There is another way. I see mounting evidence that predictive genomics (PG) can provide individuals and health systems with key information on who is at risk of a wide range of diseases. And, crucially, how this risk can be reduced to improve outcomes and use finite resources well. Information is power. Prevention is at the heart of this new model which I am confident has the potential to make our systems more sustainable,...