Genomic medicine – much promise, many challenges

Genomics will transform many aspects of medicine in the coming decade though exactly how is still not fully clear. In the first week of January, I attended a meeting on genomic medicine (Global Leaders in Genomic Medicine) convened by NIH and attended by research funding bodies and policy makers from around 20 nations.

A number of countries are making substantial progress in introducing genomics approaches into their health care systems. These are mostly the smaller countries, but also some larger though less wealthy countries.

NHMRC has an important responsibility to help our own country to benefit from genomic advances. We identified ‘Preparing Australia for the ‘omics’ revolution in health care’ as one of our formal Major Health Issues in our current Strategic Plan.

Australia needs to capture the benefits of advances in genomics. The costs of DNA sequencing have fallen dramatically and there have been major improvements in knowledge and processes to better analyse and interpret the data generated. These advances are already making their ways into some areas of policy development and practice in health care, to improve precision in patient care through better targeting of therapies and prevention strategies.

Despite all that has already been achieved, we have only just begun this research and translation journey in genomic medicine. Technical advances have outstripped our knowledge of the implications and we don’t yet know nearly enough about the steps that lead to clinical conditions and outcomes and about how our genes interact with all the social and environmental factors that affect our health. Much of the promise of genomics will come from research in this field.

The major policy challenge is how best to integrate genomics into Australia’s health care system. Managing the vast genomic data alone will require new thinking and approaches for the benefit of policy making, clinical decision making and research. Its value needs to be realised by linking genomic data to other individual and administrative data, and this will itself bring much further complexity to the challenge we already face in handling and linking data in health and health research.

The goals of the NIH “Global leaders in Genomic Medicine” meeting were to:

  • Identify areas of active translational and implementation research, potential common strategies, and opportunities for collaborative efforts.
  • Identify common barriers to implementation of genomics in healthcare and a policy agenda relevant to advances in the field.
  • Identify nations with unique capabilities (such as national healthcare systems) that may allow rapid implementation and measures of key outcomes.
  • Discuss opportunities (such as national healthcare systems) that may allow rapid implementation and measures of key outcomes.

I am keen for NHMRC to play an active role in this international cooperative effort of universal significance, as well as in the Global Alliance to Enable Responsible Sharing of Genomic and Clinical Data and the International Cancer Genome Consortium. Australia has much to contribute; for its size Australia has strong genomics research, Australian researchers value international collaboration in research, and our health care system is well placed to take advantage of genomic discoveries for the benefit of our fellow citizens.

In March, a meeting of the NHMRC’s Human Genetics Advisory Committee and an associated workshop will further develop NHMRC’s advice in this area.

I will also convene a CEO Roundtable to discuss a potential major NHMRC initiative in genomic medicine research and translation

Your comments are welcome –

Professor Warwick Anderson AM
Chief Executive Officer
National Health and Medical Research Council