A View from David Ewing Duncan
Britain Calls for a Genomic Health Road Map
The plan would introduce a comprehensive link between genomics and health care. Should the United States follow Britain’s lead?
In the U.K., a report commissioned by the House of Lords’ Science and Technology Committee has recommended that Britain set up a comprehensive plan to integrate genomics into its state-run National Health Service (NHS). The chairman of the group that wrote the report is the geneticist and peer Lord Kamlesh Patel, who has been a leading figure in Britain’s pro-science stem-cell-research protocols.
This is from Genomeweb Daily News:
The group has made wide-ranging recommendations for NHS and the government in the 127-page report, and it has advised drafting a white paper that will address several specific issues.
“Genomic medicine will clearly have a huge impact on health provision and the NHS in particular over the next few years,” Lord Kamlesh Patel, who chaired the inquiry, said in a statement.
The white paper should include details about how the Department of Health will help to translate genomic medicine into clinical practice, including planning changes that will “bring genetic testing into mainstream clinical practice,” the committee said.
“It is time for a comprehensive statement from the Government on how genomic medicine will be incorporated into the NHS, including details of the extra training doctors and nurses will need in this area,” Patel continued.
A roadmap plan of measures should be developed for how these tests could be incorporated into NHS, and there should be proposals for a program “of long-term funding to support these measures,” according to the committee. Because there currently are “several barriers” that keep some new genomic tests from being translated from invention into use in the NHS, the committee has recommended that a Health Technology Assessment program fund research into the use of such tests within NHS, and that the Office for Strategic Coordination of Health Research draft a strategic vision on how they should be incorporated.
Perhaps most important in this 127-page report is a call to reclassify genome-wide association studies under European Union law from their current status of “low risk” to “medium risk,” which would trigger a more thorough investigation into each test’s validity and usefulness. The report also calls for a “voluntary code of practice” for providers of direct-to-consumer testing companies that operate in the U.K., presumably including 23andMe, deCodeme, and Navigenics.
“Without proper qualified interpretation, results of genetic tests could cause people to worry unnecessarily and place new demands on NHS services,” said Lord Patel.
The United States should use Britain’s example and establish its own comprehensive road map for validating and then integrating these tests into our health system. Discussion along these lines is being done by the Secretary’s Advisory Committee on Genetics, Health and Society, appointed by the secretary of the U.S. Health and Human Services. This week, the Genetics and Public Policy Center at Johns Hopkins University also published a blueprint in Public Health Genomics calling for a registry of genetic tests and data–a crucial step also envisioned in the House of Lords report.
As laudable as these efforts are, however, the U.S. remains a long way from developing a national road map to truly integrate genomics and health care–a prospect made far more difficult than in Britain, given the American penchant for decentralized health care.