The Impact of The Genomics Revolution on Healthcare: Better Outcomes Through Precision Medicine
Across the table view: Seated on the most right is Professor Rory Shaw, Medical Director, Healthcare UK, UK Trade & Investment (UKTI), London, who is also co-chairman of the programme
The genomics revolution is already changing the approach of healthcare in the UK and USA with large scale programmes already launched. The UK started this in a big manner when the Prime Minister, Mr. David Cameron, announced the 100,000 Genomes Project for England in 2012, focusing on cancer and rare diseases. A total of 13 Genomic Medicine Centres (GMC) has been established all over England and many patients have benefited directly. For the rare diseases, whole genome and whole exome sequencing have yielded a diagnosis between 30-40% of cases providing not only closure for parents and families but also identifying the treatment in many of the cases (for some of them it involves just the use of steroids or a particular vitamin B!). The USA has followed the UK, although somewhat 3 years later, when President Obama announced the Precision Medicine Initiative at the State of Union Address in 2015.
I had the privilege of attending a study tour and a dialogue on the 29th February to 3rd of March 2016 in a programme organized by the Healthcare UK, Foreign and Commonwealth Office, and Wilton Park. A total of 28 international participants were invited from 12 countries. Malaysia had 3 participants and I was the lucky representative from ¼¯ÃÀÂ鶹. There were more than 40 experts from various top institutions in UK at the meeting too.
The UK is offering to help attending countries to set up their own programme for genomics and precision medicine. This includes technical expertise, education and training, advice on regulatory issues and requirements on the appropriate infrastructure for a GMC. They are also willing to help convince our leaders and potential funders on how important this programme is for Malaysia. Through this collaboration, the UK will lend its full support behind the international GMC set-up in partnering countries and increase the global knowledge on genomics and its direct application to healthcare.
Precisely how will the use of whole genome sequencing help cancer patients? The answer is in providing the best of treatment to the patients in the form of targeted therapies. Precision medicine means giving the right patient the right treatment at the right time with the right cost and the right outcome. Identifying targetable mutations on each tumour will allow treatment with inhibitors (not toxic chemicals) which can shrink the tumours dramatically. The use of pharmacogenetics will also help avoid adverse drug reactions and maximize efficacy of each drug.
Genomics medicine will also increase our insight and understanding of diseases leading to new treatments, devices and diagnostics. The use of genomic medicine practice should be integrated into the healthcare system as it will result in better patient outcomes. There will also be an increase in public and private sector investment and also commercial activities including technology development.
Malaysia should indeed respond by setting up a few of these Genomic Medicine Centres both within the Ministry of Health and also the universities. UMBI is in a great position to be one of these GMCs as it has already the infrastructure in place and also plenty of expertise available. UMBI has the most comprehensive set-up for genome sequencing in the nation and also has a large biorepository made up of The Malaysian Cohort Biobank and the PP¼¯ÃÀÂ鶹-UMBI Biobank. UMBI has already been offering pharmacogenetics services to patients from PP¼¯ÃÀÂ鶹 and molecular diagnostics for thalassaemias and cancers.
Let us take this opportunity to work together and make Malaysia one of the leading nations for genomics medicine in Asia.