Could genome sequencing help relieve pressure on the NHS?
The UK’s National Health Service (NHS) recently announced that individuals could pay to unlock their genome as part of a push towards personalised, preventative health care. Here’s why that’s great news for UK residents and global personalised health acceleration.
The need for personalised, preventative healthcare has never been greater. While advances in science, technology and medicine are happening in leaps and bounds, our sedentary lifestyle is taking its toll on our health. The world is in desperate need of change. If we’re to overcome the plight of modern living, we need to understand why some people are more prone to certain diseases than others and, how we can take action to help these people live healthier based on their unique genetic makeup.
Genetic science could assist millions of people in living a longer, healthier and happier life — while alleviating a huge strain on the healthcare system.
According to the World Health Organisation (WHO), “Most of the world’s population live in countries where overweight and obesity kills more people than underweight.” In fact, 1.9 billion adults were overweight in 2016 (650 million of those adults were considered obese).
Obesity and excess weight are a major risk factor in the development of diseases such as type 2 diabetes, cardiovascular disease, musculoskeletal disorders and certain cancers.
While obesity is considered a preventable disease, it’s more complicated than simply eating less. There are both genetic and environmental factors at play. Having said this, it’s vital to remember that genetic science is only part of the picture. Everything boils down to a combination of nature and nurture. You could have the best genes in the world and live and unhealthy lifestyle that makes you ill. On the other hand, by understanding our genes and our predisposition toward weight gain, for example, we can make positive lifestyle changes to reduce the likelihood of becoming obese. This in turn helps us reduce our risk of developing lifestyle-related diseases such as type 2 diabetes.
“Many people seem concerned about the ethics of genomic testing, but isn’t it unethical as well as uneconomical not to let people know about their increased risk for heart attacks, especially when so much can be done to prevent them?” writes The Spectator. “Quite low-tech lifestyle changes such as losing weight and having blood pressure checks can save lives; preventing a single severe heart attack could save the NHS hundreds of thousands of pounds. Validated polygenic scores exist right now to predict the risk of many other preventable diseases. Polygenic scores are the perfect early warning system. DNA needs to be genotyped only once and then the same genotyping results can be used to create hundreds of polygenic scores for a wide range of disorders. It’s not a question of whether we do it but rather when we do it.”
Our own Head of Sport Science here at DNAFit, Craig Pickering talks about the exciting opportunity presented by the NHS’ push towards personalisation:
“Genetic testing from a healthcare perspective is still in its infancy. Whilst its right to take a skeptical approach to new technologies, this initiative by the NHS has the potential to be hugely successful by combining genetic information with well-kept medical records. The data gained from this initiative will hopefully enable us all to better understand how, when, and why certain diseases develop, and what the relative effects of genetics and environment, both alone and when interacting, can have on disease. I, for one, am looking forward to seeing how this develops.”
As with any new technology, however, there will always be those who fear change and those who embrace it. There are also existing market forces within existing systems that would be impacted and, as a result, need to resist by virtue of what is lost in the process.
There is always a difference in cadence between new technological possibilities and the regulatory environment, this is natural (I’ve even experienced the sharp end of this first hand with a previous venture). Both need to be managed. And, it is this meeting in the middle, where a compromise is reached between the two that is the sweet spot for innovation. It’s interesting to read people’s views on the potential of personal genomics. In particular, Dr David King’s article in the Guardian, The NHS should run a mile from the genome sequencing gold rush, published earlier this week — which paints a more negative picture of the possibilities of genetic science. There are always good and bad sides to both, but I am myself very much of the opinion that the opportunities presented far outweigh any potential pitfalls.
Dr David King writes:
“The direct-to-consumer testing companies have marketed genome sequencing as fun and exciting personal discovery. But behind that facade, the business plan of some genome companies was always similar to Facebook et al — to amass vast troves of genomic data, which could be sold to the pharmaceutical industry. This is the game that Matt Hancock now wants the NHS to join. Despite the dubious health benefits of genome sequence information, neoliberal governments have never seen fit to regulate this industry — caveat emptor. Now the NHS is being turned into another snake-oil salesman.”
I find the idea that the NHS is turning into a “snake-oil” salesman extremely far fetched. Rather, this is a very smart move to advance the National Health Service. Matt Hancock is embracing and, therefore, leading the acceleration of genetic research and better preventative health globally.
Why should a world leading institution such as the NHS not be run with a fast-paced, but responsible velocity, whereby it seeks to advance its intellectual property and improve its financial position in the process. Which in turn feeds back into the economy of its own health system? Furthermore (and most importantly), UK citizens would gain tremendous advantage in terms of health benefit as a result.
This is surely a worthwhile cause that has numerous benefits. The issues relating to the millions of hours of counselling can too be resolved by technology solutions. I refer to Babylon Health, again not without its detractors, but a technology that is already making strides in providing solutions to address the existing burden on the NHS through extremely impressive AI technology.
“The controversial smartphone app, by Babylon Health, officially launched in early 2017, and allows patients in some areas to register with the on-demand service, giving them access to a GP 24/7 through virtual consultations. It also gives patients access to a symptom checker, driven by Babylon’s artificial intelligence (AI) tool,” writes Computer Weekly.
Actually, one should applaud the likes of Ali Parser, founder and CEO of Babylon Health, who is leading this medical/AI revolution and disrupting incumbent industries akin to the likes of Elon Musk from Tesla or Jeff Bezos from Amazon. The vision of what is taking place is one we as a country should embrace for the ultimate objective of living a longer and healthier life.
As far as the privacy of individuals is concerned, there are indeed risks. However, these risks are no greater than any current risks involved in the storage of any medical records. This is why choosing a reputable supplier who does not sell your data to third parties (and takes every precaution to protect your genetic information) is of utmost importance. The NHS, like most public health systems, are significantly empowered to handle medical data and this is not different to the medical records that exist currently within the health service. If there is a privacy risk, it is the same risk that has existed as long as the NHS has held any patient data. Which is to say it’s entire length of existence.
“Such worries expressed in the article could have been relevant in 2000 — but the facts have changed. Over 26 million people in USA and elsewhere around the world have taken the 23andme and AncestryDNA health and genealogy tests over the last 12 years. So far, none of the fears in the Guardian article have been realised. GPs have not been overwhelmed, nor have counsellors,” says Dr Keith Grimaldi, Chief Science Officer at DNAFit. “We have 12 years of good data, of unworried people, of interested people. The upward trend in direct-to-consumer DNA testing quite amazing. It is a good idea to start with paid customers to begin the process towards mass sequencing in the NHS. This allows time to understand the systems, problems, pitfalls, and address them — the era of personalised, preventative healthcare is coming, get ready.”
Consumer demand is driving the adoption of genetic technologies. The industry is no longer just for the early adopters, and is now making strides to become a core mass majority product. A system as beloved and as important as the UK’s NHS should not be left behind. So, the fact that Matt Hancock is pushing and embracing this emerging opportunity is not just positive news — it’s going to make a huge difference to generations to come, both here in the UK and within the international landscape.
This decision will position the UK as a leader in the race for better, more informed medicine, which will undoubtedly assist generations to come.
