The Australian government needs to develop a bold vision and strategic plan to create the data-driven healthcare system and bioeconomy of the future.
In my new report for ASPI, Biodata and biotechnology: Opportunity and challenges for Australia, I explain how the extraordinary developments in genome sequencing and genetic engineering will transform all biological enterprises, especially healthcare, and create new ones, like the electronic revolution. I explain why Australia should harness and capitalise on our high-quality biomedical science, agricultural research and development, and healthcare systems to realise a once-in-a-generation opportunity to play a leading role in a major economic revolution.
Biotechnology dates back over 6,000 years to the domestication of wheat and the use of yeast for fermentation, but has entered the province of human design and invention as a consequence of the gene-cloning, gene-manipulation and genome-sequencing revolutions of the past 50 years.
While often thought of in terms of drug development and genetic engineering, biotechnology is fundamentally becoming an information industry with a universe of applications.
Humans have acquired the ability to read the genetic programming and analyse the structure of the molecules of life—how cells work, how we’re different from each other, and what makes a lime different from a lemon. Life has evolved the most exquisite nanomachines—protein machines that can bind oxygen and almost any other type of molecule; trap photons to turn carbon dioxide and water into carbohydrates; detect electric fields or sound waves and turn them into visual images; pump ions; facilitate the entry of viruses, bacteria and parasites into cells; and make molecular motors that spin or contract to trap prey, exert force and move.
The extraordinary advances in DNA sequencing are leading to an avalanche of genomic information. Genetic engineering can now be done with high speed and precision. The pace of change is accelerating, and biological technologies are intersecting with optical technologies, nanotechnologies, advanced computing and artificial intelligence to create possibilities that were, if not beyond imagination, well beyond feasibility just a few years ago.
The advent of population-scale genomic and smart sensor data will transform health care, health economics, medical research and drug development. It will also transform the national economy and create digital products that can be exported to the world. To achieve this, the Australian government needs a strategic plan for acquiring genomic, clinical, pharmaceutical, sensor and patient self-reporting data and for providing trusted online evidence-based analysis of that information and advice to healthcare practitioners and citizens.
Governments also need to convince citizens of the personal and national value of big data in health care, and the privacy and security of that data, using a model that combines political leadership with subject-matter expertise.
The Australian government should establish a secure national repository for genomic and phenotypic data for research and healthcare use. This de-identified data should be made available to Australian researchers and health system managers. It could be provided to external parties, such as pharmaceutical companies, under appropriate conditions in exchange for early access to expensive treatments or shared benefits.
The Australian government should establish a central unit to assemble and supply evidence-based, well-curated and continuously updated genomic analysis, integrated with clinical and other data, and linked to national treatment guidelines, for decision support at the point of care.
The cost of doing this will be trivial compared with other costs in the healthcare system, and trivial in relation to the cost reductions and healthcare improvements that it will enable. This work could be funded from the Medical Research Future Fund and public–private partnerships.
Smart sensors should be made available through Medicare and routinely installed in hospitals, clinics and other healthcare settings, such as aged-care homes.
Conversion to electronic health records should be mandatory for all healthcare providers receiving government support or reimbursement in Australia, as recommended by the Australian Academy of Technology and Engineering.
Genetic tests should be progressively upgraded to whole-genome sequencing to build the national genomic estate. That would convert diagnostic expenses into an enduring strategic asset.
All suitably accredited health professionals, including general practitioners, should be able to obtain a genomic report, pharmacogenomic advice, early warning of an incipient disease, or any combination of that information, about a patient (with patient approval) upon request, and bulletins issued where relevant. Citizens should also be entitled to access such information in the interests of caring for their own health, provided it is conservative and actionable.
Security and police agencies should establish internal expertise in biotechnology and biodata analysis. They should have access to national genomic information under defined circumstances and subject to judicial approval and oversight.
Major investment funds and relevant government departments should consider establishing bio-intelligence units to keep abreast of opportunities and incorporate those opportunities into their strategic planning. Australian research funding agencies and the CSIRO should continue to invest in advanced genetic engineering and vaccine and drug development. Superannuation funds should be encouraged to invest at least 1% of their resources into domestic start-up and early-phase high-tech and digital enterprises, especially in health and biotechnologies.
Universities should provide training in computer programming and big-data analysis as a core component of all science and engineering degrees.