Genetics In Canadian Health Care

Most Canadians believe that their health is shaped by luck, genetics, lifestyle choices, and treatment options--and government agencies, public health units, and disease associations all reinforce this perception. This study, however, tells a different story, arguing that it is the social determinants of health, as imposed by the financial markets, that dictate the health of Canadians today. Showing that health care can be greatly improved with simple changes to social policy, the discussion describes the impact of food, housing, employment, education, and social services on the nation`s health.

Our report describes particular aspects of Canada's intellectual property regime as they relate to human genetic material and discusses the issues and impacts of these aspects in three interconnected spheres of activity involved in making new HGM-based products and services available for in health care: research; development and commercialization; and health services.

Biotechnology-based health innovations over the past century have contributed significantly to the remarkable improvements in the health of Canadians. Recent advances suggest that biotechnology may play an even more significant role in the future. Describes the potential role of biotechnology in relation to the various factors that influence health, discusses some of the social and ethical considerations involved in the applications of biotechnology, sets out a policy framework, and recommends actions necessary to equip our systems to meet the challenges that the unfolding era of modern biotechnology will present.

From Research to Reality describes the stages involved in the approval and use of gene therapies in Canada, and examines challenges associated with regulatory oversight, manufacturing, access, and affordability, and identifies promising approaches to address them.

Today, scores of companies, primarily in the United States and Europe, are offering whole genome scanning services directly to the public. The proliferation of these companies and the services they offer demonstrate a public appetite for this information and where the future of genetics may be headed; they also demonstrate the need for serious discussion about the regulatory environment, patient privacy, and other policy implications of direct-to-consumer (DTC) genetic testing. Rapid advances in genetic research already have begun to transform clinical practice and our understanding of disease progression. Existing research has revealed a genetic basis or component for numerous diseases, including Parkinson's disease, Alzheimer's disease, diabetes, heart disease, and several forms of cancer. The availability of the human genome sequence and the HapMap, plummeting costs of high-throughput screening, and increasingly sophisticated computational analyses have led to an explosion of discoveries of linkages between patterns of genetic variation and disease susceptibility. While this research is by no means a straight path toward better public health, improved knowledge of the genetic linkages has the potential to change fundamentally the way health professionals and public health practitioners approach the prevention and treatment of disease. Realizing this potential will require greater sophistication in the interpretation of genetic tests, new training for physicians and other diagnosticians, and new approaches to communicating findings to the public. As this rapidly growing field matures, all of these questions require attention from a variety of perspectives. To discuss some of the foregoing issues, several units of the National Academies held a workshop on August 31 and September 1, 2009, to bring together a still-developing community of professionals from a variety of relevant disciplines, to educate the public and policy-makers about this emerging field, and to identify issues for future study. The meeting featured several invited presentations and discussions on the many technical, legal, policy, and ethical questions that such DTC testing raises, including: (1) overview of the current state of knowledge and the future research trajectory; (2) shared genes and emerging issues in privacy; (3) the regulatory framework; and (4) education of the public and the medical community.