What is New Zealand’s genomic testing roadmap?
Genetic tests have the capacity to generate information that may have a profound effect on the tested individual. It is vital that genetic testing occur within a framework that promotes and protects patient safety and well being. While discovery using genome-based technologies has accelerated, these have only begun to be adopted into clinical medicine.
New Zealand has been steadily building up resources, projects and services to enable genetic testing. In 2017, the government announced up to $35 million over 7 years to Genomics Aotearoa. This was aimed at establishing Genomics Aotearoa as a collaborative platform of genomics research that grows our capability, builds international connections, and develops technologies that will support our genomics researchers in delivering excellent science. Following on from this in 2019, the Rakeiora programme received a Government cash injection of nearly $5m to build New Zealand's first genomic database with the hope of tackling some of the biggest diseases hurting Kiwis.
In late 2021, a first of its kind programme in New Zealand, for Auckland's Regional Cancer and Blood Service was commenced. It was part of an Australian-based clinical trial called the Cancer Molecular Screening and Therapeutics (MoST). Cancer patients who had exhausted other treatment options could have their specific cancer analysed using genomic profiling, to determine if other more targeted therapies were available.
Sequencing and analysing a person’s entire genome: whole genome analysis (WGA) is the most comprehensive method of arriving at a genetic diagnosis. In NZ, the capability to implement WGA in healthcare has yet to be realised.
In New Zealand, Genetic Health Services New Zealand (GHSNZ) provides expert genetic advice, counselling and diagnostic services to patients and health professionals throughout the country. GHSNZ was launched as a national service in May 2012 and has clinics throughout New Zealand staffed by clinical geneticists and genetic associates, as part of the public health system.
Interesting to note that while many countries have banned or restricted genetic test results from being used in insurance, New Zealand has not. Earlier this year, NZMJ published an article that covered a survey about the use of genetic test results in insurance underwriting. The authors aimed to document their experiences and concerns about the potential misuse of the information, and called for stronger regulatory protection.
Over the next few years, genetic testing will become more available and more affordable. Combining this with ongoing research around precision health, and we will begin to see clinical applications emerge. In parallel, we will require national policy and government regulations to form supporting guardrails that enable progress and protect New Zealanders. What does New Zealand's genomic testing roadmap look like?