Thank you very much.
Thank you, Madam Chair.
Thank you, members of the committee.
I will give my presentation in English, but I would be glad to answer questions in French, if you'd like, during the question period.
Members of the committee, on behalf of Genome Canada I'm very pleased to contribute to your study of technological innovation, including best practices, in health care in Canada.
As you may know, genomics is the science that aims to decipher and understand the entire genetic information of any organism, any living thing. As such, this science is fundamental to all biological research and can help us gain better insight into a wide range of questions about life. Genomics is a relatively young science, and its potential is rapidly being tapped by new technologies, a reality that has powerful implications for health care and many other sectors in Canada.
Before I present some of the applications and implications of genomics technology in health care, let me briefly say a few words about Genome Canada. Genome Canada is a not-for-profit corporation dedicated to developing and applying genomics science and technology to create economic wealth and social benefit for Canadians. We work in close partnership with six regional genome centres and with the federal and provincial governments, academia, and industry.
We invest in and manage large-scale research and translate discoveries into commercial opportunities, new technologies, applications, and solutions in key life science sectors of the economy. These sectors include human health, of course, but also agriculture, fisheries, forestry, environment, energy, and even mining.
In all of our work, we make it a priority to consider the economic, ethical, environmental, legal, social, and other challenges—we call this GE3LS research—and opportunities related to genomics. We do this to help policy-makers and others understand the broader impacts of the science and to accelerate its acceptance and the uptake of innovations into society.
Since 2000 the Government of Canada has committed $1 billion towards our mandate, and we've succeeded in leveraging this investment to secure a further billion dollars in co-funding over the same period to support our work. More than 60% of that $2-billion total has been invested in health-related genomics research and applications.
We are already seeing a return on that investment as witnessed by Canadian genomics findings that have saved lives, improved treatments for patients, and reduced health care costs.
The biggest genomics game changer for health care in Canada and elsewhere is the unprecedented technological progress leading to our ability to read a person's DNA, which is his or her personal code of life. The time is rapidly approaching when each of us will be able to quickly and inexpensively have our personal genome sequenced and available for analysis for a variety of health-related queries.
The very first human genome was sequenced at a cost of $3 billion and took thousands of scientists over 10 years to complete—and that was done in 2003. Less than 10 years later, any one of the many established genome sequencing centres in the world—and there are three world-class centres in Canada—can do this job in a few days for only $3,000, and the cost is getting cheaper by the week.
Few, if any, other areas of science and technology have undergone such a rapid evolution—where the cost of a significant operation has seen a millionfold drop within a 10-year period.
Obviously, there is considerable speculation among health professionals, policy-makers, and patients regarding how this relatively new, now-accessible technology will be used in the clinical setting. How will this information be analysed, by whom, who will own the data, and how on earth will we integrate this new world of medicine into an already stressed health care system?
In order to answer these questions, we first need to understand what our personal genome can and cannot tell us about our individual health status and our susceptibility to certain diseases later on in life.
The degree to which our genes impact our health differs greatly depending on the condition or disease in question. At one end of the spectrum are single-gene disorders, some of which are extremely rare and others more common, such as cystic fibrosis, certain forms of bleeding disorders—you know the term “hemophilia”—and Huntington's disease. For these diseases, the genetic component is the main, if not the only, driver of the disease. In other words, no matter what environmental factors are at play, if you're unfortunate enough to have a defective gene set for these kinds of diseases, you will most likely have the disease.
At the other end of the spectrum are the much more common chronic diseases, to which many genes may conspire to increase a person's likelihood of falling prey, but which may only manifest themselves if environmental factors are added to the mix.
Type 2 diabetes is a prime example of this situation. There is a complex genetic aspect to most cases of type 2 diabetes, but the disease will express itself preferentially in those who, perhaps, don't exercise regularly, have poor nutrition, and/or consume abnormally high levels of alcohol. Incidentally, the incidence of type 2 diabetes in particular is escalating and driving health care costs to unsustainable levels in most developed countries.
All this is to say that decoding our personal genome plays a pivotal, albeit partial, role in combatting diseases and addressing challenges in the health care system.
So what is actually happening now to make the most of this technology? Our health authorities and provincial and federal ministers of health are asking good questions and challenging the promoters of genomics technology as to how we can integrate it into the health care system in an economically sustainable manner.
Genome Canada, in partnership with the Canadian Institutes of Health Research and the regional genome centres, is rising to this challenge. Last year the Minister of Health and Minister of State (Science and Technology) jointly supported us in launching a new $150 million large-scale applied research initiative in personalized health.
We asked project teams across Canada to deliver proposals that would make use of the best technology available in the world to address serious medical needs, which included an economic rationale as to why health authorities should be proactive receptors for this new technology. In other words, to be successful, the projects would need to justify how they would serve the interests of the health care system as a whole. We are delighted that in the very near future, we will be in a position to announce the results of this competition.
Already genomics is being applied in our heath system in specific areas. For example, genomics is being used to decide appropriate treatments for many forms of cancer. Canada is playing a prominent role internationally as the coordinator of the International Cancer Genome Consortium.
Canadian genomics research has also helped prevent infant fatalities. A Genome Canada-funded study discovered several years ago that there was a genetic basis behind some forms of sudden infant death, linked to the use of codeine by breastfeeding mothers. As soon as this study was published, both Health Canada and the United States Food and Drug Administration changed labelling for codeine, banning it from being used in the postnatal period.
The field of adverse drug reaction is ripe for genomics-based, evidence-driven application, as here once again the genetic component is very dominant in many cases. This is significant given that adverse drug reactions cost the Canadian health system $7 billion per year. Imagine if we could cut that figure just by half.
We will see other major developments over the next three or four years, as progress made in genomics will impact health fields as diverse as epilepsy, autism, schizophrenia, cardiovascular disease and stroke, cancer, and many inflammatory diseases.
This is just the beginning. Canada is beautifully positioned to reap the benefits of this technology, notably because of the world-class research capacity that's been created here over the past decade. The huge potential for efficient integration into the health system is thanks to a research-intensive health-delivery infrastructure and the fact that Canada has some of the best disease-specific clinical research networks in the world.
That being said, there certainly are some broader challenges, which the committee is familiar with, that Canada must overcome to develop and maintain a financially sustainable, modern health care system and to facilitate the integration of genomics efficiently and effectively. These include such things as electronic health records; efficient, modern, and harmonized provincial health technology assessment systems; education and training modules for health professionals in genomics and alterations to the medical school curriculum; a more mature interface between health research and health delivery; and productive research partnerships with the private sector.
Furthermore, patients and patient advocacy groups will have an important voice going forward, and individuals will have to be accountable for maintaining and monitoring their own health and for adjusting behaviours as they go through life. Although challenging, this concept will be key, and government funding will be required to encourage Canadians to partake in healthy living practices.
Genome Canada would like to thank the committee for its time and consideration.