“Diabetes amputations top 1000” : so ran a headline in the NZ Herald over a report on what is becoming one of the public health disasters in this country.
Public health is the science and art of preventing disease, prolonging life and promoting health through organised efforts of society, says Professor Sir David Skegg, one of NZ’s most respected epidemiologists.
“Unfortunately NZ’s performance in this is even less adequate than its treatment services”.
He cites weak leadership and a lack of political will as fundamental problems for public health in NZ.
Point of Order contends that the lack of any significant progress by the Ardern government in delivering major improvements in health services — -or even to signal they are preparing them — helps explain why its poll ratings are sliding rapidly.
Health services are chronically underfunded, meaning that patients miss out on treatments which could increase their well-being—but also hospitals have to care for people with advanced disease that could have been avoided.
Sir David finds it “ puzzling” why a government with a prime commitment to well-being could shrink from one of the most obvious and remediable challenges to the well-being of its citizens: to limit the enormous harm that excessive alcohol consumption inflicts on families, communities and health.
He also points to insufficient action relating to the epidemic of obesity.
Point of Order sees gene editing as another area where the health system is being handicapped from the top.
The 21st century revolution in genetics has been as dramatic as that seen in computer technology. The first human genome to be sequenced took 13 years: it can now be done in a day. There are conditions – particularly rare diseases, such as childhood development disorders – where genome sequencing is extremely beneficial, and may even be life-saving in some cases.
While Australia has deregulated gene editing in human cell lines, animals and plants, NZ is still held back by the restrictive 2003 legislation.
The National Opposition has signalled it will overhaul the act regulating gene editing, if it becomes the government.
What the current Health Minister David Clark plans to do about it is not known, though one of his more intelligent colleagues, David Parker, has said he has requested
“ … officials to advise me where lower regulatory hurdles ought to be considered to enable medical uses that would result in no inheritable traits, or laboratory tests where any risk is mitigated by containment. The recommendation to clarify conflicting or inconsistent definitions across the regulatory framework will also be considered”.
Parker made his comment in response to the Royal Society Te Apārangi releasing papers which spelt out “the considerable benefits that gene editing can bring to our lives, particularly in health.”
He says he’s “aware” there are instances where gene editing techniques could be applied to improve the lives of NZers and and even agrees with the Prime Minister’s Chief Science Adviser there is a spectrum of genetic modification.
“Although New Zealand takes a precautionary approach, advancements in gene editing are not prohibited. There are already instances where the EPA has approved the use of modified organisms, for example Pexa-Vec currently used in clinical trials for the treatment of liver and kidney cancer”.
Contrast the NZ situation with that in the United Kingdom, where much of the available genome data comes from the UK government-backed 100,000 Genomes Project, which has sequenced genomes from NHS patients affected by rare diseases or cancers.
In a feature on medical research, The Guardian last week reported there is any army of biotech companies looking to get a foothold in the ever-expanding health market of “precision medicine”.
It notes privately owned laboratories offer personalised reports based on genome sequencing. Others focus on a selection of conditions for which there are known genetic markers, such as type 2 diabetes, breast cancer and coeliac disease. One, Dante Labs, through a genetic testing service offers users a full check-up for all common and rare diseases.
NZ – which used to pride itself on being in the forefront of medical developments – has a long way to catch up.
Point of Order 