Public health practice will not be able in the 21st century to ignore the impact of genomics, cell and molecular biology. It will need to take into consideration issues that include, among others: the complementary nature of social and biological models of disease, genetic exceptionalism, the readiness of public and patient to respond to genomic information, the relationship between individuals and populations, and concepts of population stratification. Health systems will need to adapt their practice and organisation to include new sequencing technologies, bioinformatic expertise and proper evaluation of genetic and molecular tests. Links with the commercial sector will increase in importance. The impact on developing countries cannot be ignored and will require special attention.

Keywords:
Genetics, Genomics, Health policy, Personalised medicine, Public health, Translation
1.
Bellagio Group: Report of an expert workshop held at the Rockefeller Foundation Study. 2005.
2.
Burke W, Khoury MJ, Stewart A, Zimmern RL; Bellagio Group: The path from genome-based research to population health: development of an international public health genomics network. Genet Med 2006;8:451–458.
3.
Stewart A, Brice P, Burton H, Pharaoh P, Sanderson S, Zimmern RL: Genetics, Health Care and Public Health Genetics. An Introduction to Public Health Genetics. Cambridge, Cambridge University Press, 2007.
4.
Khoury MJ, Little J, Burke W (eds): Human Genome Epidemiology: A Scientific Foundation for Using Genetic Information to Improve Health and Prevent Disease. New York, Oxford University Press, 2004.
5.
Khoury MJ, Bedrosian SR, Gwinn M, Higgins JPT, Ioannidis JP, Little J (eds): Human Genome Epidemiology: Building the Evidence for Using Genetic Information to Improve Health and Prevent Disease. New York, Oxford University Press, 2010.
6.
Nuffield Council on Bioethics: Medical profiling and online medicine: the ethics of personalised healthcare in a consumer age. Nuffield Council on Bioethics, 2010.
7.
House of Lords. Science and Technology Committee: 2nd Report of Session 2008–09. Genomic Medicine. Vol I, Report 2, June 2009. HL Paper 107-I.
8.
Khoury MJ, Bowen MS, Burke W, Coates RJ, Dowling RF, Evans JP, Reyes M, St Pierre J: Current priorities in public health practice in addressing the role of human genomics in improving population health. Am J Prev Med 2011;40:486–493.
9.
Nuffield Council on Bioethics: Public health: ethical issues 2007. Executive Summary, p xvi. Nuffield Council on Bioethics, 2007.
10.
Nuffield Council on Bioethics: Public health: ethical issues 2007. Box 3.2. p 42. Nuffield Council on Bioethics, 2007.
11.
Thaler RH, Sunstein CR: Nudge: improving decisions about health, wealth and happiness. New Haven, Yale University Press, 2008.
12.
Marteau TM, Oliver A, Ashcroft RE: Changing behaviour through state intervention: when does an acceptable nudge become an unacceptable shove? BMJ 2008;337:121–122.
13.
Rose G: Sick individuals and sick populations. Int J Epidemiol 1985;14:32–38.
14.
Pharoah DP, Antoniou A, Easton DF, Ponder BA: Polygenes, risk prediction, and targeted prevention of breast cancer. N Engl J Med 2008;358:2796–2803.
15.
Burton H: Genetics and mainstream medicine. PHG Foundation 2011. ISBN 978-1-907198-07-6.
16.
Skirton S, Lewis C, Kent A, Coviello DA; Members of Eurogentest Unit 6 and ESHG Education Committee: Genetic education and the challenge of genomic medicine: development of core competences to support preparation of health professionals in Europe 2010. Eur J Hum Genet 2010;18:972–977.
17.
Department of Health: Report of the Review of NHS Pathology Services in England. Chaired by Lord Carter of Coles, 2006. http://www.pathologists.org.uk/publications-page/Carter%20Report-The%20Report.pdf.
18.
Department of Health. Report of the Review of the Second Phase of the Review of NHS Pathology Services in England. Chaired by Lord Carter of Coles, 2008. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_091984.pdf.
19.
Teutsch SM, Bradley LA, Palomaki GE, Haddow JE, Piper M, Calonge N, Dotson WD, Douglas MP, Berg AO; EGAPP Working Group: The Evaluation of Genomic Applications in Practice and Prevention initiative: methods of the EGAPP working group. Genet Med 2009;11:3–14.
20.
Evaluation of Genomic Applications in Practice and Prevention (EGAPP). http://www.egappreviews.org.
21.
Wang L, McLeod HL, Weinshilbourn RM: Genomics and drug response. N Engl J Med 2011;364:1144–1153.
22.
McDermott U, Downing JR, Stratton MR: Genomics and the continuum of cancer care. N Engl J Med 2011;364:340–350.
23.
Holmes MV, Harrison S, Talmud PJ, Hingorani AD, Humphries SE: Utility of genetic determinants of lipids and cardiovascular events in assessing risk. Nat Rev Cardiol 2011;8:207–221.
24.
Zimmern RL: Testing challenges: evaluation of novel diagnostics and molecular biomarkers. Clin Med 2009;9:68–73.
25.
UK Genetic Testing Network. http://www.ukgtn.nhs.uk/gtn/Home.
26.
National Institutes of Health: Genetic Testing Registry. http://www.ncbi.nlm.nih.gov/gtr/.
27.
Centers for Disease Control and Prevention: Cancer GEM KB: Cancer genomic evidence-based medicine knowledge base. http://www.hugenavigator.net/CancerGEMKB/home.do.
28.
Kesselheim AS, Mello MM: Gene patenting: is the pendulum swinging back? N Engl J Med2010;362:1855–1858.
29.
Wright CF, Hall A, Zimmern RL: Regulating direct-to-consumer genetic tests: what is all the fuss about? Genet Med 2011;13:295–300.
30.
Hudson K, Javitt G, Burke W, Byers P; American Society of Human Genetics Social Issues Committee: ASHG Statement on direct-to-consumer genetic testing in the United States. Obstet Gynecol 2007;110:1392–1395.
31.
Goetz T: The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine. Emmaus, Rodale Inc., 2010.
32.
World Health Organization: The initiative on genomics and public health. http://www.who.int/rpc/igph-resources/en/.
33.
Burke W, Burton H, Hall AE, Karmali M, Khoury MJ, Knoppers B, Meslin EM, Stanley F, Wright CF, Zimmern RL; Ickworth Group: Extending the reach of public health genomics: what should be the agenda for public health in an era of genome-based and ‘personalized’ medicine. Genet Med2010;12:785–791.
© 2012 S. Karger AG, Basel
2012
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