Interview, Koen Kas – Our Genomic Future
Are digitally driven, human enabled solutions a cure all?
Health is our most important asset. It seems odd then, that the healthcare industry is built on the premise that patients should be treated only once a problem occurs. This wasn’t always the case – in ancient China, local doctors were paid as long as the village members remained healthy. In other words, prevention was better than cure. Backed by the digital revolution and the rise of genomics, it’s time to revert to this predictive, preventative model.
D/SRUPTION spoke to Koen Kas, Professor of Oncology and Healthskouts CEO, to find out how.
The genomic revolution
Genomics, the interdisciplinary field of science that focuses on the evolution, mapping and editing of genomes, is teaching us more about our own biology than we have ever known before. Our genome is made up of three billion digits. Only one per cent encodes for 20,000 proteins, which are the actual building blocks of our body. The remaining 99 per cent are merely instructions for how to build and regulate. Of these 20,000 building blocks, we only really know what half of them do. As we learn more about our genomes, says Kas, we can work out how to live better lives.
Kas’s first entry point into the field was a natural progression from his training as a molecular oncologist, trying to understand why some genes lead to cancer. He explains that in order to find tangible links between genomes and certain diseases, technology needed to catch up. Fully understanding what our genomes could tell us relied on advanced data collection and analysis techniques that have only recently become commonplace. Computer chips embedded with algorithms can already process an entire human genome in approximately 20 minutes. This is much faster than traditional CPU systems, which take around 20 to 30 hours. The result: our DNA becomes a manual for the human body.
“The technological revolution has enabled the biological and genomic revolutions,” says Kas. “You need to have a certain amount of data before you can find causalities. That is why the human genome’s initial promise to make us so much smarter in preventing disease took a while. We really needed to understand thousands of samples – initially from sick people who provided access to their genomes to find out what made them different – and to personalise medication.”
What does genomics mean for the future of healthcare?
Genetic insights taken from individual genomes can begin to identify people who might be susceptible to certain conditions, as well as how responsive they are likely to be to certain medication. This is in stark contrast to today’s healthcare system, which offers impersonal cures (rather than preventative advice) that are not guaranteed to suit individual needs. Knowing who is predisposed to a certain disease, and why, could help people to get personalised advice and tools to help them change their lifestyles. This is what Healthskouts, founded by Kas in 2017, hopes to achieve.
“Nowadays, as a doctor, I can hardly treat my patients because I don’t know anything about them. But with Healthskouts, I can scan for insights based on genomes (and technologies like sensors) to find new ways to change behaviour. I can show people how they can use the insights themselves to get their own personal digital assistants.”
In future, Kas believes that we will all have our own digital assistant, otherwise known as a human digital twin, that will turn data from genomes and sensors into health insights. This digital twin will be a visible hologram that helps us know ourselves on a deeper level. A consortium of close to 100 different European teams is currently trying to raise over one billion euros to generate the first generation of human digital twins for the European population.
CRISPR: cutting edge
Digital twins aside, genomics is already helping to prevent disease and offer precise medical treatments. Using gene editing technique CRISPR, it is possible to snip out errors in genomes. But what constitutes an error?
“Roughly 10 years from now, it will be unacceptable to be born without our genomic chart with conditions that can be treated with CRISPR. Each child born will have full genomic charts. CRISPR might accelerate access to our genomes because we will have something to deal with mutations. But what is the definition of an error? If a child is predisposed to having blue eyes but the parents want their child to have brown eyes, should it be changed? What is it morally acceptable to change?”
Changing someone’s genome is fundamentally changing what makes them who they are. Before CRISPR can be applied to human genomes, Kas calls for intense, global negotiations about how to regulate its use and this is a key issue. Another is privacy. Could our genomic information damage our access to certain products, services or opportunities? Insurers, for example, might use genomic data to discriminate against people when offering life insurance. Could this discrimination spill over into education, work, and social interactions?
“That is a big fear, but I would like to turn that around,” says Kas. “If we start to see more and more people accessing their genome, we will start to see that more people have a predisposition to certain disease. If we see that insurance companies are not insuring someone because they are predisposed to a condition, at the end of the day there will be nobody left to insure because we all have a predisposition.”
Kas goes on to explain that greater access to genomes will cause a shift in business models. Instead of guarding their personal data, Kas believes that people will be willing to share this information because it will help them to identify and respond to potential problems. This may well encourage more companies to offer genome sequencing as a service so they can better understand their customers.
Rather than rely on impersonal, universal cures, future healthcare should leverage digital technology to anticipate consumer needs and offer personalised, predictive and preventative treatments. Given the rate of acceleration in the field of genomics, and the consequent development of solutions like Kas’s human digital twins, our genomes could be the all important key to building this reality. There is still the worry that the data could be leaked or stolen, but this concern consistently underpins digitalisation. There will also need to be extensive conversations about what genomic data really means for business and society before it truly begins to improve consumer health on a mass scale. The important thing, though, is that it will.
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