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REVIEW article

Front. Public Health
Sec. Public Health Policy
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1464701

"Equity" in genomic health policies: A review of policies in the international arena

Provisionally accepted
Prabhathi Basnayake Ralalage Prabhathi Basnayake Ralalage 1,2*Tala Mitchell Tala Mitchell 3Claire Zammit Claire Zammit 2Gareth Baynam Gareth Baynam 4,5Emma Kowal Emma Kowal 6Libby Masey Libby Masey 7Julie McGaughran Julie McGaughran 8Tiffany Boughtwood Tiffany Boughtwood 9Misty Rayna Jenkins Misty Rayna Jenkins 10Gregory Prat Gregory Prat 11Angeline Ferdinand Angeline Ferdinand 2
  • 1 Torrens University, Melbourne, Australia
  • 2 Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Victoria, Australia
  • 3 The University of Melbourne, Parkville, Victoria, Australia
  • 4 Rare Care Centre, Perth Children's Hospital, Perth, Western Australia, Australia
  • 5 Western Australian Register of Developmental Anomalies (WARDA), King Edward Memorial Hospital, Subiaco, Western Australia, Australia
  • 6 Deakin University, Geelong, Australia
  • 7 James Cook University, Townsville, Queensland, Australia
  • 8 Genetic Health Queensland, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia
  • 9 Australian Genomics Health Alliance, Melbourne, Australia
  • 10 Walter and Eliza Hall Institute of Medical Research, The University of Melbourne, Parkville, Victoria, Australia
  • 11 Central Queensland University, Rockhampton, Queensland, Australia

The final, formatted version of the article will be published soon.

    The field of genomics is rapidly evolving and has made significant impact on the diagnosis and understanding of rare and genetic diseases, in guiding precision medicine in cancer treatment, and in providing personalised risk assessment for disease development and treatment responses. However, according to the literature, there is widespread socio economic and racial inequities in the diagnosis, treatment, and in the use of genomic medicine services. This policy review sets out to explore the concept of equity in access to genomic care, the level of inclusion of equity and how it is addressed and what mechanisms are in place to achieve equity in genomic care in the international health policy.A systematic search for genomic policies was conducted using 3 databases. In addition, General and Specific Policy Repositories, Global Consortia in Genomic Medicine, WHO Collaborating Centres in Genomics, Australian Genomics, Public Policy Projects, Global Genomic Medicine Consortium (G2MC), G2MC conference Oct 2023 and National Human Genome Research Institute databases were searched using the inclusion and exclusion criteria. Seventeen policies were selected and analysed using the EquiFrame.The Core Concept of access is highly cited in most of the selected policies. The CCs that are covered to a lesser degree are participation, quality, coordination of services, cultural responsiveness and nondiscrimination. The CCs of liberty and entitlement are not addressed in any of the selected policies. The coverage of vulnerable communities in the policies varies from country to country.Genomic health science is rapidly evolving and presents a major challenge for policies to remain current and effectively address new discoveries in the field. There is a relative dearth of policies that focus on clinical genetic services which may reflect a gap in policy and policy research translation and implementation. Recommendations for countries, irrespective of their economic and social contexts, include conducting regular policy reviews to accommodate the advances in genomics field and inclusion of specific mechanisms to achieve equity in genomic health. Insights and experiences in achieving healthcare equity in HICs and LMICs can offer valuable lessons for each other.

    Keywords: policy1, genomic2, genetic services3, equity4, Core Concept5

    Received: 14 Jul 2024; Accepted: 06 Nov 2024.

    Copyright: © 2024 Basnayake Ralalage, Mitchell, Zammit, Baynam, Kowal, Masey, McGaughran, Boughtwood, Jenkins, Prat and Ferdinand. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Prabhathi Basnayake Ralalage, Torrens University, Melbourne, Australia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.