15 Apr 2019
The importance of public health genomics to ensure health security for Australia
A coordinated, national approach to whole genome sequencing is urgently needed to future-proof Australia’s health security.
In a Perspective in the latest issue of the Medical Journal of Australia (MJA), University of Melbourne Associate Professor Deborah Williamson, Deputy Director of the Microbiological Diagnostic Unit Public Health Laboratory at the Doherty Institute, and colleagues argued the need for the “integration of whole genome sequencing-based surveillance into existing communicable diseases control systems” as recently recommended by the World Health Organization (WHO).
Genomics uses sequencing technologies and bioinformatic analyses to determine the genome sequences of pathogens – the data can be used to predict resistance to antimicrobials, a pathogen’s virulence traits and to understand the relationships between pathogens at the highest possible resolution.
Associate Professor Williamson said whole genome sequencing could provide accurate detection of outbreaks and timely and targeted public health responses, particularly in light of the threat posed by antimicrobial resistance.
“Whole genome sequencing has the potential to revolutionise the investigation and surveillance of communicable diseases by providing the highest possible characterization of pathogens,” she said.
The implementation of a practical national strategy for microbial genomics in Australia is required to ensure the best health outcomes and keep pace internationally, with both the US and UK already successfully implementing national strategies.
Associate Professor Williamson and colleagues reported in the MJA that although certain places in Australia had used the technology, the complexities of Australia’s communicable diseases systems meant that the full potential of microbial genomics was not being realised.
“There remain considerable constraints in sharing epidemiological and laboratory data at a national level (and privacy concerns about sharing data across state borders), along with jurisdictional differences in laboratory testing and reporting,” they reported.
“Further, smaller jurisdictions often do not have access to timely whole genome sequencing and associated bioinformatic expertise, leading to an inequity of resource and infrastructure across the country.”
In Australia microbiology laboratories recently established the Communicable Diseases Genomic Network, “a collaborative public health, clinical microbiology and infectious diseases partnership that aims to facilitate the implementation of whole genome sequencing into infectious diseases surveillance and response”.
The authors called for “national resourcing, coordination and transparent collaboration between state and territory microbial genomics systems”.
“[This] is critical to increase Australia’s capacity to detect, respond to and control infectious threats, and to improve regional health security,” Associate Professor Williamson and colleagues concluded.