Personalized healthcare initiatives in Qatar are part of a coordinated and comprehensive strategy aiming to deliver world-class future health care. Qatar Foundation (QF) has recently established the Qatar Precision Medicine Institute (QPMI), by merging two Qatar Foundation entities – Qatar Biobank and the Qatar Genome Program.
This Institute will be responsible for consolidating national efforts and resources and steering future activities in a coordinated manner towards the realization of Precision Medicine strategy for Qatar.
The Qatar Precision Medicine Institute plans to implement a shift from supporting precision medicine endeavours, at the basic research level, towards clinical implementation. The Institute will capitalize on the great wealth of data generated by activities of Qatar Biobank and Qatar Genome Program and their research results and translate this into impactful clinical practices that positively influence the health of the local population.
The Precision Medicine strategy has been taken with strong collaboration between healthcare providers and research institutes in the country.
Director of Clinical Operations, Primary Health Care Corporation, Dr. Maryam AI Emadi, has contributed to the development of the recent policy briefing on Precision Medicine that was launched by the World Innovation Summit of Health (WISH) during the WISH 2020 Summit.
Dr. Al Emadi highlighted the main elements needed to achieve the broader integration of precision medicine in healthcare systems, given the involvement of various stakeholders.
“We have collaborated with WISH, Qatar Foundation’s healthcare initiative, to develop and launch a policy briefing on Precision Medicine (PM) that provides concrete recommendations on moving forward with the initiatives in Qatar and internationally. According to the policy, there are five key recommendations for implementation of Precision Medicine that are needed to achieve the broader integration of precision medicine in healthcare systems,” Dr. AI Emadi told The Peninsula.
The first is to create community awareness and precision medicine education programs. These need to be delivered across various platforms. Examples include online educational information, collaborative forums, identification of physician, pharmacists and community leaders to engage patients and participate in regional events that raise awareness and promote precision medicine and updating medical and pharmacy schools curricula to integrate precision medicine concepts and continuing Medical Education Programs.
The second is to engage and empower patients. This can be achieved by including patient representatives in the development of proactive policies and practices related to patient protections and the use of individual molecular information.
Additionally, programs need to be developed to explain diagnostic test results to patients; provide them with recommendations and easy access to related information and counseling services.
The third is to communicate the value of precision medicine. Several methods to achieve this can be implemented, including conducting precision medicine economic impact studies that are meaningful to stakeholders; developing standards and measurable targets for comparative effectiveness studies; and implementing proactive policies that incentivize healthcare providers for optimizing treatments based on individual patient characteristics.
The fourth is to develop appropriate infrastructure and information management systems. This will require effective coordination of institutional policies and processes that assure effective communications through the continuum of care and across research and clinical programs and the development of an effective process for making programmatic decisions.
Policies will need to be developed to incentivize data sharing and facilitate real-time data exchange for learning health systems.
The final key element is to integrate precision medicine into standard healthcare system and ensure access to care. To achieve this, policies will be needed that ensure clinical guidelines and support technologies are focused on providing the best treatment strategies for individual patients. Additionally, professional fees for precision medicine services must be adequate, access to experts and counselors, where appropriate, must be available and a precision medicine healthcare system-wide approach and delivery models must be implemented.
“Integration of precision medicine into healthcare systems will be challenging. The challenges include, a lack of awareness, knowledge and value recognition by healthcare service providers and the general public about precision medicine practices and benefits.
"Another challenge relates to a lack of clarity regarding the clinical and cost effectiveness of precision medicine. Additionally, the requirement for roles and responsibilities to be redistributed among different health professionals to enhance work performance and standards of care is a significant challenge,” said Dr. AI Emadi.
Precision Medicine is a dynamic field encompassing a diverse approaches that allow the targeting of new medicines, screening programs or preventive healthcare strategies.
A fundamental dimension of precision or personalized medicine is identification of subtypes of diseases, most often viewed as driven by knowledge of molecular biomarkers that influence disease presentation.
According to Dr. AI Emadi, Qatar Foundation plays a pivotal role in driving and boosting precision medicine and implementation in the national healthcare system. Qatar Biobank and Qatar Genome Program have been instrumental in boosting the concept of precision medicine in Qatar and now with the establishment of Qatar Precision Medicine Institute, QF can continue to move forward with implementation of the Precision Medicine strategy for Qatar.
“QF’s research, development, and innovation ecosystem and the organization’s commitment to helping to build a healthier nation and a healthier world through knowledge and innovation will be key to realizing the aims of Qatar’s precision medicine strategy,” said Dr. AI Emadi.
“QF’s support for many educational institutions across Qatar will help to develop new generation of scientists and innovators in the field of precision medicine. QF has invested in graduate-level training of professionals who will be able to make use of genomic data. Some of the QF programs aim to develop researchers who can derive new genomics insights that can be translated into clinical practice and other QF programs train professionals to be able to effectively advise patients and their families about a range of genetic conditions,” she added.
Qatar has many members of its population who are exposed to risk factors for developing chronic disease. In 2012, the Qatar Stepwise Survey found a 70.1% prevalence of overweight and obesity among respondents and a 46% prevalence of low physical activity. It also found a 91.1% prevalence of poor nutrition and a 16.4% prevalence of tobacco consumption among respondents.
The Qatar National Vision 2030 is founded upon four pillars. One among them is the human development pillar which seeks to empower the people of Qatar to be able to sustain and support Qatar’s growth. This pillar identified that the prosperity of any country depends on the health of its people. As a result, Qatar aims to build a comprehensive world-class healthcare system that is effective, affordable and universally available to all citizens.
As part of this transformation effort, in 2016, Qatar Foundation established the Qatar Genome Program, which aims to position Qatar among the pioneering countries in implementing precision medicine into their healthcare systems.
The mission of the Qatar Genome Program is to improve healthcare of its people and contribute to a knowledge-based economy through innovation and integration of genomic and other ‘omics’ technologies into medical and research practices.
Speaking about the role of government policy makers in terms of implementing regulations to ensure a wider use of precision medicine, Dr. Al Emadi said: “Contemporary applications of precision medicine, and the potential impacts of these on public health policy and decision-making has a significant dependence on how government policy makers set the framework for implementing regulations to ensure a wider use of precision medicine.”
Precision Medicine challenges the historical methods of allocating healthcare funds based on safety, efficacy, and efficiency, as Precision Medicine focuses on individualized variations in pathology rather than a "one size fits all" approach.
Public health policy and decision-making must adapt to this new frontier of healthcare delivery to ensure that the broad public health goals of reducing healthcare disparities and improving the health of populations are achieved, through effective and equitable allocation of healthcare funds.
“Regulations for engaging health-care professionals are important for the transition towards a precision medicine-based health care system. Precision medicine’s ultimate goal is improving health of well-defined patient groups. Policy makers must bear in mind that precision medicine will affect all stakeholders in the healthcare system at multiple levels spanning the individual perspective to the societal perspective,” added Dr. Al Emadi.
