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Guest curator: Prof Dame Sally Davies

I remember sitting in a dark office in 2012 in the UK’s Department of Health working through the complexities of how we could make the 100,000 Genomes Project happen. This week, I had the pleasure of speaking at the celebratory event recognising its success. The UK is the first country in the world to sequence 100,000 genomes. I am very proud of what has been achieved by the researchers, staff and most importantly patients and families.

However, we must not rest on our laurels if we are truly to unlock the potential of the human genome. The power of genomics is available and we need to embed it into the fabric of NHS services, which is the role of our new NHS Genomic Medicine Service.

Antimicrobial resistance was a big part of my work this week, as always. I am proud of the work of the NHS and of meat producers to reduce antibiotic use, but globally much more needs to be done. I am working hard alongside the World Health Organization to implement the recommendations of the United Nations Interagency Group on AMR, of which I am a co-convener: we need a UN leadership group covering human health, agriculture, animals and the environment to keep up momentum and action across the world.

Looking ahead for fresh opportunities has always been a strong theme for me. My last annual report explored what health could and should be like in 2040. My final report as chief medical officer will be on global health: last week I convened a workshop to identify some of the key themes, such as how the UK should support global health.

Global health is about security, sustainability and equity. Some communities in England have poor health outcomes that are often hidden by national averages. This is why I believe we need a composite health index to judge our progress, which would look not only at health outcomes but also social determinants and modifiable risk factors such as obesity, exercise and smoking.

A key aim of my annual reports is to look strategically and make recommendations on how to improve systems and, ultimately, health. So, watch this space but if the global health workshop is anything to go by, it will be fascinating.

What I'm reading

I have just finished Educated by Tara Westover, which is moving on the human level but also demonstrates the power of education to ignite people’s lives.

I have also just started The Masters by C.P. Snow as a fun preparation for my installation in October as Master of Trinity College, Cambridge. I am listening to a wonderful young composer called Owain Park, who writes ethereal music and I hope will compose a Te Deum for my installation ceremony at Trinity.


Three questions

Jon Symonds CBE, HSBC’s deputy group chairman and Genomics England chair

Why did you decide to become the chair of Genomics England?

It took a nanosecond to decide. The introduction of genomic-based medicine is the most ambitious project I have been involved in and the one with the most far-reaching impact. It is also one of the few areas where the UK has the ability legitimately to lead the world in the introduction of personalised medicine at a national scale. It represents the true confluence of biology, physics, computing power and data analytics on a huge scale. We now need to move from a project to an operational organisation in partnership with the NHS as we move from 100,000 genomes to up to 5m through the NHS and with research partners. That is a hugely inspiring and challenging task that is, quite simply, too important not to be achieved.

What are the challenges of getting genomics into the NHS?

The introduction of genomic-based medicine in the NHS has the potential to turn the system upside down. Genomics has the power to both predict and anticipate the incidence of chronic illness and debilitating disease, speeding up earlier diagnosis and treatment. This will generate better health outcomes, use more cost-effective therapies and enable the NHS to deliver more for less. We have to proceed in partnership with the NHS and its patients, but the progressive digitisation of health and the power of analytics can transform the provision of health in the UK. If we can do that, the NHS will continue to be the envy of the world.

In my last annual report, I made the case to reposition health as the nation’s primary asset. As a leader in the finance sector, could you outline how important you think health is to the economy?

The “health of the nation” is the most productive asset we own. It has always puzzled me that healthcare has only ever been characterised as a cost or a percentage burden on GDP. In truth, it’s the biggest single economic investment the UK makes and it’s time that we measured the economic potential released from better health. It’s a triple win – people living longer with a lower incidence of chronic disease, and being more economically productive later in life while reducing the overall cost of health. That is an economic policy well worth fighting for. 


News round-up

Crackdown on junk food ads as Chief Medical Officer warns of impact of social media promotions (Telegraph). I believe we need to fundamentally reposition health as the nation’s primary asset. Part of this is creating an environment that makes the healthy choice the easy choice.

Anti-vax movement must be resisted for the sake of world health (FT). Vaccines work, they are safe and have saved countless lives. I implore everyone to vaccinate their children to protect them from potentially deadly diseases.

The relationships between democratic experience, adult health, and cause-specific mortality in 170 countries between 1980 and 2016: an observational analysis (CFR). Demonstrating the association between democracy and health gain.

The war on ‘prediabetes’ could be a boon for pharma — but is it good medicine? (Science). We have continually to challenge our priors, so this is fascinating.


Best from the journals

Breast Implant-Associated Lymphoma (JAMA). Confirming the association, though rare, between implants and lymphoma

How secret conversations inside cells are transforming biology (Nature). What is says on the tin

Intimate Partner Violence (NEJM). Such an important area, which I highlighted in my annual report.

Cardiology’s problem women (Lancet). Opening the debate on gender relating to involvement in research and patient management. For all I know about it, this is still shocking

Antibiotic and acid-suppression medications during early childhood are associated with obesity. (BMJ Gut). I cannot get this article out of my head

Exposing Anopheles mosquitoes to antimalarials blocks Plasmodium parasite transmission (Nature). So malaria eradication may be possible. A new approach.

Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol.(NEJM). High cholesterol is associated with heart attack and stroke. New treatments and approaches will help. As I have hypercholesterolaemia I follow this science carefully.

A Longitudinal Study of Ebola Sequelae in Liberia. (NEJM) A sobering read. The world is good at emergency response but this demonstrates the need for following through.

Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials (BMJ). A systematic review (the gold standard for evidence in health) of management of an all too common problem for many of us.

Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories 1990-2016 (Lancet). Highlighting how gender inequity remains a powerful driver of poor adolescent health in many countries.


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