How genetic testing can change healthcare in South Africa

Genes also relate to a much broader range of physical capabilities and traits, such as how you absorb nutrients, which sports you’ll perform better at, and even whether the medication a doctor prescribes for you will work efficiently.

That’s why we’re so excited about the power of genetic testing in improving people’s health, and why we’re rolling out a pilot campaign with a South African-based medical biotech company Intelligence in the first quarter of 2023.

Let’s take the efficacy of certain medications as an example of its potential. When HIV medications are in the development phase, most are tested on Europeans in Europe or the US, or on Asians in Asia. So when evaluating the success of these medications, the focus tends to be on the predominant gene type found in those particular ethnic groups, which isn’t necessarily suitable for our population in South Africa (in fact, the most commonly prescribed HIV medication here isn’t necessarily well metabolised by those from an African ethnic group). However, if you do a gene test, you can immediately ascertain which available medicine would likely be the best option for a particular person.

Another example is that certain people don’t produce sufficient Vitamin D when exposed to sunlight. Vitamin D is essential for strong bone growth; if you don’t have enough of it in your body, you could have a higher propensity for stress fractures and broken bones. But suppose you did a gene test and discovered this about yourself. In that case, you could take a vitamin D supplement, which would strengthen your bones and hopefully equate to fewer injuries and a healthier body overall.

These two use cases demonstrate how genetic testing could improve the care of patients, reduce costs, and save time. Instead of doctors having to go through a process of trial and error with medication, sometimes even increasing medication dosages if the current dose isn’t working for a patient, gene testing means they’d be presented with data that would empower them to make more informed treatment decisions.

This will particularly help those living with chronic conditions, as well as identify those who have a propensity for certain conditions. A high-profile example of this was Angelina Jolie who chose to have a double mastectomy after discovering she had a gene mutation that carried a much higher risk of developing breast and ovarian cancers.

So how does Fedhealth plan on using genetic testing? To start with, we’ve identified a large group of members currently using chronic medication to manage five specific conditions, including diabetes and hypertension. We’re offering to run a free gene test for them to test for drug-to-person interaction, so we can assess whether their current medication is doing the best job possible to manage their condition.

We’ll also be approaching a subset of people with a specific claim history and offering them gene testing to see whether they’re at risk for contracting certain diseases, in what’s known as a predisposition check. For example, this could reveal that a person’s body doesn’t process sugar properly so they’re at higher risk of developing diabetes. While they may feel healthy at the moment, knowing this now means that we can help them make lifestyle changes to ensure that they don’t become diabetic in future.

The gene testing itself is painless and requires a simple buccal swab, which is like a long earbud swiped on the inside of a person’s cheek. The swab is placed in a sealed container and sent off to the lab, where it is processed and collects over 800 000 gene data points.  This information is then loaded onto a secure server to ensure confidentiality.

Beyond these two pilot programmes (paid for by the Scheme), we’ve negotiated a special rate for those Fedhealth members who voluntarily want to have gene testing performed – depending if they want pharmacogenomic (how your body reacts to medication), predisposition (as mentioned above) or lifestyle data (nutrition, sport, etc).

It’s important to know that while gene testing can tell you that you have a predisposition for heart issues, for example, it doesn’t mean that you will definitely have a heart attack one day. Similarly, just because it doesn’t show up that you have a predisposition for cancer, it doesn’t mean you will never get cancer.

If our pilot programmes start to deliver results in terms of people receiving better quality care and reducing healthcare costs (for example by having fewer members hospitalised) then we plan to roll gene testing out on a bigger scale, making it an ongoing part of our patients’ treatment programmes.

The human body is complex and affected by many factors, but knowledge is power. We’re excited about the potential for this technology to improve our members’ healthcare and well-being, as well as empower medical professionals to make better decisions.

Author: Jeremy Yatt, Fedhealth Principal Officer