Geneticist sees end of treatment inequities as personalised medicine gains traction.
Dr Geoff Chambers sees an era, maybe only a decade away, where we'll all receive personalised medicine based on our own distinct DNA make-up.
But until then, the leading Victoria University molecular geneticist says, there are already enough known differences between Maori, Pacific Islanders and Europeans that our country should no longer have a "one size fits all" approach to healthcare.
Over the past 25 years, Dr Chambers has identified genetic markers that trace the origin of Austronesian people - Polynesian, Maori, Melanesian, Micronesian and people from parts of Southeast Asia - tens of thousands of years back to Taiwan.
His work has also created molecular methods to pinpoint indicators for a range of diseases, including diabetes, and his latest research has produced even more evidence.
Recent research has suggested these bug-busters are likely to behave differently depending on whether we're Maori, Pacific Islanders or Europeans.
"It goes some way to explaining why some autoimmune diseases that are relatively common in people of European descent - such as multiple sclerosis - are virtually unheard of among Maori and Pasifika," Dr Chambers said.
"It also partly explains why diseases such as type 2 diabetes are more common in Maori or Pasifika people." On the flip side, other conditions like coeliac disease and some forms of rheumatoid arthritis were very rare in Maori.
Because of his research, Dr Chambers believed there was a case to reconfigure what he saw as an "existing inequity" in medical treatment.
"Many new drugs have been developed by Europeans for Europeans, but if we are to deliver these advances effectively to Maori and Pasifika people then we need new information, which we must uncover ourselves," he said.
"This requires knowing something about their genetic make-up."
With genetic technology becoming more accessible, cheaper and quicker to use, he believed the future looked promising for DNA-tailored healthcare.
"I can see that in 10 years, we will have an era of personalised medicine where everybody can get their complete profile, and will know much more about what's important in our genes and what isn't."
Professor Andrew Shelling, head of Auckland University's Medical Genetics Group, also saw big advances in personalised medicine on the near horizon. While genetics would play a strong part around understanding genetic diseases, there would be challenges when it came to targeting more complex conditions, such as obesity, where clinicians were also dealing with a range of potential contributing factors.
Dr Stewart Jessamine, the ministry's acting director of public health, said it was already well known in New Zealand that some diseases occurred at different rates in people with different ethnicities or when they are located in different countries.
"While some of these differences may be due to local factors such as diet, the environment or socioeconomic deprivation, these external variables cannot explain all of the differences that can be found in terms of the rates of a medical condition, or in the differences in how patients respond to standard medical treatments," he said.
"There is no doubt that the evolving area of genomics will provide an explanation for some of the differences in frequency and outcomes of morbidity and mortality found between people with different ethnicities."
But while genomics could help fill in some of the existing knowledge gaps, Dr Jessamine said, it was unlikely to provide the answer to all outstanding questions as to why a person develops a particular disease.
"Like the rest of the world, New Zealand will be monitoring and adapting its health services on the basis of advances in best practice, some of which will be driven by advances in genetics."
Assassins choosy on targets
They call them natural killer cells - a roaming group of assassins whose job is to seek and destroy viruses and other foreign organisms that enter our bodies.
Recent research has suggested these bug-busters are likely to behave differently depending on whether we're Maori, Pacific Islanders or Europeans.
Victoria University's Dr Geoff Chambers said this had been highlighted by the behaviour of what he called "molecular spies".
Once they identified an infected cell, they travelled back and docked with the killer cells to deliver their reports.
"These guys basically ring back on a molecular telephone - only what we've seen is that in Europeans, the killer cells only listen to reports on Vodafone, and in Maori and Polynesians, they only listen to 2degrees reports.
"So responses to infectious diseases are quite likely to be quite different, but we don't yet know anything about that because we haven't yet tied it on to a survey."
