On 19 October, Belgian health Minister Maggie De Block submitted to Parliament her traditional "note de politique générale" on health for the year 2018.
As a sign of the times, one of the proposals is the introduction of whole genome sequencing ("WGS") in routine clinical practice in oncology and haemato-oncology. The Belgian Health Care Knowledge Centre is currently studying the practical arrangements for such an introduction, its societal implications and what will be needed, in particular in terms of the training of health care staff.
The Minister also announced that she is currently working on a reimbursement scheme for WGS, through an amendment to the nomenclature Article 33bis (laboratory services, under ISO 15 189).
At this stage, it is difficult to envisage the extent to which this project, if it materializes, would involve action on the ground. Indeed, the recommendations from the ongoing reviews include the establishment of a "centralized infrastructure", implying that, if routine genomics in oncology were to emerge, the related expertise would nevertheless be concentrated on one or a limited number of actors.
Also, the general policy note does not, at this stage, envisage WGS in relation to other areas of care, such as rare diseases.
If this initiative is carried out to completion, it may enable Belgium to make up for its relative delay in comparison with other OECD countries in terms of WGS in oncology, as recently highlighted in data from the Global Alliance for Genomics and Health (GA4GH) [Birney, E, Genomics in healthcare: GA4GH looks to 2022, Table 3, first posted online 15 October 2017: http://dx.doi.org/10.1101/203554].