Abstract
Accumulating evidence from international and Belgian pilot studies suggests that genomic newborn screening has reached a level of maturity that now justifies structured evaluation within a public health framework. Recent international pilot studies, including large Belgian data, now provide evidence that first-tier or adjunct genomic screening is technically feasible, clinically informative, and highly acceptable to parents.
Belgium has played a leading role in this field. The BabyDetect program has shown that targeted next-generation sequencing can be implemented in a maternity setting with high parental uptake and a meaningful added diagnostic yield beyond conventional screening. At the same time, the rapid development of international programs has exposed major unresolved questions regarding gene selection, variant interpretation, health-economic evaluation, data governance, and equitable access.
In this Insight, we argue that the debate should now move beyond whether gNBS is technically possible and instead focus on how it can be evaluated and governed responsibly within the Belgian healthcare system. We review the current evidence, highlight the specific Belgian contribution, and outline the principal challenges that must be addressed before broader public implementation can be responsibly considered.