Precision Medicine: Tailoring Healthcare for Individual Needs

It’s official: The rate of non-communicable diseases (NCDs) and infectious diseases is a major challenge in South Africa and worldwide. For example, according to a report published by Statistics South Africa, deaths in South Africa resulting from NCDs, comprising chronic lower respiratory disease, diabetes, cancer, and cardiovascular diseases, increased by 59% in the 20 years between 1997 and 2018.?

While the news that the rate of NCDs and infectious diseases is on the rise is worrying, precision medicine provides a glimmer of hope that we may be able to turn the corner in the near future. Precision medicine has gained increasing attention in healthcare because of technological advances, genomics, and our better understanding of individual variations. It has profoundly impacted oncology, making possible more effective and less toxic treatments for precise genetic mutations.?

But what is precision medicine, how will it impact healthcare, and what must we do to ensure it benefits everyone? This is the question I have been asking myself lately. In this piece, I want to attempt to answer it and look at how precision medicine may be the answer to the development of personalised diagnostics, targeted therapies, and individualised treatment plans based on genetic information.

Precision medicine, or personalised medicine (PM), is an emerging field that leverages data analytics and state-of-the-art technology to create treatments and prevention strategies tailored to prevent medical conditions or treat them based on unique genetic, lifestyle, and environmental factors.

Genomics: Denotes studying a complete set of genes (genome) to understand how genetic information impacts disease and health.

Proteomics: Involves the study of an individual’s proteins to identify biomarkers, develop personalised treatment plans, and understand disease mechanisms at a molecular level.?

Oncology: Refers to applying tailored medical treatments based on precise molecular and genetic characteristics of an individual’s cancer.?

Data analytics: Involves deploying advanced technology to analyse large datasets of clinical and biological information to identify personalised treatment approaches based on an individual’s specific characteristics.?

Precision medicine differs from the traditional one-size-fits-all approach in that it considers the individual characteristics of each patient. Taking a personalised approach permits targeted, more accurate strategies, making it possible to identify therapies with the best chance of being effective for specific individuals.

At the foundation of precision medicine is genomic research, which involves the study of genes to gain precise insights into the genetic basis of diseases. Research helps understand genetic variations and how specific genetic changes impact disease susceptibility, progression, and response to treatment.?

When research is used to identify genetic factors for different diseases, it becomes easier to assess an individual’s risk of developing specific conditions. Genomic data also allows for patient stratification, which plays a profound role in developing clinical trials and interventions for specific subpopulations, boosting the chances of successful outcomes.?

Through genomic research, large amounts of data can be generated. When this data is integrated with environmental, clinical, and other applicable information, it becomes possible to gain a wide-ranging understanding of individual health. With machine learning and artificial intelligence techniques, the analysis of data collected through research becomes more efficient, making it possible to gain insights from the research.

Notwithstanding the promise of precision medicine, which is huge, we need to recognise the challenges associated with it. Dealing with the challenges is important if we ever hope to realise the full potential of precision medicine and ensure that it is implemented responsibly and doesn’t leave anyone behind.?

Here are some of the challenges we need to look out for:?

I recently read a press release from the Keck School of Medicine of the University of Southern California, which highlights the disparities in the accuracy of determining risk for disease between Caucasians and Hispanics. The false positive rate for the former is 10%, while the latter is 60%.?

The same press release adds, “Such a disparity means that minorities are being left out of the major advances made by precision medicine in the detection and treatment of disease.” If these issues are not addressed, and these technologies are unavailable to the majority, they are likely to exacerbate existing healthcare disparities .

Precision medicine heavily relies on personal genetic health data. Because this type of data is often sensitive, it is crucial to ensure the security and privacy of such information. If patients do not believe that their information is secure and their privacy is guaranteed, gaining their trust would be a huge challenge, which would be detrimental to the whole precision medicine project.??

There are also complex issues around obtaining informed consent for genetic and personal data use. Understanding the consequences of sharing their data can be a huge challenge for the ordinary patient.?

In the excitement of the potential represented by precision medicine, it’s easy to overlook the challenges associated with cost and access. The costs associated with rolling it out can be so high that accessibility to particular communities can be limited.?

Also, integrating precision medicine into the existing healthcare infrastructure requires a huge investment in infrastructure and practices. Healthcare providers must train staff to understand and use genetic information effectively.

The reality that precision medicine will transform healthcare in the foreseeable future is no longer in doubt. We all agree that the approach holds great potential in terms of prevention and early detection of diseases, especially in the area of oncology, where it has been noted that targeted therapies are more effective.?

What is not certain is whether we will use the potential of precision medicine to close the gaps currently existing in the provision of healthcare or we will allow it to exacerbate them. To attain desirable outcomes, it will be vital for us to work in collaboration to deal with ethical issues and challenges linked to data privacy and ensure that precision medicine includes as many people as possible.