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Precision Medicine


For years, gaps in communication networks


formed part of the problem. With phone lines and cable internet only reaching more built-up commu- nities in Africa, anyone living outside of a decent- sized town would be unable to use any web-based services to easily connect with clinicians. Establishing a phone cable network is a huge and costly undertaking, and these networks were never able to connect every person on Earth. But with the arrival of mobile technology, access rapidly improved26. Placing a mobile reception mast is far less costly than laying a cable network and this has allowed remote communities to ‘leapfrog’ past cable technology straight to wireless connectivity. This brings new opportunities for creative solu-


tions to bring healthcare to everyone. Any technol- ogy that can be delivered through a wireless net- work can reach far and wide. This could include healthcare apps, drone delivery or designs for 3D- printing medical materials. Some of this is already happening. In Rwanda, the local government worked with Babylon Health to launch a nation- wide service that allowed people to access virtual consultations through an app on their phone, from anywhere in the country27. With digital healthcare technology already


democratising access to medical expertise around the world,more people than ever before are getting access to healthcare. This is all the more reason to make sure that future medical advances in preci- sion medicine will be available to everyone. By democratising genomic research in the same way, hand in hand with new digital technology, coun- tries whose populations are currently under-repre- sented in genetic databases can make great strides in filling this gap in information by actively recruit- ing participants into research studies. Increasing the diversity of genetic databases


helps everyone, not only those people who are cur- rently not well-represented. Investment in this area will increase the opportunities for finding new genetic links to disease, providing knowledge that can benefit all of us. With more diverse genomes being sequenced, formerly rare genetic variants may turn out to not be so rare after all, attracting industry investment in what might have seemed like relatively niche targets for new drug develop- ment. And with a broad collection of genetic vari- ants from many different populations, we may bet- ter understand the pharmacogenetic reasons for adverse drug effects, which ultimately saves time and money in clinical testing. There is enormous potential for the develop-


ment of new precision medicine drugs to reach large, global markets, but that can only happen


Drug DiscoveryWorld Summer 2019


with access to more genomic information and insights from different populations around the world. It is time to move from the concept of a gold-standard ‘human genome’ to ‘humanity’s genome’ – a globally-diverse set of reference genomes drawn from many populations – to ensure that the revolution in precision healthcare will bring benefits to everyone, wherever they come from and wherever they live.


DDW


Continued from page 54


Sumit Jamuar is co-founder, Chairman and CEO of Global Gene Corp. He has held several senior leadership positions in start-ups, global client cov- erage, strategy&transformation and a turnaround unit in an FTSE 100 company in London.


Dr Jonathan Picker is co-founder and co-Chief Scientific Officer of Global Gene Corp. He is Assistant Professor of Paediatrics at Harvard Medical School and a clinical geneticist at Boston’s Children’s Hospital.


Dr Saumya Jamuar, MBBS, MRCPCH, is co- founder and co-Chief Scientific Officer of Global Gene Corp; Head, SingHealth Duke-NUS Genomic Medicine Center, Singapore; Attending, Genetics Service, KK Women’s and Children’s Hospital, Singapore; Assistant Professor, Paediatrics, Duke-NUS Medical


School,


Singapore; Clinical Director, SingHealth Duke- NUS Institute of Precision Medicine, Singapore; and PI, Singapore Undiagnosed Disease Programme


Dr Yaron Turpaz MBA is Chief Data and Technology Officer and Managing Director of Global Gene Corp. He was previously the Chief Information Officer at Human Longevity, Inc (HLI) and Managing Director of Human Longevity Singapore. He has previously worked at AstraZeneca as Vice-President, R&D IT, the Eli Lilly Singapore Centre for Drug Discovery as Director of Integrative Computational Sciences and Affymetrix, Inc.


20 Kaiser, J.Million-person U.S. study of genes and health stumbles over including Native American groups. Science (2019). doi:10.1126/science.aay2081. 21 Mulder,N et al.H3Africa: current perspectives. Pharmacogenomics and Personalized Medicine (2018). doi:10.2147/PGPM.S141546. 22 Akinyemi, R et al.APOL1, CDKN2A/CDKN2B, and HDAC9 polymorphisms and small vessel ischemic stroke. Acta Neurologica Scandinavica 137, 133-141 (2018). 23 A massive genome- sequencing effort is coming to India.MITTechnology Review Available at: https://www.technologyreview. com/f/610573/a-massive- genome-sequencing-effort-is- coming-to-india/. (Accessed: 16th June 2019). 24 BIA. Precision medicine heads to Namibia, courtesy of Global Gene Corp and UNAM.Available at: https://www.bioindustry.org/ne ws-listing/precision-medicine- heads-to-namibia-courtesy-of- global-gene-corp-and- unam.html. (Accessed: 16th June 2019). 25 Bylstra,Y et al. Implementation of genomics in medical practice to deliver precision medicine for an Asian population. npj Genomic Medicine 4, 12 (2019) doi: 10.1038/s41525-019-0085-8. 26 Aranda-Jan,CB,Mohutsiwa- Dibe,N and Loukanova, S. Systematic review on what works,what does not work and why of implementation of mobile health (mHealth) projects in Africa. BMC Public Health 14, 188 (2014). 27Tran Ngoc,C et al. Conclusions of the digital health hub of theTransform Africa Summit (2018): strong government leadership and public-private-partnerships are key prerequisites for sustainable scale up of digital health in Africa. BMC Proceedings 12, 17 (2018).


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