Genomics and the future of health

Genomics has moved from scientific promise to clinical inevitability, reshaping how nations think about disease, prevention and the very architecture of healthcare. Across the world, the case for precision medicine is no longer theoretical. It is anchored in a simple, uncomfortable truth: modern medicine is not serving enough people well enough. As Dr Alireza Haghighi of Harvard Medical School puts it, “Modern medicine is one of the best achievements of humankind, but it is not as precise as it should be.” 

The scale of the challenge is staggering. The WHO estimates that 4.5 billion people lack access to essential healthcare services. Even where care is available, it often misses the mark: nearly every individual carries genetic variants that alter how they respond to standard treatments, according to large-scale pharmacogenomics studies.  

Against this backdrop, the rise of population-scale genomics is more like structural necessity. In the UAE, Professor Shahrukh Hashmi, Director of Research at the Department of Health, Abu Dhabi, describes a system moving deliberately toward “a data-driven approach to a resilient and digital health ecosystem,” one built on multi-omics, pharmacogenomics and a widening research network that now spans every continent. The Emirati Genome Programme, for instance, which has sequenced more than 850,000 whole genomes, has become one of the largest and most ambitious population genomics initiatives globally. “Our collaborations are culminating in clinical research projects helpful not only for people in the UAE but for the globe,” Hashmi says. 

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What sets these newer genome programmes apart is not scale alone but inclusivity. More than 100,000 expatriates have already contributed samples. National biochemical screening at birth and early pharmacogenomics implementation are widening the clinical pipeline further. For Hashmi, fairness is foundational: “Anytime you develop precision medicine or gene therapy, you’re helping the whole world. That is the goal.” 

Haghighi argues that genomic data, long neglected in many regions, is finally being recognised as a core health asset. Before large national programmes began in the Middle East, home to over 400 million people, around 5% of the world population, contributed well under 1% of the genomic data used in major studies. In some genome-wide association datasets, only about one in 600 participants is Arab. “This data is super precious,” he says. “Countries don’t need charity. They have something the world needs, unique human datasets, which can be responsibly monetised and used to expand access.” 

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Europe offers a different model: one built on public governance and structural trust. Estonia’s experience stands out. Twenty-five years after founding its national biobank, the country has genomic data from 20% of its adult population and remarkably high public approval. “We started with the law,” says Professor Mait Metspalu, Head, Estonian Genome Centre, University of Tartu. “Clear governance and constant communication have kept trust strong.” Participants now receive personalised polygenic risk scores for conditions such as type 2 diabetes and coronary artery disease, a reminder that the value of participation must flow both ways. 

Digital inequity remains the unresolved fault line. Precision medicine hinges not only on sequencing capacity but on digital literacy and technological access. As Metspalu notes, “To benefit from personalised medicine, patients must be digitally educated.” The divide exists as sharply within countries as between them.