Nigel Paneth, MD, MPH, University Distinguished Professor, Emeritus from the Departments of Epidemiology & Biostatistics and Pediatrics & Human Development at Michigan State University.
Title: PUBLIC HEALTH IN THE AGE OF GENOMICS: WHY PRECISION MEDICINE IS FAILING
Abstract: The past three-quarters of a century in biomedical science can be characterized as the genetic age. Between 1958 and 2024, 21 Nobel prizes in medicine or physiology have been awarded for discoveries in molecular genetics, 32% of the total. In 1999, Francis Collins said, “Since the 1970’s nearly all avenues of research have led to the gene.” (Collins F: New Engl J Med 1999; 341:28-37). The Human Genome Institute at NIH has spent $10 billion since its founding in 1989, $7 billion since 2003 when the human genome was sequenced.
And what improvements in health can be attributed to these scientific efforts? While the application of molecular genetics to microbial agents has made important contributions (e.g. mRNA vaccines), and disorders of strongly genetic origin are now better understood, the repeated assertions that human genomic information would lead to large scale improvements in health has not proven to be the case.
The seven decades of the genetic age have witnessed remarkable improvements in public health, but, paradoxically, virtually none of these benefits can be attributed to human genomics. They have largely been the result of studies, many of them epidemiological, of factors operating in the environment, and the use of these findings to improve health. The discordance between the resources devoted to human genomics and the extraordinary hype surrounding precision medicine on the one hand and the paucity of any measurable public health impact on the other is striking and requires a re-evaluation of priorities in biomedical research funding.
