As genomic sequencing becomes more accessible, healthcare systems face a broader challenge: translating genetic information into useful, reliable and equitable patient care. Across Asia Pacific, this requires evidence that represents the region’s diverse populations, consistent data standards and healthcare professionals equipped to interpret and apply genomic findings.
In this interview, Prof Patrick Tan explores the opportunities for precision medicine across the region, the barriers to routine clinical adoption and how Singapore’s National Precision Medicine Programme is building evidence for future implementation. The discussion also examines PRECISE’s role as the Global Alliance for Genomics and Health’s first Regional Hub Institution in Asia Pacific.
From your perspective, what are the biggest opportunities for precision medicine to improve healthcare across Asia Pacific over the next decade?
Asia Pacific is home to more than half the world’s population, with tremendous diversity in its populations, healthcare systems and research capabilities. The region has a mix of established and emerging national genomics and precision medicine programmes, each bringing valuable experiences and perspectives. Over the next decade, as these programmes evolve, many will generate new insights into the genetic diversity, health and diseases of Asian populations. This will strengthen the global evidence base, improve how genetic risks and variants are interpreted, and create opportunities for better disease prevention, diagnosis and treatment.
Equally encouraging is the growing international interest in the Asia Pacific and recognition of the region’s importance to global genomics. Greater participation in international collaborations will allow Asia Pacific’s diverse experiences and research findings to help shape how genomic research is conducted, data is shared and international standards are developed.
As the Global Alliance for Genomics and Health’s (GA4GH) first Regional Hub Institution in Asia Pacific, PRECISE hopes to support this growing momentum. Building on Singapore’s experience with its National Precision Medicine Programme, we aim to connect genomics programmes and institutions across the region, facilitate knowledge exchange and collaboration, and create more opportunities for Asia Pacific to contribute to and help shape the global genomics agenda.
What are the main barriers preventing genomics and precision medicine from being integrated more widely into routine clinical care?
Genomic sequencing, including whole-genome sequencing (WGS), is a core component of precision medicine. While sequencing costs have fallen considerably, they remain a barrier for some healthcare systems, particularly at scale. Beyond affordability, common standards are essential to ensure genomic data is of reliable quality and can be interpreted consistently across programmes, laboratories and technologies, and shared securely across institutions and healthcare systems. PRECISE researchers have contributed to the development of GA4GH’s Whole-Genome Sequencing Quality Control Standards, which are now being advanced towards international ISO standardisation. This underscores the importance of international collaboration in developing standards that support the wider adoption of genomic medicine.
Equally important is the readiness of healthcare systems to integrate genomic information into clinical practice. A key challenge is building a workforce equipped to deliver genomic medicine. As genomic testing becomes more widely available, healthcare professionals must be able to understand, interpret and apply genomic information in patient care. This requires sustained investment in education, training and capability development, not only for genetic specialists but also for the broader healthcare workforce.
International initiatives such as the Global Genomics Network for Education and Training (GGNET) play an important role in addressing this need by facilitating knowledge exchange and improving access to genomic education and training resources. PRECISE recognises the value of such efforts and shares GGNET’s commitment to strengthening genomic workforce capabilities. Our Chief Innovation Officer, Clinical Associate Professor Tan Ee Shien, also serves as a trustee of GGNET, bringing an Asia Pacific perspective to international discussions on genomic education and training.
How important is greater representation of Asian populations in genomic research, and what impact could this have on diagnosis and treatment?
Greater representation of Asian populations in genomic research is critically important because the consequences of underrepresentation extend beyond research. Lack of representation of Asian genomes can translate into missed diagnoses, inaccurate risk assessments and treatments that may be less effective or appropriate for certain populations. When genomic reference datasets are drawn predominantly from populations of European ancestry, genetic variants that are more common or unique to Asian populations may not be adequately understood or interpreted.
In Singapore, familial hypercholesterolaemia (FH), an inherited condition associated with high cholesterol and an increased risk of premature heart disease, provides a compelling example. FH affects approximately 1 in 140 people in Singapore, compared with global estimates of around 1 in 250 to 300. This difference highlights the importance of population-specific research in understanding disease prevalence and informing screening, early diagnosis and preventive care.
Another example is pharmacogenomics, where genetic differences influence how individuals respond to medications. Certain genetic variants are more prevalent in Asian populations and can increase the risk of serious adverse drug reactions. Research in Thailand, for example, established a strong association between the HLA-B*15:02 genetic variant and severe adverse skin reactions to carbamazepine, a medication commonly used to treat epilepsy. A subsequent Thai study demonstrated that genetic screening was associated with significantly fewer severe adverse reactions. Similarly, in Singapore, the introduction of HLA-B*15:02 screening as standard of care in 2013 contributed to a 92% reduction in reported cases of severe skin reactions associated with carbamazepine. These examples demonstrate how genomic research involving Asian populations can translate into safer, more personalised treatments and inform clinical practice across the region.
Against this backdrop, we are particularly pleased that Singapore hosted the GA4GH Plenary for the first time in Asia, bringing together the international genomics community and highlighting the region’s growing contributions to genomic research and medicine. The designation of PRECISE as GA4GH’s first Regional Hub Institution in Asia Pacific during the same week marks another important milestone. Through this role, we hope to build on the momentum generated, strengthen connections among genomics programmes and researchers across the region, and create more opportunities for Asia Pacific’s diverse populations, experiences and perspectives to contribute to and help shape the global genomics agenda.
What role should governments, healthcare systems, researchers and industry play in building a stronger precision medicine ecosystem across the region?
Building a strong precision medicine ecosystem requires close collaboration among governments, healthcare systems, researchers, industry and the public. Each brings different capabilities and perspectives, but the real value comes when these stakeholders are aligned around shared priorities, with clear pathways for research findings to be translated into healthcare, policy and economic outcomes.
Singapore’s National Precision Medicine (NPM) Programme is an example of a national programme that has successfully brought these different stakeholders together within a coordinated national strategy. PRECISE was established as the central entity to coordinate NPM, working across research institutions, healthcare clusters, government agencies and industry partners. This has enabled us to build an ecosystem that spans the research-to-impact continuum, from scientific discovery and evidence generation to clinical implementation, policy development and enterprise growth.
Importantly, the value of such an ecosystem lies not simply in bringing stakeholders together, but in ensuring that there are mechanisms and institutions ready to take research findings forward. For example, research on familial hypercholesterolaemia (FH) has helped inform Singapore’s national FH genetic testing programme, providing a pathway for genomic evidence to be applied in preventive healthcare. This illustrates how research can generate impact when healthcare systems and policymakers are ready to act on the evidence.
The same principle applies to industry partnerships. By bringing together public-sector research strengths and specialist industry capabilities, we can accelerate technology development, build local expertise and create opportunities for Singapore companies to grow. These partnerships generate value beyond individual research projects, contributing to the development of a sustainable precision medicine ecosystem.
As genomic technologies become more accessible, how do you see their use expanding beyond rare diseases and cancer into broader areas of healthcare?
Under NPM Phase II, PRECISE launched five Clinical Implementation Pilots to explore how genetic testing could be responsibly integrated into routine clinical care and to generate local evidence on clinical utility, cost-effectiveness and system readiness. FH and hereditary breast and ovarian cancer (HBOC) have provided sufficient evidence for the Ministry of Health (MOH) to consider broader adoption. MOH is reviewing some of the other pilots as future use cases.
One of our pilots on pre-emptive pharmacogenomics to guide prescriptions represents a change of model—rather than responding after a patient has had an adverse reaction, the information is available before the first prescription is written.
The same shift is reflected in the design of the programme itself. Phase II studied healthy volunteers. Phase III will recruit patient participants through our three healthcare clusters, across a wide spectrum of conditions and at a scale of roughly 10 per cent of Singapore’s local resident population. Studying people with existing medical conditions allows us to understand how genetic, lifestyle and environmental factors interact across the full range of conditions Singaporeans are being treated for.
The pace of expansion is set not by technology alone, but by the evidence, assessed together with our healthcare clusters, clinical specialists, and patient, public and policy stakeholders. Together, this group assesses the following before a condition is proposed for mainstreaming: whether early diagnosis leads to better patient outcomes; how common the condition is and what it contributes to disease burden in Singapore; whether the healthcare system is ready, with clear care pathways, trained clinicians and the capacity to act on findings; and how patient participants themselves wish to be approached.
What developments in genomics and precision medicine are you most excited about, and where do you think the field is heading next?
One of the most exciting developments in genomics is the shift from research and discovery towards clinical implementation. Advances in sequencing technologies have enabled us to generate genomic data at an unprecedented scale. The next challenge, and opportunity, is translating this wealth of information into meaningful improvements in healthcare, from earlier diagnosis and more accurate risk prediction to more targeted treatments.
As more countries move towards clinical implementation, the focus is moving to establishing clinical utility, developing appropriate care pathways and ensuring that healthcare systems are equipped to use genomic information effectively. In Singapore, our National Precision Medicine (NPM) Programme is now in its third phase, with a focus on studying patient populations and linking genomic data with health information. Building on the population-level insights generated in earlier phases, we aim to better understand the genetic basis of diseases and generate evidence to inform future clinical applications. We look forward to sharing findings as the research progresses, particularly insights that could help shape how precision medicine is introduced into healthcare.
Equally exciting is the growing contribution of Asia Pacific to the global genomics landscape. With a mix of established and emerging national genomics programmes across the region, we can expect new insights into the genetic diversity, health and diseases of Asian populations over the coming decade. As these programmes evolve, there will be greater opportunities for researchers and institutions to exchange experiences, collaborate and contribute to shaping global research priorities and standards.
Hosting the GA4GH Plenary in Asia for the first time, together with PRECISE’s designation as GA4GH’s first Regional Hub Institution in Asia Pacific, comes at an opportune time. Singapore has benefited greatly from being part of the international genomics community, and we look forward to building on these relationships to strengthen regional collaboration and support the translation of genomic advances into better health outcomes for our populations.
