Putting Precision Into Practice

Putting precision into practice

While Singapore may certainly be a bustling metropolis today, the early days of the emerging Republic were markedly different. Grappling with the country’s limited size, population and lack of natural resources, late founding Prime Minister Lee Kuan Yew made it a point to prioritise investments in science and technology (S&T) talent and capabilities.

In 1991, the first National Technology Plan was launched. Now known as the Research, Innovation and Enterprise (RIE) plan, the strategy lays the groundwork for Singapore’s S&T efforts over a five-year period. Indeed, the country’s robust COVID-19 response can be attributed largely to the gains in biomedical research made possible by previous iterations of the RIE. With a budget of S$25 billion lasting from 2021 to 2025, the recently-launched RIE2025 will continue to enhance local biomedical capabilities—this time, with an added emphasis on furthering human potential.

Precision medicine, with its data-driven and patient-centric approach, represents a novel way for the country’s healthcare system to deliver greater value and better health to Singaporeans. Accordingly, under the RIE2025, the National Precision Medicine (NPM) research programme will be expanded—with the resulting efforts hopefully advancing the population’s potential for healthier and more meaningful lives. Currently in its second phase, the NPM programme will be implemented and coordinated by Precision Health Research, Singapore (PRECISE).

Through the years, the national healthcare system has received much praise. Just last December 2020, Singapore topped Bloomberg’s Health Efficiency Index—an annual listing that tracks national healthcare services with the best outcomes. But with the twin pressures of an ageing population and the rising chronic disease burden, the country must innovate to continue its tradition of excellence in health.

By harnessing data from multiple sources to predict disease risk and develop targeted treatments, precision medicine represents a new, unexplored frontier in healthcare. These data sources can range from genetics to lifestyle factors like stress and diet, allowing medical conditions to be diagnosed in a more accurate, population-specific manner.

Consider how Singapore and the wider region has historically been hampered by the lack of Asian-specific genetic data, leading to incidents of misdiagnosis and ineffective treatments. Given the local presence of three ethnic groups—Chinese, Malay and Indian—the country is uniquely positioned to uncover genetic insights that can be broadly applied to these groups even outside Singapore.

In 2017, a collaborative team led by Professor Patrick Tan and Professor Tai E Shyong, now Executive Director and Chief Medical Officer of PRECISE, embarked on an ambitious project to create the world’s first multi-ethnic Asian genetic database. Known as SG10K, the effort sequenced the genomes of more than 10,000 Singaporeans. Based on these sequences, scientists identified 52 million novel variants and 14 genetic regions commonly altered in Asian populations. These altered genetic regions influence characteristics like alcohol metabolism and immune response—confirming precision medicine’s capability to reveal crucial health information benefitting Singaporeans and Asians, as a whole.

Given the potential of precision medicine, it comes as no surprise that the NPM programme’s first phase has already attracted considerable industry interest, validating the relevance of the initiative. In the next phase of the NPM programme, PRECISE will integrate population-level genomic, phenotypic, lifestyle and clinical data. These efforts will give scientists and clinicians a better understanding of the factors influencing health and disease, providing them with a sophisticated toolkit to tackle national challenges like ageing and chronic disease.

With precision medicine, high-risk groups more likely to get a certain disease can be identified and targeted testing performed to diagnose conditions at earlier and far more treatable stages. By catching and overcoming these diseases early, individuals are free to live the rest of their days to the fullest—lowering the incidence of chronic disease and fulfilling the nation’s goal to advance human health and potential.

In the NPM programme’s upcoming phase, PRECISE will also support existing precision medicine initiatives in various ways. This includes seeking to better understand public sentiment surrounding precision medicine and actively communicating its value when needed.

To accelerate clinical adoption of precision medicine, PRECISE will also generate health technology assessments to translate generated data into actionable insights. For instance, the collected data could be used evaluate the approach’s economic impacts and identify the most cost-effective ways for clinical implementation. Accordingly, more healthcare practitioners will be trained in cost-effective genomic methodologies in hopes of making precision medicine mainstream.

The SG10K project will also be scaled to 100,000 individuals, representing a treasure trove of genetic and lifestyle information. Not only will the information from SG100K result in better health outcomes, but it will also catalyse the development of local biotechnology ecosystem. By harnessing the insights made possible by precision medicine, companies in Singapore can develop and commercialise new Asian-specific biomarkers, diagnostics, and therapeutics—unlocking opportunities whose impact will surely be felt even after 2025.

With the RIE2025’s expanded focus on precision medicine, it’s an opportunity for PRECISE and Singapore to advance potential across all fronts—the economy, biomedical innovation and of course, human health.