Precision medicine should not be viewed as a distant technological concept, but as part of an ongoing shift in how healthcare systems understand and respond to human diversity, writes Sarker M Shaheen
WHEN a DNA test can reveal not only ancestry but also how a person’s body responds to specific medications, healthcare begins to shift from generalisation to individualisation. This is the promise of pharmacogenetic testing, an emerging field within precision medicine that studies how genetic differences influence drug response. It marks a departure from traditional approaches that rely on standardised treatment protocols for entire populations.
Precision medicine represents a broader transformation in healthcare delivery. Instead of applying a ‘one-size-fits-all’ model, it integrates genetic makeup, environment and lifestyle to guide medical decisions. The goal is more targeted treatment, selecting the right drug at the right dose for the right patient. This approach can reduce adverse drug reactions, improve treatment effectiveness and minimise the economic burden of ineffective therapies.
Traditional medicine, by contrast, is largely built on population averages. Clinical guidelines are developed based on how most patients respond, but individuals often differ significantly in metabolism and genetic structure. As a result, treatments that work well for some may be less effective, or even harmful, for others. Precision medicine seeks to address this gap by tailoring care to biological variation rather than statistical averages.
In mental healthcare, for example, this limitation is particularly visible. Patients with depression, anxiety, or neurodevelopmental disorders are often prescribed medications through a trial-and-error process. Several rounds of adjustment may be needed before an effective drug is found, exposing patients to prolonged side effects and families to additional financial strain. Pharmacogenetic testing can reduce this uncertainty by identifying how an individual is likely to respond to specific medications, improving both safety and efficiency in treatment.
Globally, pharmacogenetics is already being integrated into selected healthcare systems. In some clinical settings, it is used to guide psychiatric medication selection and reduce adverse drug reactions, particularly in cases involving complex or treatment-resistant conditions. While still an emerging field, its early applications suggest meaningful potential in improving treatment precision and reducing healthcare inefficiencies.
Bangladesh, however, faces a distinct set of health system challenges that make this discussion particularly relevant. The country is currently experiencing a dual burden of disease: persistent infectious diseases alongside a rapidly rising prevalence of non-communicable diseases such as heart disease, diabetes, cancer and stroke. At the same time, mental health conditions are becoming increasingly visible, though still significantly under-addressed within the health system.
These challenges are compounded by structural inequalities in healthcare delivery. Access to quality medical services remains uneven between urban and rural areas, while resource constraints continue to limit long-term planning and investment. Environmental pressures, including pollution and rapid urbanisation, further strain public health systems. Although Bangladesh has achieved notable successes in areas such as immunisation and child health interventions, sustaining and expanding these gains is becoming more complex as disease patterns evolve.
In this context, precision medicine and pharmacogenetic testing offer a potential pathway toward improving treatment efficiency and reducing systemic strain. By minimising trial-and-error prescribing, especially in chronic and psychiatric care, such approaches could help reduce both medical costs and patient suffering. They also align with the growing need for more efficient resource use in a health system facing increasing demand.
However, the adoption of such technologies requires more than scientific possibility. It demands institutional readiness, regulatory frameworks, trained professionals, and equitable access mechanisms. Without these, precision medicine risks remaining confined to experimental or urban elite healthcare settings, rather than becoming part of the broader public health system.
The policy implications, therefore, extend beyond technology alone. They raise questions about how Bangladesh prepares its health system for a future in which personalised treatment may become increasingly relevant. This includes investment in medical research capacity, ethical frameworks for genetic data use, and integration of new tools into existing healthcare structures without widening inequality.
Ultimately, precision medicine should not be viewed as a distant technological concept, but as part of an ongoing shift in how healthcare systems understand and respond to human diversity. For Bangladesh, where disease burdens are rising and healthcare systems are under pressure, the question is not whether such tools are scientifically valid, but whether institutional and policy frameworks can evolve quickly enough to make them accessible and effective.
The future of healthcare will not only depend on new technologies, but on how effectively they are integrated into systems that are already stretched. Precision medicine may offer part of that future, but only if it is accompanied by the infrastructure and commitment required to translate scientific potential into public benefit.
Sarker M Shaheen is a researcher in neurogenetics and precision medicine of psychiatry at University of Calgary.
