Often associated with sophisticated exams and high-cost treatments, precision medicine is still seen as a reality restricted to highly specialized centers. A new international commission created by the scientific journal The Lancet, titled “The Lancet Commission on Precision Health”The group aims to change this perception. It brings together more than 20 experts from various countries, including Iscia Lopes-Cendes, a professor at the Faculty of Medical Sciences (FCM) at Unicamp and a researcher at the Brazilian Institute of Neuroscience and Neurotechnology (Cepid-Brainn), based at Unicamp.
Lopes-Cendes, a specialist in genomic medicine and technologies applied to neuroscience, is one of two representatives from Latin America in the group, which also includes psychiatrist Christian Kieling from the Federal University of Rio Grande do Sul (UFRGS). According to her, the commission's objective is to formulate recommendations so that precision health strategies can be equitably incorporated into health systems worldwide.
In this process, he emphasizes, Brazil can play an important role. "I see Brazil as having a great responsibility to do the right thing, because we are a showcase for other countries in Latin America and for countries in the Global South."
According to Lopes-Cendes, the country occupies a strategic position because it possesses characteristics that can transform it into a benchmark. "We can implement this equitably because, as long as it occurs within the Unified Health System (SUS), which has enormous reach, it will benefit all Brazilians."
The researcher emphasizes that the combination of a universal public system, the increasing integration of health databases, and the accumulated experience in prevention policies puts Brazil in a privileged position to test models that can later be replicated in other regions of the world.
“Given Brazil’s characteristics—a country that produces a great deal of statistics and is currently transitioning to a higher level of development—there is significant international interest in what happens here. Brazilian case studies may be published within the commission. Our healthcare system is very organized in terms of record-keeping and data production, and this allows for the development of very interesting research,” he added.
The commission was created to address a growing challenge in healthcare systems. Although scientific advances have demonstrated that genetic, environmental, behavioral, and social factors influence the onset of diseases and the response to treatments, most medical care is still based on population averages and standardized protocols. The so-called precision health seeks precisely to incorporate this diversity. "We decided not to call the commission 'precision medicine,' but 'precision health,' because we can recommend actions related to lifestyle, behavior, and even public policies," he explains.
According to Lopes-Cendes, the approach will only fulfill its potential if it is adapted to different economic and social realities. “This is another area where Brazil can contribute a great deal. We have very well-established prevention strategies within the SUS (Brazilian Unified Health System). One example is the Family Health teams, which go to homes, make diagnoses, monitor people, and act before they need to seek care at a health unit. When the team goes to a person's home, they see what the person eats, observe the environmental conditions, and understand the social context. All of this is important information.”
Over the next few years, the group will conduct systematic reviews of the scientific literature and analyze experiences already implemented in different countries. The goal is not to produce original research, but to identify the strategies that worked and those that failed in order to develop recommendations for governments, health managers, and researchers. “We want to prevent governments and health systems from having to reinvent the wheel. We will show how far the knowledge has progressed and propose recommendations.”
Lopes-Cendes also emphasizes that the commission seeks to preserve its independence from economic interests. According to the researcher, the The Lancet It adopts rigorous criteria both for selecting members and for raising funds. "The goal is to avoid, as much as possible, the impression that groups with specific economic interests are influencing the work," he emphasizes.
The results are expected to be released over the next three years in a series of documents and scientific articles published by The Lancet, covering areas such as cancer, cardiometabolic diseases, mental health, and neurological diseases.
Guidelines strengthen research
The advancement of precision medicine depends not only on new technologies, but also on the quality of research produced in the field. With this goal in mind, an international group of experts published, in 2024, a set of guidelines aimed at standardizing studies on precision medicine.
Named BePRECISE, the document was prepared by 23 researchers and published in the scientific journal. Nature MedicineThe initiative arose after an analysis of hundreds of studies that identified frequent flaws in the way scientific results are presented, making it difficult to compare research with the practical application of findings.
The recommendations propose more rigorous criteria for describing methods, results, and clinical impacts, as well as emphasizing the need to include historically underrepresented populations in scientific research. The goal is to ensure that the benefits of precision medicine reach different social groups and not just populations in wealthier countries.
According to the authors, precision medicine has the potential to make diagnoses, treatments, and prevention strategies more effective by considering the biological, environmental, and behavioral characteristics of patients. However, for this potential to translate into concrete benefits for the population, it is necessary to produce more consistent, transparent, and representative scientific evidence that reflects population diversity.
Learn more on the official website.
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