Adopt precision medicine to improve treatment and lower medical costs

A trolley with pills on a blue background in the concept of cost of medicines. [Getty Images] One of the most ambitious goals of humanity is to live longer while still being young and healthy. The drafters' of Article 43 of the Constitution sought to guarantee every Kenyan the right to the best possible standard of health. This is also the mantra of Universal Health Coverage and Sustainable Development Goal (SDG) 3. A World Health Organisation (WHO) report published in 2018 depicted the state of health in the African region and gave guidelines to countries as they plan to achieve the SDGs. The report noted that Kenya's health status was low in comparison to what was required to achieve the SDGs and advised the country to expedite efforts to address communicable diseases, non-communicable diseases, and injuries among hard-to-reach populations. One approach to catalyse this goal is to ensure that our country is gradually in sync with the rest of the world. As medicine advances around the world, it is prudent for the Ministry of Health to espouse new medical technologies that will improve our health and substantially reduce high medical expenditures. One way to ameliorate the high medical cost is to adopt precision medicine, a new therapeutic and preventive approach that sets out to galvanise a new model of patient-powered medicine which delivers 'the right treatment at the right time to the right patient'. Currently, the modus operandi for most medical treatment accommodates the "one-size-fits-all" approach which is a costly undertaking in the long run from the standpoint of health economics. Globally, research has shown that only 40 per cent of the drugs prescribed are appropriate or effective for the right patient. This could explain why there is a rise in antimicrobial resistance as indicated by the Lancet Journal. It is quite dispiriting but that is how things are. Today, we practice trial-and-error medicine which does not take into account person-to-person variability, and this becomes the primary factor contributing to the variations in how well medications work for various people. Precision medicine ingeniously takes into account individual differences in genealogy, environment, and lifestyle. The three-prong discovery will grant doctors the latitude to design and sagaciously predict a therapeutic plan that is most effective and consequently keep our families healthier. However, political benevolence will play an impetus role in making this initiative a reality, especially when it comes to financial allocation for research focused on specific characteristics such as genetic profiling. Because of our apathy toward new medical discoveries, the honed abilities of molecular scientists have become redundant and as such, developed implementation slough. They do not have the luxury of practicing what they were taught in school, and the country is likely to face a brain-drain if they are given a wide berth due to inaccessibility and unavailability of the most advanced molecular technology. Without any doubt, precision medicine will unlock the conundrum surrounding cancer prevention and treatment. For example, molecular testing is frequently performed on patients with leukemia, melanomas, and other malignancies as well as breast, lung, and colorectal cancers as part of patient care. This enables doctors to choose therapies that increase prognosis and lessen the risk of side effects. Haphazard drug administration without adequate testing leads to unnecessary drug overload which might not only be ineffective in particular patients but may be detrimental to them. Mr Marcomic is a Field Epidemiology and Laboratory Training Programme Resident-Nairobi. mjmaragia@gmail.com

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