Robert Maciejewski is a member of the Board of the SIP Medical Family Office, based in Zurich, Switzerland
Looking back at the history of healthcare, medicine has, for the most part, been reactive in its practical application, taking action, in other words, when health issues or symptoms occur. With few exceptions, it has also been highly standardized — a ‘one size fits all’ approach for both treatments and medications.
However, in the past few years, modern medical science has come to understand that each patient’s unique genetic and molecular profile opens vast opportunities for better, individualized treatments and more effective drug administrations leading to cost savings. With rapid advancements in genetic, pharmacogenetic, epigenetic, and other research areas, preventive (or precision) medicine has come to be the key driver in new ways to approach healthcare, attempting to discover diseases before they manifest.
This understanding is not only of medical importance. It is also a matter of developing a global view on healthcare for the good of all citizens on this planet. While precision medicine has made remarkable progress in the last few years, it is still in its infancy, with many more exciting developments on the horizon. To develop it further requires both private and governmental actors across the globe to take not a mindset of scarcity and protectiveness, but rather one of collaboration — an open approach to sharing scientific breakthroughs. Most importantly, it also requires developed countries to take the lead and make knowledge and developments available to countries with fewer resources in order to save and improve lives.
This global approach can present a huge opportunity to identify patients at risk of a specific disease or a severe variant of a disease before it materializes, greatly improving quality of life and reducing costs by allowing preventive interventions. For people with rare diseases, this global approach could lead to treatment for conditions that would otherwise not be identified or attended to. And finally, as we will discuss, it is likely to affect residence and citizenship by investment choices in the upcoming years as well.
A variety of countries, among them some that offer residence or citizenship by investment, have understood the importance of moving personalized medicine forward on a larger scale and have thus established national initiatives to support the development of personalized, or precision medicine.
Then-President of the USA Barack Obama launched the national Precision Medicine Initiative in 2015, aiming to revolutionize the way that the country improves healthcare and treats diseases. This initiative set out key focus areas such as better cancer treatments, a large‑scale national research database, privacy improvements for patient data, regulatory modernization, and stronger public‑private partnerships in healthcare.
In a similar vein, in 2014, Canada established CGEn, a federally funded national platform for genome sequencing and analysis. During the Covid‑19 pandemic, the platform proved its relevance, supporting a rapid response that allowed for the sequencing of over 150,000 virus sequences and enabling better tracking of virus transmission, understanding of host responses informing policy decisions, and guiding testing and tracing strategies, vaccine development, and drug treatments.
In 2015, Japan launched its Initiative on Rare and Undiagnosed Diseases, which has accepted thousands of patients into the program and uncovered dozens of rare diseases that would otherwise have left patients undergoing an odyssey of unclear diagnoses. Meanwhile, a strong global collaboration led to the development of the Undiagnosed Diseases Network International and a successful partnership with the International Rare Diseases Research Consortium.
In Europe, Switzerland launched the Swiss Personalized Health Network initiative in 2016 to establish and strengthen personalized medicine, with its first phase initially aimed at a nationally coordinated health data infrastructure. As of 2021, it has spawned or is supporting several national and international initiatives to foster personalized health and precision medicine, bioinformatics, and genetic research as well as better collaborations between science, government, and society. In 2017, a similar setup was launched in Austria with the establishment of the Austrian Platform for Personalized Medicine.
Finally, the question remains, ‘How do national precision medicine initiatives impact choices about residence and citizenship by investment?’ All these initiatives have in common that they are an important indicator that a country is willing to evaluate and implement changes in its healthcare system at the governmental level.
As the World Economic Forum recently stated in one of its ‘global agenda’ essays, what stands in the way of precision medicine is not science and technology, but policy and governance. Many of the questions and challenges about precision medicine concern issues such as laws for (or against) the use of health data for research, the legality of genetic testing, and the legal status of individualized and potentially life‑saving treatments for which no standardized approval processes have yet been established.
It is therefore safe to assume that countries with government initiatives around precision medicine are more likely to adapt policies that allow for better availability of personalized medicine and therefore ensure better healthcare for individuals living in these countries — including simplified regulatory frameworks that allow for faster access to scientific and medical breakthroughs, better privacy for personal health data, and more.
The quality of healthcare systems should be an important factor in the decision-making process for anyone looking into residence and citizenship by investment programs, making a review of the current state of precision medicine initiatives in a specific country a helpful, and important, indicator.
Robert Konrad Maciejewski is a member of the board of the SIP Medical Family Office, the world’s leading independent consultants for International Health Insurance and Health Management, based in Zurich, Switzerland. He is also CEO of Biolytica AG, a longevity-focused data analytics platform and personalized health solutions provider, based in Zug, Switzerland.
Before these appointments, he held executive positions in multiple industries and worked as a performance improvement strategy consultant with numerous pharmaceutical and healthcare companies.