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Non-communicable diseases (NCDs) kill more than 41 million people every year, accounting for 71% of all deaths globally. The prevalence of NCDs is estimated to be higher than that of infectious diseases in Africa by 2030. Precision medicine may help with early identification of cases, resulting in timely prevention and improvement in the efficacy of treatments. However, Africa has been lagging behind in genetic research, a key component of the precision medicine initiative. A number of genomic research initiatives which could lead to translational genomics are emerging on the African continent which includes the Non-communicable Diseases Genetic Heritage Study (NCDGHS) and the Men of African Descent and Carcinoma of the Prostate (MADCaP) Network. These offer a promise that precision medicine can be applied in African countries. This review evaluates the advances of genetic studies for cancer, hypertension, type 2 diabetes and body mass index (BMI) in Africa.

According to the Precision Medicine Initiative, a long-term research measure involving the National Institutes of Health and other centers, precision medicine is defined as “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.” By contributing to the prevention and treatment of disease and improved health, big data and artificial intelligence play critical roles in precision medicine. The idea of harnessing all available data and techniques can be traced to the Huangdi Neijing, a book about ancient Chinese medicine practices. Currently, we have the tools to collect vast amounts of genomics data along with state-of-the-art data analytics for interpretation. With the availability of new resources and techniques, we are advancing our understanding of genomics and medicine with increasing precision.

Precision medicine as defined by the Precision Medicine Initiative is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.” The overarching goal of precision medicine is to yield information that helps us move away from an untargeted “average response” treatment approach to a more personalized and selective approach that aims to increase the benefits and reduce harm. In this chapter, we provide a brief overview of the approaches of precision medicine and examples of the current clinical applications and discuss the challenges associated with its implementation.

Errors in the preanalytical phase, spanning activities from ordering a test to presenting a sample for analysis, were reported to constitute the majority of clinical lab errors; however, the issue is still undermined, especially, in clinical trials. Patient preparation does not only include deprivation of food or, even, alcohol intake for a certain period of time, but noncaloric beverages, smoking, and exercise can make big differences in lab results. Type of blood collection tube, level of filling, way and magnitude of mixing, size of the needle, amount of pressure, and length of time for tourniquet application, capillary versus venous blood collected by a syringe or from intravenous line, plasma versus serum all can be significant preanalytical variables. Tumor acquisition with the length of warm and cold ischemia, preservation and embedding into paraffin can alter tissue quality and biomarker results remarkably. Unless properly controlled, specimen processing, handling, storage, and transportation can induce a lot of errors. Unfortunately, these variables can be exaggerated in clinical trials where samples are, mostly, dealt with busy staff with limited or no lab experience.

While reports praised the significant improvement in clinical lab analyses due to automation and implementation of internal and external quality tools, lack of traceability and the concept of gold standard is making clinical lab quality as a moving object with no hope to get better but, instead, worsen by time. Revealing real-life data, this chapter shows unbelievable discrepancies in biomarker results with its imminent disastrous impact on patients and drug discovery. Results from a single sample can be different by as much as more than 100-fold if analyzed by different labs or even by a single lab using different instruments. Just changing a lot of reagents can cause difference in results from a single sample that conceals a medical decision cutoff. These issues are not just in novel high complex molecular diagnostics but in grandfather, believed standardized, short list of assays such as lactate dehydrogenase, low-density lipoprotein cholesterol, and international normalized ratio.

Precision medicine initiative is an attempt to improve disease treatment and prevention by taking into account individual variability in genes, environment, and lifestyle for each person. Successful application of new knowledge generated by precision medicine will ultimately require the availability of precision drugs: drugs that act exclusively on disease molecular targets without impacting adversely on the rest of the body. This review examines recent progress to developing such site-specific targeting drug systems. Progress to such a goal has been slow. It is concluded that material science needs to take into full consideration the essential properties and requirements of body physiology. In turn, biology needs to define unique features of disease on which effective drug-delivery systems could be based.

The US government has launched a major initiative to develop precision medicine into a workable model that can eventually be applied in day-to-day clinical practice. This chapter sums up the main components of the Precision Medicine Initiative (PMI), which includes a 10 year -1 million person study that looks at numerous genetic, clinical, environmental, and psychosocial factors that contribute to health and disease. This chapter also covers PMIs at several major academic centers.

President Obama announced in his 2015 State of the Union address that he was launching the Precision Medicine Initiative (PMI), calling it “a bold new research effort to revolutionize how we improve health and treat disease” [(1)][1]. Under the auspices of the PMI, the National Institutes of