Bridging Precision Medicine and Population Health at A*STAR

Singapore's Agency for Science, Technology and Research (A*STAR) is at the forefront of integrating precision medicine with population health research, as highlighted in the recent feature article "Found in a crowd" from A*STAR Research Issue 51. This approach, termed Precision Preventive Population Health (P3H), leverages multimodal data—including genetics, medical records, behavioral trends, and environmental factors—to identify high-risk individuals within populations and deliver tailored early interventions. Unlike traditional one-size-fits-all public health guidelines, P3H aims to shift healthcare from reactive treatment to proactive prevention, particularly relevant for Singapore's multi-ethnic Asian population facing rising non-communicable diseases (NCDs) like diabetes, cardiovascular disease, and cancer.

Meijia Ng, Director of AI for Health and Preparedness at A*STAR’s Biomedical Research Council (BMRC), emphasizes that P3H enables a deeper understanding of health risk statuses at both individual and population levels, fostering targeted strategies that enhance healthspans. A*STAR's efforts span fundamental biological research, data integration, artificial intelligence (AI), industrial partnerships, and clinical translation, positioning Singapore as a leader in Asian-centric precision health solutions. Collaborations with universities such as the National University of Singapore (NUS), Nanyang Technological University (NTU), and Duke-NUS Medical School amplify these initiatives, training the next generation of researchers through programs like NUS's Master of Science in Precision Health and Medicine.

National Precision Medicine Programme: Scaling Genomics for All Singaporeans

The National Precision Medicine (NPM) programme, coordinated by Precision Health Research Singapore (PRECISE), forms the backbone of these efforts. Launched in 2017, NPM has progressed through three phases, with Phase III announced in November 2025 aiming to enroll about 10% of Singapore's resident population—roughly 400,000 to 450,000 individuals—over five years. This phase focuses on translating genomic insights into clinical practice, partnering with public healthcare clusters like National Healthcare Group (NHG), National University Health System (NUHS), and SingHealth, alongside A*STAR's Genome Institute of Singapore (GIS).

NPM builds on earlier phases that sequenced genomes from 10,000 and 100,000 Singaporeans, creating a multi-ancestry resource reflecting Chinese, Malay, Indian, and other groups. A*STAR GIS leads in population genomics, identifying millions of novel Asian variants and contributing to precision oncology, rare disease diagnostics, and consortia on diabetes, kidney disease, and cancers prevalent in Asians. For instance, GIS's recent perspective in Nature Cancer calls for stricter standards in cancer microbiome studies to avoid contamination pitfalls, ensuring reliable biomarkers for diagnostics and therapies. Read the GIS-led guidelines in Nature Cancer.

University involvement is pivotal; NUS and NTU researchers co-lead NPM analyses, while Duke-NUS advances precision oncology through the SingHealth Duke-NUS Institute of Precision Medicine (PRISM).

Maternal and Child Health Cohorts: Insights from GUSTO and S-PRESTO

The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, initiated in 2009, exemplifies P3H in action. This prospective cohort follows over 1,000 mother-child pairs from pregnancy, collecting extensive data on lifestyle, biology, imaging, and clinical outcomes. Led by A*STAR's Institute of Human Development and Potential (IHDP) Executive Director Johan Eriksson in collaboration with NUS and KK Women's and Children's Hospital, GUSTO revealed that 1 in 5 pregnant women had gestational diabetes mellitus (GDM)—far higher than prior estimates—with 43% progressing to prediabetes or type 2 diabetes (T2D) postpartum. These findings prompted Ministry of Health (MOH) updates to postpartum screening guidelines, demonstrating real-world policy impact.

Complementing GUSTO, the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO), launched in 2015, recruits women before pregnancy to link preconception exposures to lifelong health risks. Recent GUSTO analyses show maternal mental wellbeing strongly shapes children's cognitive development, underscoring early interventions' role in precision pediatrics. NUS Yong Loo Lin School of Medicine researchers integrate these datasets with genomic profiling for predictive models.

Adolescent Wellbeing: The iAdoRe and IARP Initiatives

Extending from birth cohorts, A*STAR IHDP's Integrative Adolescence Research Programme (IARP) includes the iAdoRe study, profiling 1,191 Secondary 2 students across physical, mental, socioemotional, and biomarker data. Principal Investigators Evelyn Loo and Desiree Phua highlight shifting resilience patterns influenced by societal changes, informing public health strategies for Singapore's youth.

In partnership with the Ministry of Education and National Institute of Education (NIE, NTU), IARP identifies levers for building adolescent identity and wellbeing, crucial as Singapore grapples with rising mental health challenges amid urbanization.

Chronic Disease Determinants: Singapore Chinese Health Study

The Singapore Chinese Health Study (SCHS), involving 63,257 participants and over 520 publications, uncovers dietary and lifestyle factors in ageing. Senior Principal Investigator Woon-Puay Koh (NUS/A*STAR IHDP) links midlife plant-based diets rich in nuts, antioxidants, and B vitamins to lower risks of cancer, cardiovascular disease (CVD), and frailty. Molecular tools reveal Asian-specific genetics-lifestyle interactions, advocating culturally tailored prevention over Western models.

Precision Nutrition and Microbiome Research

Project REMEDY, led by A*STAR Singapore Institute of Food and Biotechnology Innovation (SIFBI)'s Germaine Yong with AMILI, examines ethnic diets' impact on Asian gut microbiomes dominated by Segetella from high-fiber intake. This informs personalized nutraceuticals for metabolic disorders prevalent in Singapore (e.g., T2D rates twice Western averages due to visceral fat at lower BMIs).

NTU's Melvin Leow explores functional foods like capsinoids to activate brown fat, promoting "food as medicine" for population-scale prevention. The HELIOS study (Health for Life in Singapore), a 10,000-participant cohort published in Nature Communications (2025), integrates multi-omics to dissect ethnic disparities in diabetes and CVD, revealing novel gene-metabolite links. Explore the HELIOS study details.

Allergy Management and Project ENTenna

A*STAR's Singapore Immunology Network (SIgN) Principal Investigator Anand Andiappan addresses suboptimal allergy care (affecting 90% of patients) via Project ENTenna, Asia's first rhinitis database with AI chatbots. Comprehensive profiling (IgE, eosinophils, microbiome) enables personalized therapies, partnering with NUS and Ng Teng Fong General Hospital.

AI-Driven Analytics and University Partnerships

A*STAR Institute for Infocomm Research (I²R)'s Pavitra Krishnaswamy develops AI for NPM genetic screening (e.g., familial hypercholesterolemia, FH in 1/140 Singaporeans). Collaborations with NUS, NTU, and Duke-NUS extend to systems metabolomics centers and MSc programs training precision health experts.

The A*STAR-EVYD Joint Lab deploys national platforms in Brunei for AI risk prediction and wearables, scalable to Singapore.

Photo by Mia de Jesus on Unsplash

Challenges, Future Outlook, and Higher Education Role

Challenges include data interoperability, contamination in low-biomass studies, and Asian under-representation. Future: AI platforms for digital twins, policy influence, and Asia-wide solutions. Singapore universities drive this via curricula and research hubs, positioning graduates for /research-jobs in genomics.

A*STAR's P3H promises equitable, preventive healthcare, with NPM Phase III and HELIOS accelerating discoveries.