Precision medicine registered significant progress since the release of the First Draft of the Human Genome Project with technical advancements in sequencing approaches and a continuous drop in the cost of genome sequencing. However, the lack of diversity in the genetic datasets limits its impact on the real world as selective sequencing within and among countries excludes a large segment of the world population. Moreover, the precision medicine advancements are mostly restricted to High-Income countries (HIC) with a minimal presence in Lower and Middle-Income Countries (LMIC). It would further expand the health disparities between HIC and LMIC. Diversity in genomic research is essential from a scientific perspective too, as diverse genomic variability across the human population is pertinent to realise the full potential of precision medicine. It would, therefore, be in the interest of HIC to engage with the LMIC to better understand the biology of diseases. COVID-19 exemplifies how a unified approach to the pandemic through sharing and collaboration leads to meaningful results.

India has a gene pool of 4000 population groups and a heavy share of inherited diseases. It reflects a wide range of challenges relating to precision medicine in LMIC. With a thriving start-up culture, strong IT base, and an excellent pool of scientists and medical experts, India holds the potential to become a hub for precision medicine. However, to translate this potential into practice, India needs to address numerous challenges: affordability and accessibility of precision medicine to the average population, unorganised health and insurance sector, fragmented research structure (individual research-driven), uncertain IP policies (largely untested in the context of precision medicine) and sub-optimal regulatory system. In addition, genetic literacy and awareness among patient's/research participants and trust in the healthcare system are primary challenges. India makes significant progress by emphasising predictive and promotive health care, innovative and multi-prong approaches to collaboration, and science diplomacy in its National Health Policy and the Genome India Project 2020 (aiming at reference genome in a phased manner). However, a dedicated policy framework for precision medicine helps translate its potential into practice.