Precision medicine and public health interventions: tuberculosis as a model?

Tuberculosis provides an excellent model for how precision medicine can enhance public health through adoption of new technology and facilitation of rapid expansion at the population level. Drug-resistance is an emerging crisis for which appropriate diagnostic tools are either unavailable or inadequate. Conventional phenotypic drug-susceptibility testing can identify only low numbers of resistance mutations with a long delay from the time of tuberculosis diagnosis. Consequently, only a fraction of patients with drug-resistant tuberculosis are detected and placed on adequate treatment; ineffective or delayed treatment renders patients infectious longer and propagates the crisis.