Precision for all children: embedding equity into precision medicine for children

Precision medicine promises to improve the health and well-being of individuals with rare diseases1 2 and describes an approach to disease prevention and treatment that accounts for individual genetic, environmental and lifestyle factors.3 In paediatrics, precision medicine has included the use of genomic technologies, biomarker-guided therapies, predictive analytics and individualised prevention and treatment strategies that account for children’s contexts.3 To date, many paediatric hospitals around the world have launched precision medicine initiatives, which have largely focused on advancing diagnostic and therapeutic options for patients through genomic discovery and targeted therapies.4 Although precision medicine offers important opportunities for improving diagnosis and treatment, many children globally continue to face barriers to accessing healthcare, medications, preventive services and other foundational supports necessary for health. Reimagining precision medicine through a health equity and public health lens offers an opportunity to address systemic inequities that undermine children’s health outcomes. As precision medicine evolves, equity must be intentionally integrated so that the concept of precision extends beyond genomics and rare diseases, ensuring that persistent disparities in paediatric care are not unintentionally widened.