Precision medicine has the potential to transform healthcare by moving from one-size-fits-all to personalised treatment and care. This transition has been greatly facilitated through new high-throughput sequencing technologies that can provide the unique molecular profile of each individual patient, along with the rapid development of targeted therapies directed to the Achilles heels of each disease. To implement precision medicine approaches in healthcare, many countries have adopted national strategies and initiated genomic/precision medicine initiatives to provide equal access to all citizens. In other countries, such as Sweden, this has proven more difficult due to regionally organised healthcare. Using a bottom-up approach, key stakeholders from academia, healthcare, industry and patient organisations joined forces and formed Genomic Medicine Sweden (GMS), a national infrastructure for the implementation of precision medicine across the country. To achieve this, Genomic Medicine Centres have been established to provide regionally distributed genomic services, and a national informatics infrastructure has been built to allow secure data handling and sharing. GMS has a broad scope focusing on rare diseases, cancer, pharmacogenomics, infectious diseases and complex diseases, while also providing expertise in informatics, ethical and legal issues, health economy, industry collaboration and education. In this review, we summarise our experience in building a national infrastructure for precision medicine. We also provide key examples how precision medicine already has been successfully implemented within our focus areas. Finally, we bring up challenges and opportunities associated with precision medicine implementation, the importance of international collaboration, as well as the future perspective in the field of precision medicine.

Race statistics and race policy have been intertwined in American history since its founding, starting with the infamous three-fifths clause, continuing with policies based on nineteenth-century race science, the restrictionist immigration at the turn of the century, the Jim Crow regime, and carrying into the civil rights era through such policy concepts as institutional racism, statistical proportionality, disparate impact, and affirmative action. Across this history, the policies and the statistics were about “race,” whether they punished or benefited, were racist or antiracist. But can there be policy that misuses race statistics, that is presented as about race when it should not be? Race statistics are a powerful policy hammer in American history, but not everything is, in fact, a nail. Today the census undercount is argued over as if it is about race; it isn't really. Posing far greater danger, census race categories have worked their way into genomic medicine. The nineteenth-century belief that “race is biological” lingers in the American mind. The use of census categories in genomic medicine risks re-biologizing race. Maybe we should not leave the hammer lying around.