Didier Trono Interview “Switzerlands Genetic Diversity is Unique”

Were there ethical concerns from the public about sequencing?

Samples for the pilot phase came from the CHUV biobank and were processed according to a protocol approved by the cantonal ethics committee. We used an opt-out approach, whereby participants were informed and given the option to decline. In the end, less than 2% opted out, which shows that there’s strong public interest in genomic research and much less resistance than commonly thought. For the full-scale project, we will use new technologies allowing a more complete and in-depth sequencing of the genome. Earlier approaches, while highly efficient, did not yield clear insights into what many still call “the dark genome” which accounts for more than 50% of our DNA that is derived from virus-like genetic elements and is increasingly recognized as playing fundamental roles in human biology and disease. Some groups in Switzerland have developed world-leading expertise in this field.

How is the project funded?

Sequencing the first 1,000 samples was jointly funded by PHRT and SPHN. But now we need about 12 million Swiss francs to complete the full-scale project. We are looking for support from both private and public sources. In a joint response, the heads of the State Secretariat for Education, Research and Innovation (SERI) and of the Federal Office of Public Health (FOPH) turned down a request for support for the Genome of Switzerland project, citing the difficult federal budget situation and a lack of legal basis for financing this type of project. Thirty-one European countries are participating in the Genome of Europe project, with the EU covering only 20% of its costs. The UK was early to identify genomic science as a cornerstone of future health management and is investing heavily in this field, as are the US, Singapore, China and others. It is very worrisome that the Swiss government fails to identify genomic medicine as a strategic priority. Consequences could include second-rate medical care, or the management of our health by foreign companies that may not share our ethical values or may operate under the authority of governments with nationalistic priorities.

What will be the key benefits of this research?

Genetic factors play a role in nearly all human diseases, and, accordingly, genomics constitutes an essential pillar of precision medicine. A prerequisite to the practice of personalized health and precision medicine is to acquire a good knowledge of the genetic diversity present in the population and to apply frontline technologies within a legal framework that reflects the core ethical values of our society. In oncology, sequencing tumor genomes is already a standard approach for optimizing treatments. If Switzerland does not step up its efforts, it risks lagging behind in this critical field. Genomics also plays a major role in prevention. By identifying genetic risk factors early on, we can implement proactive health strategies. Take pharmacogenomics, for example, which helps determine which medications work best for an individual based on their genetic makeup. It is simply not acceptable that patients in a rich country such as Switzerland continue to receive ineffective or even harmful medication, just because genomic screening is not being utilized as it should be.

Is artificial intelligence being used in this research?

Absolutely. Machine learning is essential for analyzing the vast quantities of genomic data being generated. Many patterns in genetic data can only be detected through statistical modeling and AI-driven analysis. Medicine has always been somewhat empirical—treatments often work before we fully understand why. AI allows us to identify meaningful patterns and drive discoveries at an unprecedented pace. But even with AI, you need data to train your models and to gain a better understanding of the mechanisms. Without large-scale sequencing, there is no such data to feed the algorithms.

Why is it critical for Switzerland to be part of the European genome project?

First, it is the expertise. If we do not do our own sequencing, we remain dependent on others and cannot advance our own technology. Second, it is representation. Switzerland’s genetic diversity is unique, and excluding our population from these databases would be a missed opportunity. Lastly, it is autonomy. I don’t want Swiss health data to be controlled by foreign tech companies in the US or China. It is a matter of national sovereignty in one of the most sensitive aspects of life.

How long will it take to sequence the 15,000 genomes?

With proper funding, we could finish within a couple of years. We have the technology and expertise in place; we just need financial backing.

Do you think genomic awareness is increasing in Switzerland?

Yes, it is, but we definitely need more education in politics, in the training of physicians and also among the public. Preventive medicine ultimately saves costs and improves quality of life. Unfortunately, Switzerland still focuses more on treatment than on prevention. That mindset needs to change.

What’s your final takeaway?

Switzerland has the potential to become a global leader in the field of genomics, which is not only a pillar of modern healthcare but also acts as a catalyst for the growth of health-related companies. The people of Switzerland are ideally suited to take responsibility for their health if provided with all the necessary information. We have an educated population, top-tier research institutions, and the financial capacity to invest. The Genome of Switzerland project and the skills it will foster will empower our country to exercise full sovereignty over the generation and use of highly sensitive information to deliver the highest standard of healthcare to its people.