The contemporary development of genomics – the decoding of our DNA – marks an important turning point in how we understand the human. This is nowhere more apparent than in the UK, which is leading the world in investing in and developing powerful genomic technology platforms that may have profound consequences for the future of healthcare, civil liberties and personal identity. While these developments have been gestating for two decades, they matured and moved centre stage during the pandemic with the massive increase in gene sequencing for tracking Coronavirus. This chapter will examine the social implications of the growing use of genomics and gene-based screening technologies, and analyse how they are contributing to an important shift in how we understand human health. This emphasizes the biological and individualized nature of disease in contrast to the social determinants of health and illness, supporting an increasingly biomedicalized understanding of the human.

A vision of genomic medicine to improve personal and population health

The massive public and private investment in genomics over recent years is inspired by a vision of so called ‘personalized medicine’, where treatment is guided by a knowledge of an individual’s genetic makeup. This is used to assess the risk of disease, design better treatment regimens and predict response to therapy. It is being enabled by the growth of targeted therapeutics and gene-based diagnostics that stratify patients and diseases into discrete sub-populations. This utopian imaginary also aims to improve public health by enabling new forms of population surveillance based on genetic risk profiling and reproductive ‘choice’ through improved antenatal screening. For its advocates this offers hope for a new kind of medicine which identifies the underlying cause of many diseases as being within the body, rather than in the external environment.

The development of genomic medicine is an international phenomenon, being actively pursued in North America, Europe and East Asia. It is driven by major government investment, as well as novel forms of public-private collaboration, and is best illustrated in the UK, which is establishing itself as a global leader.

Over recent years, a series of large-scale projects have started to develop the core infrastructure for the widespread adoption of genomic medicine in the UK National Health Service (NHS).