32 Bangladesh Journal of Medical Science Vol. 19 No. 01 January’20 Review article: Prospects and Challenges of Precision Medicine in Lower- and Middle-Income Countries: A Brief Overview Mainul Haque 1 , Tariqul Islam 2 , Massimo Sartelli 3 , Adnan Abdullah 4 , Sameer Dhingra 5 Abstract: The trend of NCDs in most LMIC countries is slowly but gradually follows that of in the developed countries. There are four significant diseases reported by WHO, which are equally common, such as CVDs, diabetes, cancer, and chronic respiratory disease that causes widespread early death & morbidity. Indeed, it incurs an overwhelming financial burden to most countries in the world. The rise of drug-resistant microbes is another major problem. To overcome this issue, precision medicine (PM) comes into play whereby individual variability in genes, environment, lifestyle, and nutrition of each person is considered for disease treatment & prevention. PM provides a personalized approach, the right treatment to the right people at the right time. Many wealthy countries in the West have started adopting PM though the initial cost is high, ultimately, in the long run, will reduce the healthcare cost by getting rid of the ineffective treatment strategies. However, the PM in LMICs is still at an early stage due to issues such as lack of population- specific data, competency, expertise, and poor financial support. Keywords: Prospects; Problems; Precision Medicine; Lower- and Middle-Income Countries; Prevalence; Non-Communicable Diseases; Advantages; Adoption; Cost Attainment, or Upsurge; Changeless; Prospects; Oral Health; Nutritional Diseases; Antibiotics; Antimicrobial Resistance; Benefits; Transnational Corporate House. Correspondence to: Mainul Haque , Professor of the Unit of Pharmacology, Faculty of Medicine and De- fence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia. Land Line: +60 3 9051 3400 Ext 2257 (Office). +60 3 6179 5871 (Home). Cell Phone: + 60 10 926 5543. Email: runurono@gmail.com 1. Professor of the Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia. Land Line: +60 3 9051 3400 Ext 2257 (Office). +60 3 6179 5871 (Home). Cell Phone: + 60 10 926 5543. Email: runurono@gmail.com Orcid ID: 0000-0002-6124-7993 2. Country Representative, UChicago Research Bangladesh, Road 2B, House 4, Dhaka - 1230, Bangladesh. Cell Phone: +8801713042651. Email: drtariqul@gmail.com. Orcid ID: 0000–0002–5838–6554 3. Professor of Emergency Surgery. Department of Surgery, University of Macerata, Macerata Hospital, Via Giovanni Mario Crescimbeni, 28, 62100 Macerata MC, Italy. Email: massimosartelli@infectionsinsurgery.org Orcid ID: 0000-0003-3202-7542 4. Professor of the Unit of Occupational Medicine, and Dean, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, (National Defence University of Malaysia), Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia. Cell Phone: + 60 10 926 5543. Email: dradnanabdullah@yahoo.com Orcid ID: 0000- 0003-4323-7617 5. Lecturer, School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St.Augustine Campus, Eric Williams Medical Sciences Complex, Trinidad & Tobago. Telephone: +1 868 645 2640 Ext. 5005. Mobile: +1 868 460 3832. Fax: +1 868 662 1472. Email: sameer.dhingra@sta.uwi.edu Orcid ID: 0000-0003-2537-8889 Bangladesh Journal of Medical Science Vol. 19 No. 01 January’20. Page : 32-47 DOI: https://doi.org/10.3329/bjms.v19i1.43871 1. Introduction 1. A. Definitions Regarding Precision Medicine US National Library defines PM as “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person” 1 . The same institute Library voices personalized medicine is an older terminology of PM 2 . The Institute for PM defines “PM is a medical approach that proposes to prevent and treat disease based upon a person’s unique genetic makeup and their lifestyle habits” 3 . After that, PM possesses the strength to diagnose