Personalized_Medicine_A_New_Medical_and_Social_Challenge

4.5 A Glimpse into the Future of Public Health: From

Proactive P4 Medicine to PersonalisedPreventive

Medicine

In the context of public health, personalised medicine can be broadly described as a
customisation of healthcarethat accommodates individual differences as far as
possible at all stages in the process, fromprevention, through diagnosis and
treatment, to post-treatment follow-up. In an attempt to act beyond targeted ther-
apy, “public” personalised medicine embraces the concept ofindividual and col-
lective wellbeing, ESF ( 2012 ).^46 This is why it can find its key place and role within
the concept of “Health 2020”—the new European health policy. In regard to public
health, this initiative emphasises the need for further development of public health
systems, capacities and functions and promotion of public health as a key function
in society, by promoting

• the right to health and health care;


• equity, solidarity, sustainability;


• the right to participate in decision-making relating to personal health and that of
  the society in which people live, Jakab ( 2011 ).^47
  This potential of personalised approach to the entire health care system can be
  highlighted through the concept ofproactive P4 medicine(predictive, preventive,
  personalised and participatory), Hood and Friend ( 2011 ),^48 Weston and
  Hood ( 2004 ).^49
  However, the attempt to deepen the collaborative relationship of personalised
  medicine and public health brings a new time-framed initiative into horizon—the
  “Health 2050”. This initiative recognises that the key public health challenge at
  present is the realisation ofpersonalised preventive medicine. This could be
  achieved through a shift in understanding a wider concept of health and health care:


• which is now seen as a systemic complexity of wellnessmaintenanceand
  prevention as key activities;


• where the focus is placed on the 80 % of the life cycle of a certain condition
  when it is still preclinical and perhaps avoidable;


• through the empowerment of an individual, at any age, to self-monitor and self-
  manage health and wellness, and conditions of higher risk and existing diagno-
  sis, and, further, to start doing this today with tools that are already available,
  that is, to take the role of aparticipatory biocitizen;


• where public health initiatives becomeparticipatory health initiatives, taking
  action inparticipatory health communities, Swan ( 2012 )^50 (Fig. 3 ).

(^46) Ibid., 21.
(^47) See Jakab ( 2011 ), pp. 130–132.
(^48) See Hood and Friend ( 2011 ), pp. 184–187.
(^49) See Weston and Hood ( 2004 ), pp. 179–196.
(^50) See Swan ( 2012 ), pp. 93–118.
90 V. Mic ́ovic ́et al.