A landmark gathering in Sāmoa has brought together researchers, clinicians, community leaders and Pacific experts to shape the future of precision medicine, with a strong focus on ensuring Pacific peoples benefit from advances in genetic research.
The inaugural Precision Medicine Conference for Polynesian Peoples, held in Sāmoa on 29 – 31 July, marked a decade since the publication of groundbreaking research into the CREBRF gene variant, found at high rates among Māori and Pacific populations.
The conference, which grew from collaborations involving researchers from Waipapa Taumata Rau, University of Auckland, the Maurice Wilkins Centre and the Oceania University of Medicine Samoa, looked beyond scientific discovery to address the cultural, ethical and governance issues needed to ensure precision medicine serves Indigenous communities.
Dr Natalie Netzler, a University of Auckland researcher and conference organiser, says the gathering was intentionally different from a traditional scientific conference.
“We wanted to bring together community voices, clinicians and researchers and weave those strands of expertise together,” she says.
“The goal was to get everybody in the same waka, moving in the same direction for greater efficiency, greater collaboration and maximum positive impact for our communities.”
Celebrating a decade of discovery
The conference opened by reflecting on ten years of research since the publication of studies on the CREBRF gene variant, a genetic adaptation found predominantly in Māori and Pacific peoples, originally discovered in Samoa in 2016 by Asiata Professor Satupaitea Viali and their research team from the US.
Research has shown the variant is associated with higher levels of lean muscle mass and increased bone density, while also appearing to offer protection against Type 2 diabetes.
The findings have contributed to growing evidence that Body Mass Index (BMI), a widely used measure of health, may not accurately reflect body composition in Pacific populations.
“One of the key messages is that BMI doesn’t work well for Pacific peoples,” says Netzler.
“The genetic adaptations we’re learning about are helping us understand that Pacific bodies may be fundamentally different in ways that aren’t captured by conventional health measures.”
The opening ceremonies reflected the gathering’s cultural foundations. Delegates participated in an ava ceremony, while a carved hoe gifted from Aotearoa symbolised the deep connections linking Pacific peoples across Te Moana-nui-a-Kiwa.
The carving featured the wheke, drawing on Pacific narratives that emphasise interconnectedness, shared whakapapa and relationships across the region.
Balancing innovation and Indigenous data sovereignty
A key focus of the conference was governance.
Netzler chaired a panel exploring how Pacific and Māori communities can help shape the future of genetic research while protecting cultural values, collective rights and data sovereignty.
Discussions addressed how genomic data should be managed, how community aspirations can be embedded in research programmes, and how emerging technologies such as artificial intelligence can be used responsibly.
“For Māori and Pacific peoples, DNA isn’t viewed as belonging only to an individual,” says Netzler.
“It is connected to our ancestors, our families and our communities. We have a responsibility to protect that while also ensuring we’re not left behind as precision medicine advances around the world.
“Our ancestors carry many messages in their genes, that it is up to us Pacific researchers to read these accurately, understand them, so that we can translate these to benefit our generations now and the future”.
The conference also considered how governance frameworks can ensure smaller Pacific nations are represented and protected alongside larger populations.
Participants included community leaders and experts from across Sāmoa, Aotearoa New Zealand, and the wider Pacific, creating what organisers described as a safe environment for open discussion around sensitive genetic research.
A Pacific approach to precision medicine
Researchers also explored the clinical potential of genetic variants unique to Pacific peoples.
Among the topics discussed were thousands of genetic adaptations that remain largely understudied because Indigenous populations are significantly underrepresented in global genetic datasets.
Much of the world’s genomic research has been conducted using European populations, creating challenges when translating findings into healthcare settings for Indigenous communities.
Professor Peter Shepherd says this highlights the urgent need for Pacific-led research.
“This genomic research is already identifying ways to better target current medical treatment so they work best for Pacific people but, excitingly, we now also see how it can be used to develop medicines that specifically target the health issues that are most relevant to Pacific peoples” he says.
For conference participants, the solution is not simply greater participation in international studies, but building Pacific research capability and governance that ensures communities retain ownership and oversight of their own data.
Netzler warns that without Indigenous leadership, important decisions about Pacific genomic information could be made elsewhere.
“If we don’t take ownership and governance over this work ourselves, then decisions about our data will be made by others without the protections that our communities expect and deserve.”
Why precision medicine matters
One of the conference’s most memorable explanations came from Asiata Professor Satupa’itea Viali of the Oceania University of Medicine.
Describing precision medicine through a simple analogy, he compared modern healthcare to being offered a pair of shoes that only comes in one size. Treatments are often targeted for the “average patient”.
“Precision medicine is about recognising that not everybody fits the same mould,” says Professor Viali.
The analogy resonated strongly with delegates because it captures the challenge facing Indigenous communities whose health needs are often assessed using models developed for other populations.
Instead, precision medicine seeks to tailor prevention, diagnosis and treatment to an individual’s genetic, environmental and cultural context.
Building momentum across the Pacific
Although attendance was by invitation to enable confidential discussions around sensitive genetic information, organisers say the gathering generated significant momentum.
New collaborations emerged, existing partnerships strengthened, and delegates agreed the conference should become a regular event.
“We all agreed this would be the first of many,” says Netzler.
“There was a real sense that something important had started. People weren’t just presenting research. They were building relationships, forming collaborations and working out how we move forward together.”
The next conference is expected to return to Sāmoa in two years, with future gatherings potentially rotating through other Pacific nations.
For Netzler, one of the most encouraging outcomes was the response from participants experiencing Sāmoa and a Pacific-led research environment for the first time.
“It felt less like a traditional academic conference and more like a meeting of minds,” she says.
“Community voices were valued equally alongside research expertise. That created conversations that were richer, more honest and ultimately more useful for improving health outcomes.”
As precision medicine continues to develop globally, Pacific researchers and communities are determined not simply to be included in the conversation, but to help lead it.
University of Auckland Press Release.
