India’s genomics moment reached a critical inflection point in 2025. This momentum is not the result of a dramatic technological leap, but of genomic testing moving decisively into routine clinical decision-making. What was once confined to specialised diagnostics is now shaping everyday medical practice, influencing how diseases are diagnosed, treated, and increasingly prevented.
This shift reflects a deeper change in how genomics is being used. This year, Indian biologists developed a unique genome database of 10,000 unrelated but healthy Indians from 83 diverse population groups, creating a foundational platform that can, in time, help kickstart precision medicine. At the same time, genomics has moved closer to the bedside. In oncology, genomic profiling increasingly determines treatment pathways, helping clinicians match patients with targeted therapies and avoid ineffective interventions.
Similarly, reproductive medicine has also seen rising adoption, with genetic screening improving risk assessment and strengthening clinical counselling. Sequencing costs have fallen, laboratory standards have improved, and clinician familiarity with genomic data has increased.
Yet what often gets overlooked in the broader genomics discussion is that clinical value today is being driven less by test availability and more by interpretive maturity. The real shift has been in how genomic results are contextualised, linked to clinical guidelines, treatment pathways, and patient outcomes, rather than delivered as standalone data. This interpretive layer is what has enabled genomics to move from information to intervention.
Despite these advances, a stark reality has emerged further down the line: India currently lacks the capability to conduct accurate, large-scale genetic screening. While genomics works well for acute or highly specific conditions, preventive, population-level screening remains a needle in the haystack challenge. Scaling this capability safely and effectively represents both the greatest opportunity and the most formidable hurdle for the country. The growing interest from emerging players and increased investments underscores the urgency, but success will depend on building standardised interpretation frameworks, workforce readiness, and infrastructure capable of supporting population-level impact. Without these, rapid expansion risks diluting clinical accuracy and eroding public trust.
As adoption accelerates, the real risk for India is no longer whether genomics will scale, but whether it will scale responsibly. Expanding testing faster than the availability of trained clinicians, genetic counsellors, and standardised interpretation frameworks could dilute clinical value and erode trust. In genomics, evidence must lead adoption, not enthusiasm.
Public policy has begun to recognise this moment. The Union Budget 2025–26 has significantly boosted genomics and life sciences through major R&D investments, including the ₹1 lakh crore RDI Scheme and ₹2,300 crore for Bio-RIDE, with a focus on AI, digital health, and biopharma innovation. This surge in public investment signals a clear intent to build domestic scientific capability and reduce reliance on imported technologies.
2025 also brought a necessary dose of realism. While India has built genomic reference datasets and strengthened public investment in life sciences, population-scale genetic screening remains aspirational. Large-scale implementation requires far more than sequencing capacity: it demands robust data governance, widespread access to genetic counselling, standardised interpretation frameworks, and careful integration into clinical pathways.
Population-scale genomics will succeed not by sequencing more genomes, but by deciding when genomic information should change clinical action and when it should not. Without clear thresholds for intervention, data risks becoming descriptive rather than decisive.
One of the most important and underappreciated developments in India’s genomics story is its geographic expansion. Genomic testing is no longer confined to a handful of Tier-I cities. Adoption is steadily increasing in Tier-II and Tier-III locations. For genomics to function as a public health tool rather than a niche service, access must extend well beyond metropolitan centres.
Preventive genomics represents the next frontier, but also the greatest test. Interest in understanding hereditary risk and lifestyle-linked predispositions is rising, reflecting a broader shift toward proactive health management. Yet preventive genomics will only be credible if India resists the temptation to market genetic risk as certainty. Predisposition is not diagnosis, and without disciplined clinical framing, scaling prematurely could undermine confidence in an otherwise powerful tool.
India possesses a rare combination of scientific capability, population diversity, and policy intent. Researchers project that India’s genomics market will reach $ 2,434.1 million by 2030, growing at an impressive CAGR of 18%. But leadership in genomics will depend as much on restraint as on speed—on using genetic information where it adds clear clinical value and scaled thoughtfully where evidence supports it.
With sustained investment, clear regulatory pathways, and stronger collaboration across industry, academia, and government, India has the potential to emerge as a global leader in genomics. Genomics will become a cornerstone of India’s health care system, guiding decisions, shaping outcomes, and enabling a healthier, more informed, and empowered population. But the journey will succeed only if scaling, particularly for preventive population screening, is done with rigour, accuracy, and responsibility.
This article is authored by Ameera Shah, promoter and executive chairperson, Metropolis Healthcare Ltd.
