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Four concrete steps are necessary for precision public health to become regularly available in the developing world.

1. Register births and deaths
It is hard to know whether a national deworming programme for children in Sierra Leone or a vaccination programme for whooping cough (pertussis) in Nigeria is reducing mortality when less than 4% of deaths are registered.

2. Track disease
Careful surveillance can guide public health in a country and track disease outbreaks that could spread beyond borders. This requires infrastructure and systems to collect and analyse data, laboratories to confirm diagnoses and adequately trained personnel.

3. Incorporate laboratory analyses
The cause of a child’s death cannot be adequately determined by interviews with relatives, especially months after death. Where feasible, tissue sampling and laboratory diagnosis should supplement or replace these ‘verbal autopsies’. 

4. Train more people
Public-health personnel at national and local levels must be educated in the fundamentals of epidemiology, empowered to use local information to set strategies, and equipped to translate those decisions into action.

Source: Nature International Weekly Journal of Science