Ever wondered why your health is so unique? It's not just about what you eat or how much you exercise; your genes play a massive role! Dr. Annie Hasan, a pioneer in the field, has dedicated her life to unraveling this fascinating world. From the moment she first learned about heredity in high school, Dr. Hasan knew genetics was her calling. "I was always interested in genetics even when genetics hardly existed in Indian medical colleges," she recalls.
Her journey began in one of Asia's top molecular biology centers, where she conducted early research and earned a PhD in Genetics. This led to a decade of international experience, including work in New Zealand and the US. But while her research flourished, Dr. Hasan felt a pull towards applying genetics directly in healthcare.
"I always wanted to bring genetics to the clinic," she emphasizes. This opportunity came in the year 2000, when she returned to India and established genetic diagnostic and testing services across three hospitals. She quickly realized that India needed not only more testing but also professionals who could interpret the results. "Medical genetics is barely covered in our curriculum," she explains. "We needed professionals who could bridge the gap between clinicians, patients, families, policymakers and the genetic tests. That is why genetic counsellors are so important."
At the time, India had none. So, Dr. Hasan helped build the first full-time genetic counseling program in the country, a field she continues to nurture. "Since 2001, Kamineni Hospitals has encouraged me to do everything — diagnostics, research, and training,” she says. She brings in students from across India, hoping they will return to serve their states. "But as you know, most prefer the metros," she says matter-of-factly.
Over the years, genetics has quietly entered mainstream clinical practice, particularly in areas like pediatrics, oncology, gynecology, and neurology. But here's where it gets controversial... Patients often wonder why genetic testing isn't included in routine health check-ups. Dr. Hasan offers a practical perspective: “It’s still expensive, but costs are falling. The test we did for ₹35,000 in 2014 is now under ₹15,000. As the price drops, it will become part of routine care.”
She believes some tests, like pharmacogenomics (the study of how genes affect drug responses), should already be routine. “People take so many medicines. Why not check whether they help or harm?” she asks. At Kamineni, pharmacogenomics has guided transplant and cardiac treatments since 2006. In transplants, “the right dose can only be found by looking at the person’s genes,” she explains. “Too low a dose and the organ is rejected; too high and it causes toxicity.”
This highlights a crucial point: genes silently influence much more than we realize. "The analogy is simple,” she says. “Genetics is a loaded gun; lifestyle is the trigger.” Some traits are entirely genetic, like certain forms of dwarfism. Others are polygenic, shaped by multiple genes and lifestyle. She gives relatable examples: families with a history of obesity or individuals who gain weight easily. "That’s genetics,” she says. “Some genes predispose people to require less food. Indians, in fact, are known to have ‘thrifty genes’ — we traditionally managed with less food and more physical activity.”
Even common conditions like thyroid disorders have a genetic component. “Excess iodine may play a role, but not everyone develops hyperthyroidism. Genes decide who is susceptible,” she explains.
And this is the part most people miss... What about genetic disorders that suddenly appear in a family? “It happens more often than people think. A baby develops from a single cell to billions. During cell division, errors can occur. A ‘de novo’ mutation means the child is the first in the family to have that genetic change.” She gives the example of NF1, a condition causing skin nodules. “Nobody else in the family may have it, but once the child has the mutation, it can be passed to future generations.”
Cancer genetics also raises difficult questions. If someone carries a cancer gene, does it guarantee cancer? “Not at all,” she clarifies. “It increases lifetime risk. A person with a BRCA1 mutation may have an 80% lifetime risk of breast cancer — but lifestyle and other modifier genes may decide when or if it appears.” Knowing the risk, she believes, is empowering. “You can monitor, prevent, intervene earlier. It gives people control.”
Next-generation sequencing (NGS) has revolutionized the field. Unlike earlier tests that looked only at chromosomes, “NGS (Next-Generation Sequencing), allows us to look at all 20,000 genes,” she says. However, this also introduces complexity, as not all genetic differences are harmful. “Bioinformatics helps us separate disease-causing changes from harmless ones.”
As for the right age to test? “It depends on the condition,” she explains. Pregnancy has its own panels, infants can undergo newborn screening, and adolescents may be tested for conditions that begin in youth. Pharmacogenomics can be done at any age. And while some countries sequence newborns at birth, she believes India needs a phased, need-based approach due to its size and resources.
Despite these challenges, Dr. Hasan remains optimistic: “Genetics will eventually become a part of every person’s healthcare story.”
What do you think? Are you surprised by the extent to which genetics influences our health? Do you believe genetic testing should be more accessible? Share your thoughts in the comments below!
