Precision Medicine Goes Global: How to Get It Right? Four Ways to Mobilize Scientific Knowledge.

Globalization and knowledge mobilization (KM) are twin challenges impacting precision medicine currently. Previous KM models have been largely limited to an implementation framework whereby knowledge is imagined as a billiard ball to be simply rolled over from the laboratory to society and from developed to developing countries. This narrow and sanitized understanding of KM and science as being detached from social forces, human values, politics, and power inequities does not help to achieve robust and responsible emergence of precision medicine, not least because tailored medicines are not simple products ready to use off-the-shelf without customization in each country, local context and society. It is time to broaden the art and science of KM by rethinking knowledge as a dynamic co-product of both technology and social systems in which science is embedded. This article presents an analysis of the four possible approaches to KM available to the precision medicine community: (1) "knowledge implementation," (2) "research collaborator capacity building," (3) "collaborative entanglement" that removes the barriers between research and practice, and extends knowledge co-creation activities beyond scientists by inviting publics, patients, and clinicians as researchers, and (4) "knowledge ecosystem" approach that adopts systems thinking, addressing not only technology development but also the politics of innovation, whereby power differences in scientific practice are addressed, for example, to achieve gender parity and diversity in the scientific work force. Blending of laboratory science with KM theory and practice informs robust and responsible emergence of precision medicine innovations, and helps strike the right balance between promotion and regulation of emerging technologies.