Why Genetics Matters More Than Ever: Dr. Annie Hasan Explains

Dr. From the moment she read her first chapter on heredity and diversity in high school, Annie Q. Hasan knew she had found what she was looking for. “I was always interested in genetics, even when genetics was barely available in medical colleges in India,” he says. Long before clinical genetics was considered a super-specialty, he had already chosen it as his life’s work.

His journey began at the Center for Cellular and Molecular Biology, one of the best places to do molecular biology in Asia, where he completed his initial research and later his PhD in Genetics. This was followed by nearly a decade working abroad on a scientist exchange program in New Zealand at Wellington Medical School and later at leading institutions in the USA. But even as his research career developed, one thought persisted: He thought genetics belonged not just in laboratories but in everyday healthcare.

“I always wanted to bring genetics to the clinic,” he says. This opportunity came when he returned to India in 2000 and established genetic diagnostic and testing services in three hospitals. The more he worked with clinicians and families, the more it became clear that India needed not just more testing, but also people who could interpret it. “Medical genetics is almost completely absent from our curriculum,” he explains. “We needed professionals who could bridge the gap between clinicians, patients, families, policymakers, and genetic testing. That’s why genetic counselors are so important.”

There were none in India at that time. In doing so, he helped create the first full-time genetic counseling program in the country, an area he continues to develop. “Since 2001, Kamineni Hospitals has encouraged me to do everything from diagnosis, research and education,” he says. He brings students from across India every year and hopes they will return to serve their states. “But as you know, most people prefer the metro,” he says matter-of-factly.

Over the years, genetics has quietly entered mainstream clinical practice, particularly in the fields of pediatrics, oncology, gynecology, and neurology. However, patients still wonder why genetic tests are not included in their routine health checks. Hasan is practical: “It is still expensive, but costs are coming down. The test we did for ₹35,000 in 2014 is now below ₹15,000. As the price comes down, it will become a part of routine maintenance.”

He believes some tests should already be routine; specifically, pharmacogenomics, which studies how our genes affect our response to drugs. “People are taking so many medications, why not check if they are working?” he asks. At Kamineni, pharmacogenomics has been guiding transplant and heart treatments since 2006. He explains that especially in transplants, “the right dose can only be found by looking at the person’s genes.” “Too low a dose will cause organ rejection; too high a dose will cause toxicity.”

It’s a reminder that genes quietly influence much more than people assume. “The analogy is simple,” he says. “Genetics is a loaded weapon; lifestyle is the trigger.” Some traits are entirely genetic; like some forms of dwarfism, where one variant can override all other healthy genes. Others are polygenic, shaped by the combination of multiple genes and lifestyles. He gives examples that everyone can relate to: families where obesity occurs over generations, or individuals who eat less and still gain weight. “It’s genetic,” he says. “Some genes predispose people to needing less food. In fact, Indians are known to have ‘thrifty genes’; we traditionally got by on less food and more physical activity.”

Even common conditions such as thyroid disorders have genetic components. “Excess iodine may play a role, but not everyone develops hyperthyroidism. Genes decide who is susceptible,” he explains.

What about genetic disorders that suddenly appear in the family? “This happens more often than people think. A baby grows from a single cell to billions of cells. Errors can occur during cell division. A ‘de novo’ mutation means the child is the first in the family to experience this genetic change.” One example he gives is NF1, a condition that causes skin nodules. “No one else in the family may have this condition, but when the mutation occurs in the child, it can be passed on to future generations.”

Cancer genetics also raises difficult questions. Does carrying a cancer gene guarantee cancer? “Not at all,” he explains. “It increases lifetime risk. A person with a BRCA1 mutation may have an 80% lifetime risk of breast cancer, but lifestyle and other modifying genes may determine when and when this occurs.” He believes knowing the risk is powerful. “You can monitor, block, intervene earlier. This gives people control.”

Next-generation sequencing has transformed this landscape. Previous tests only looked at chromosomes. “NGS (Next Generation Sequencing) allows us to look at all 20,000 genes,” he says. But it also brings complexity; Because not all genetic differences are harmful. “Bioinformatics helps us distinguish disease-causing changes from harmless ones.”

As for the right age for testing? “It depends,” he explains. Pregnancy has its own panels. Babies may undergo newborn screening. Adolescents may be tested for youth-onset conditions. Pharmacogenomics can be performed at any age. While some countries sequence newborns at birth, he believes India needs a phased, needs-based approach due to its size and resources.

But despite these challenges, he remains optimistic: “Genetics will eventually become part of every person’s healthcare story.”