image: Founding members of NalaGenetics (L-R): Dr Alexander Lezhava, Dr Astrid Irwanto, Dr Levana Sani, and Prof Liu Jianjun
Credit: A*STAR and NalaGenetics
SINGAPORE – NalaGenetics, a spin-off from A*STAR Genome Institute of Singapore (A*STAR GIS), will be transforming leprosy treatments in Indonesia with a nationwide genetic screening programme with their PGx1301 diagnostic kit. Set to launch in the fourth quarter of 2025, this initiative builds on a successful five-year pilot test in East Indonesia, which demonstrated the effectiveness of precision medicine in preventing life-threatening adverse drug reactions (ADRs).
As part of this programme, up to 16,000 leprosy patients will be screened annually for the HLA-B*13:01 biomarker, a genetic variant linked to Dapsone Hypersensitivity Syndrome (DHS)—a severe and potentially fatal reaction to dapsone, a key antibiotic in leprosy treatment. This programme marks a significant step forward in global efforts to eliminate leprosy, a disease that continues to affect vulnerable populations in tropical regions.
A Milestone for Indonesia’s Healthcare System
Leprosy, or Hansen's disease, remains a global public health concern, with a global prevalence rate of 16.9 cases per million population[1]. This chronic infectious disease, caused by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis, can lead to nerve damage and physical disabilities if left untreated.
The nationwide rollout of genetic screening represents a major milestone for Indonesia’s healthcare system. Since 2021, regional laboratories in Papua, Indonesia, have been screening all new leprosy patients using NalaGenetics’ test, resulting in near-zero cases of DHS, a condition that previously carried a 9.9% mortality risk among affected patients[2]. This success has prompted the Indonesian government to adopt the screening programme nationwide, setting a new precedent in precision medicine.
Putting Singapore on the Global Map of Precision Medicine
NalaGenetics’ journey began in 2016 with four co-founders from A*STAR GIS, including Dr Astrid Irwanto, Dr Levana Sani, Prof Liu Jianjun and Dr Alexander Lezhava, who came together to address a critical gap in healthcare: the lack of affordable and accessible genetic testing to prevent ADRs. With the support of A*STAR GIS, which licensed them the rapid, real-time PCR technology for genotyping, NalaGenetics was able to develop an affordable and accurate DNA diagnostic kit.
In 2018, NalaGenetics partnered with the Health Research Institute of the Ministry of Health in Papua, Indonesia, to run the first government-supported clinical trial for genetic screening in leprosy patients across three provinces and five districts[3]. The study confirmed that 20% of leprosy patients carried the biomarker, and no DHS cases were reported among those screened, proving the life-saving potential of genetic testing.
“This initiative is a testament to Singapore’s growing influence in the global precision medicine landscape,” said Dr Levana Sani, CEO of NalaGenetics. “By combining cutting-edge science with a deep understanding of regional healthcare needs, we’ve created a solution that not only saves lives but also sets a precedent for how genetic testing can be scaled in resource-limited settings.”
A Model for Global Health Innovation
NalaGenetics’ impact extends far beyond Indonesia. With support from the Netherlands Leprosy Relief and the Indonesian Ministry of Health, they expanded clinical trials to Nepal and India, validating the universal relevance of the HLA-B*13:01 biomarker in Asian populations. The success of NalaGenetics underscores Singapore’s commitment to translating scientific research into real-world solutions. These efforts have culminated in a peer-reviewed publication in PLOS Neglected Tropical Diseases, solidifying the scientific foundation for this life-saving intervention[4].
Dr Wan Yue, Executive Director of A*STAR GIS, said, “From the lab to the field, NalaGenetics exemplifies how A*STAR’s research can have a profound impact on global health. Their journey and achievements are a testimony to A*STAR’s commitment to grooming our talent to develop scientific research and translating our clinical research to benefit human health, not just in Singapore but also around the world.”
Prof Liu Jianjun, co-founder of NalaGenetics and Distinguished Principal Scientist at A*STAR GIS, said, “We are very excited that the Indonesian Government will implement the HLA-B*13-01 screening test nationwide with NalaGenetics’s affordable diagnostic test. While leprosy may not be prevalent in Singapore, our research has far-reaching implications for diseases that affect our region. By unlocking the potential of Asian genomics, we are improving health outcomes not just for Singaporeans but for millions across Asia.”
As NalaGenetics continues to expand its reach, they are also exploring applications of their genetic testing platform for other diseases, including cardiovascular conditions and diabetes. “Our vision is to make precision medicine accessible to all,” said Dr Sani. “By leveraging our expertise in genomics and data analytics, we aim to empower healthcare providers with the tools they need to deliver personalised, effective care.”
[1] Global leprosy (Hansen disease) update, 2021: moving towards interruption of transmission
[2] The New England Journal of Medicine. 2013 Oct 24;369(17):1620-8. DOI:10.1056/NEJMoa1213096
[3] Province (Districts): Papua (Jayapura), West Papua (Manokwari, South Manokwari), Southwest Papua (Sorong), South Papua (Asmat) and North Maluku (Ternate, West Halmahera, East Halmahera)
[4] Validation study of HLA-B*13:01 as a biomarker of dapsone hypersensitivity syndrome in leprosy patients in Indonesia, October 16, 2020. https://doi.org/10.1371/journal.pntd.0008746