Nwabufo’s thesis is simple, or at the very least, his talk presents it as such. Knowing a patient’s genetic makeup can help medical professionals tailor effective treatment plans. He presents his audience with one harrowing story to make his case. In February 2023, Dr. Anil Kapoor, a leading Canadian urologist diagnosed with cancer, passed away after taking one dose of a medication that ought to have extended his life. He had been screened for the medication before being prescribed it, but the screening had not included tests for a ‘rare’ genetic variant which would have made the drug toxic to him. But what exactly is rare? Rare from whose standpoint?

As the Canadian Broadcasting Corporation notes in a November 2023 article on the tragedy, ‘current pre-screening guidelines are based on studies that largely leave out populations that aren’t white.’ Considerations of what is rare and common are largely based on the genetic makeup of white populations. While distressing, Dr. Kapoor’s story is not a rare occurrence. The World Health Organization estimates $42 billion is spent on addressing Adverse Drug Events (ADEs), and it is the fourth or sixth leading cost of death globally. There are a variety of paths toward curbing ADEs, but the one Nwabufo advocates for, genetically guided prescriptions, is one that fits his research profile. It is also one that he is set to capitalize on via a new device set to hit the markets in 2026. 

When Nwabufo left Nigeria for graduate studies at the University of Saskatchewan in 2017, founding a company and revolutionizing prescription medicine were hardly on his vision board. Nwabufo was merely seeking an environment conducive for his goal of pharmacy research. Saskatchewan was a good fit at first, and then later, Gilead Sciences where he worked on developing medication for treating SARS-CoV-2 and HIV. Where the pandemic was a pressure cooker that upended dreams and ambitions, for Nwabufo, the pandemic would serve as a ramp to a PhD and becoming a leading researcher in pharmacogenetics. During his studies, he served as the chair of the American Association of Pharmaceutical Scientists, the largest association of pharmaceutical sciences from academic, regulatory, and pharmaceutical/biotechnology sectors with over 5,000 members worldwide. At the University of Toronto, Nwabufo would go on to publish groundbreaking research on SARS-CoV-2 and find a practical outlet for his research interests, OneDrug. 

In November 2021, Nwabufo began a medical technology startup called OneDrug. The startup’s main product is a ‘smart point-of-care pharmacogenetic test device’ that will allow healthcare professionals to take a swab of saliva and see how their patients’ genetic profiles might react to different medications. The pharmacogenetic test the device runs is already available at several medical labs. But even within Canada’s healthcare system, famed for its affordability and relative accessibility, there are cost and other logistical restraints that put it somewhat out of reach.

During our interview in his graduate residence, Nwabufo is impassioned as he describes how his device might help change that. He said:

We’re building this portable device that, if you were to come in today and you have depression and they’re trying to choose an antidepressant for you, they already have a panel of genes that they’re supposed to test according to the Clinical Pharmacogenetics Implementation Consortium and US Food and Drug Administration guidelines. They will just take that panel, take your saliva sample and run a quick test on it.

Once that test is run, the results can help healthcare providers prescribe drugs that avoid any genetic landmines. In jurisdictions where this information can be readily shared, the results can be used again and again by clinics even outside the one where the test was conducted to tailor the most effective medication regimens. Should the device clear the battery of tests and standards that the American and Canadian regulatory agencies have set up for medical devices, Nwabufo expects to have it available for widespread use by late 2026 in North America, and shortly after, around the world.

OneDrug is not just intended for the West, however. Nwabufo is invested in seeing it being used to revolutionize healthcare in Africa and Nigeria specifically. He tells me he is already exploring avenues to ensure it is affordable or, at the very least, within reach in Nigeria. In fact, one of the reasons he is late to our interview is that he was on a call with some pharmaceutical science researchers at the University of Lagos, with whom he is collaborating on a study they began in 2022. The study, which has found unique genetic mutations in some Nigerian populations, with yet to be determined clinical relevance, points to the need for more funding and research. Nwabufo stresses that there is still much to be researched about Africa’s genetic heritage. Research that can enable us to make better and more precise public health interventions. Already, there are questions their research is raising about allele frequencies, that is, how common or rare different genetic variants are within a particular population, and cancer in Nigeria.