15 MARTINDALE CENTER FOR THE STUDY OF PRIVATE ENTERPRISE efits, but continuing to evaluate and update the process for external scientific and ethical reviews used when screening applications can combat malicious intent. Continuing to foster stronger public trust in the system’s security will encourage the volunteer base to grow rapidly. Lack of public transparency Finally, the public lacks transparent understanding about how much of Taiwan’s health-care budget is allocated to this strategy. Extremely little, if any, literature describes the budget of the biobank. Precision health comes at a steep price. At the same time, the payoff could be cost savings thanks to improved accuracy of the diagnostics, resulting in better treatment outcomes and reduced need for prescriptions (Lee & Liu, 2023). Academia Sinica researcher Shen acknowledges that the effects of treatments are not yet proven, but the MOHW is continuing to reward and subsidize research (InvesTaiwan, 2024). Potential incentives for private investment appear high. For example, Henderson and colleagues (2023) found a 27% higher return on investment of precision oncology medicines compared to nonprecision oncology medicines. However, without economic analysis on TPHI, there is little evidence to convince the public why this approach is effective both clinically and financially. Recommendations Various next steps could assist the government in achieving its goals with precision health. The strategies outlined in this section aim to improve the likelihood of the initiative reaching its full potential. First, prioritize and fund data collection and studies that specifically focus on underrepresented populations. This emphasis will help uncover the interactions between health and cultural traditions, ethnicity, genetics, and lifestyle choices. As the biobank expands, studies should become more inclusive of all cultural subgroups, as suggested by Hou and colleagues (2020). Additionally, including more Indigenous people in policy making ensures diverse representation, giving these populations a voice in how their health information is used. Perhaps part of the Indigenous community’s reservations about involvement with the TPHI is concern about compromising their identity. Crafting an Indigenous genetic sovereignty council with Indigenous leadership would allow for empowerment and meaningful oversight of genetic data that respects cultural autonomy while facilitating research. Holding regular meetings with leaders in the Indigenous communities to verify the biobank adheres to the values of their culture and protects their identity would increase representation of Indigenous health data. Adding psychological data could improve understanding of the linkages between physical and mental health and reduce stigmas that surround mental illness. These data should be collected on a completely voluntary basis, as psychological information could be considered even more sensitive and private than physical data. In terms of data protection, consider the COVID-19 pandemic response. The Taiwanese government took a data-first approach, but perhaps an opt-in strategy with volunteered health status reports would have better preserved privacy. The UK Biobank established a cloud computing policy requiring compliance with its Material Transfer Agreement (Lin et al., 2020b), guaranteeing that patients provide informed consent and that privacy standards are upheld. Following a similar approach by updating current policies in Taiwan would provide reassurance to participants. Because the Taiwan Biobank is used primarily for research, personnel who can access it are limited (generally hospital employees and scientists), and accessibility is confined to specific predetermined locations (Jon Huang, personal correspondence, 2024). Sharing vast amounts of linked data is efficient yet could prove vulnerable to security breaches (Chalmers et al., 2016). Full implementation of a blockchain model would enhance security and traceability of Taiwan’s biobank. Volunteer contributors should receive access to a verifiable record of who viewed their data and for what reasons (Ortiz-Lizcano et al., 2023). Despite controversies, authorities are continuing to strive to balance maintaining public trust while accumulating as much critical data as possible for the sake of improving public health strategies for everyone. Finally, considering that the TPHI is such a large and beneficial endeavor, it would be useful to present yearly updates of the financial plan online for easy access by the general public. The UK Biobank (2024) lists specific grants and research group investments directly on its website along with detailed breakdowns of its funding, associated categories, and projects. A similar implementation on the Taiwan Biobank website would prove beneficial and serve to enhance public trust. Ideally, the Taiwan Biobank would lead to an increase in the overall quality of health while eventually reducing health-care costs. By 2027, biobanking is predicted to surpass $US53 billion in world revenue (Bagcchi, 2022). Rogers et al. (2011) predict significant reductions in the cost of clinical trials, improved patient diagnosis, and
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