Azmeraw Amare

Associate Professor Azmeraw Amare leads a Genetic Epidemiology Research Group at Adelaide University.

His team studies how clinical, genetic/multi-omics and the exposome (environment) can be combined to explain why complex conditions develop (such as mental health disorders, cardiometabolic diseases, healthy ageing), who is most at risk, and which treatments are most likely to work. Their vision is clear but ambitious: moving medicine away from trial‑and‑error approaches toward precision healthcare, where prevention strategies and treatments are tailored to each person’s unique biological and environmental profile.

CAREER PROGRESSION FOR ASSOCIATE PROFESSOR AZMERAW AMARE: FROM GLOBAL PUBLIC HEALTH TO THE GENETIC EPIDEMIOLOGY

In his early stage of academic career, Dr Amare was curious about “Why the burden of disease is so high in some populations and in some countries, but not in others”. “And why some individuals have some sort of high risk to certain chronic diseases, and why not others?” That question opened his career. It still drives it.

Amare began as a junior public health researcher who got opportunities to work with national and international collaborators to quantify the global burden of non-communicable disease. He understood that the work was necessary. It was also, in time, insufficient. “While understanding how many people were affected by mental illness or cardiovascular disease told policymakers what to plan for, it did not tell anyone why, or what to do about it at the individual level”, Amare says.

That gap sent him around the world. A master’s in public health in Belgium, a master of Clinical Epidemiology at the University of Groningen, two PhDs — one in medicine at the University of Adelaide, another one in epidemiology at the University of Groningen. Each degree filled a specific gap between what he knew and what the science required.

The result is a researcher who can speak both languages: population-level policy and molecular biology. His research has been cited more than 130,000 times, across 190 countries, referenced in 32 patents, 932 policy documents (including by WHO, and the Royal Commission on Ageing in Australia), 112 clinical guidelines, such as pharmacogenomics guidelines in Canada, the US and Europe. H-index= 64 (Google Scholar) and average field weighted citation impact (FWCI) of 63.49 (Scopus, SciVal).

- Lithium has been used to treat bipolar disorder since 1949. We still can’t predict who it will help

Associate Professor Azmeraw Amare has spent two decades asking why the same drug works for one patient and fails another. He is close to an answer.

For patients with bipolar disorder or treatment-resistant depression, lithium is often the last option and sometimes the most effective. Discovered by Australian psychiatrist John Cade in 1949, it remains a frontline treatment more than 70 years later. But whether it will work for any individual patient is still, in most cases, unknown until they try it — a process that can take months and carries real risks. The tool to predict that response before treatment begins does not yet exist in clinical practice. Amare is building it.

Associate Professor Azmeraw Amare, a clinical and genetic epidemiologist at the Adelaide University’s Medical School, leads the Genetic Epidemiology Research Group. His focus is precision medicine for complex disease — using clinical, genetic and other biological data to predict who will develop an illness and who will respond to treatment before either happens.

The lithium work sits at the centre of that mission. Working with the International Consortium on Lithium Genetics (ConLi+Gen), a global collaboration of more than 130 scientists across Australia, the US, Europe and beyond, Amare has led multiple studies identifying clinical and polygenic markers that can predict a patient’s response to lithium. A single gene cannot do this. A combination of genetic markers, layered with clinical data, can come close. The tool has been built. Clinical trials to validate it are the next step.

What success looks like for Amare is a clinician who knows, before writing a prescription, whether lithium will help this particular patient. Not after months of trial and a potential deterioration. Before. A blood test, a genetic profile, a prediction. The tool is close. For the patient who has tried everything else, the answer has always existed somewhere in their DNA. Amare is finding it.

- Ageing as a single story, not a list of diseases

The second major strand of Amare’s work concerns healthy ageing — and it has already changed how the world’s leading health body thinks about the problem. Working with WHO scientists, Amare has contributed to developing, validating and understanding the biological basis of the concept of intrinsic capacity: a holistic measure of physical and mental health that tracks how a person ages across their lifespan rather than cataloguing individual diseases.

The shift matters because ageing has long been treated as a collection of separate conditions. Intrinsic capacity treats it as a single process and asks how the full picture of a person’s biology and behaviour shapes how well they age. Dr Amare likes to explain it with a simple metaphor. “Think of a device battery,” he says. “If you charge it properly and treat it with care, it lasts longer and performs better. Our intrinsic capacity is the same — it tells us how much reserve we have, how well our bodies and minds function, and how resilient we are as the years go by.”.

Amare’s research has revealed just how much that “battery life” depends on the interaction between genes and lifestyle. He has shown that sleep, exercise, diet, alcohol use and smoking interact with an individual’s genetic profile to influence that process. Those environmental factors, unlike genes, can be changed, giving both people and health systems room to act.