Genomic screening from healthfare to warfare

Precision medicine refers to the individualization of medical treatment through the large-scale collection, integration, and interpretation of individual-level data. Although its institutional trajectories and applications vary across national contexts, precision medicine has occupied a central position in U.S. health policy since 2015, generating unprecedented investments in data extraction, integration and analysis. This article critically examines one of the United States’ flagship precision medicine initiatives – the All of Us Research Program – through a multidimensional framework that integrates political epistemology and ethnographic analysis. We argue that the program is organized around a holistic rhetorical, epistemological, and infrastructural orientation aimed at synthesizing heterogeneous biological, behavioral, environmental, and social data into a progressively unified computational framework. We argue that far from being politically neutral, this holistic orientation facilitates new forms of infrastructural concentration and enables the circulation and contamination of data between the spheres of healthcare, security, and biodefence. First, we situate All of Us within the epistemic assumptions of contemporary precision medicine through ethnographic inquiry into the program's design, practices, and institutional narratives. Second, we analyze how holistic rhetoric, epistemology, and infrastructure are operationalized within All of Us through specific technological arrangements that actively shape what can be known and managed. Third, we examine how these infrastructures become increasingly entangled with military and security logics through the growing involvement of actors such as Palantir Technologies and its wider institutional network, including the U.S. health AI strategy coordinated by former Palantir executives and emerging biosecurity companies such as Valthos. Drawing on the concepts of sphere transgression and the authoritarian stack, we highlight the risks arising from the contamination of distinct social spheres—particularly the convergence of military, security, and healthcare domains—and from the simultaneous centralization of data infrastructures.