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transcript

What Is 23andMe Doing With Your DNA?

C.E.O. Anne Wojcicki grapples with the ethical questions that come with building a business on customers’ personal information.

[THEME MUSIC] (SINGING) When you walk in the room, do you have sway?

kara swisher

I’m Kara Swisher, and you’re listening to “Sway.” My guest today is Anne Wojcicki. She’s the CEO of 23andMe. Over 12 million people have forked over $100 or more for the company’s DNA test, where you spit into a vial, mail the vial into the company, and get a report back with information about your ancestry or about your health. The genetic test might reveal you’re related to people you’ve never met, or it might suggest that you are at higher risk for developing diseases like Parkinson’s or Alzheimer’s. I was one of the service’s earliest testers, and it turned out I had a blood marker that was important to know about when I later had a stroke. In my case, it was certainly helpful information. While I got some very valuable data, so did the company. And Wojcicki and her team are using that aggregated anonymized data to grow a new business — pharmaceuticals. They’re in the process of developing several drugs and, I presume, have many more on the way. So I wanted to speak to Wojcicki about building a business off the back of their customers’ genetic code, and push her on the ethical privacy and security questions that 23andMe grapples with every day. Anne, welcome to “Sway.”

anne wojcicki

I’m so excited. Thanks, Kara.

kara swisher

So we really have talked a lot. And since the beginning of your company, 23andMe actually used its spit test at one of my events many, many years ago, when you compared my spit with Rupert Murdoch’s, and thankfully found out that we were not related, which was a relief to my family.

anne wojcicki

Yeah, I remember asking people whether or not they smelled the asparagus in their pee at that meeting. There were a lot of confused attendees.

kara swisher

That’s right. The pee — there’s a genetic component to asparagus and pee. But anyway, I want to fast-forward to today. So you recently went public. And that surprised me, because when you and I spoke a few years back, you said, I’m pretty adamant, I love being an independent company. I’m not dying to go public. Can you talk about what changed?

anne wojcicki

Yeah, there are two big driving factors for me. So one, the therapeutic side, which we’ll talk about obviously more later, has really started to take off. And therapeutics is expensive. So to really successfully develop a drug well, you need a decent amount of cash to invest. Second, the pandemic changed a lot with respect to virtual care. Like, suddenly, everyone’s used to telemedicine. If I want to call my doctor and show a picture of a mole, that might be acceptable. I don’t always have to go in. And so this opened up the opportunity for us to say, we’re already doing a lot with people at home. Now, we have this opportunity to really do more. And in order to really do that, I also want to have access to a liquid currency, so I could do acquisitions and potentially really grow that side of the business.

kara swisher

So is it the consumer or the therapeutic become more important? Presumably, the therapeutic, which is development of drugs, because that’s where the money is, right?

anne wojcicki

People always ask that, and it’s a little bit always like asking who is your favorite child.

kara swisher

Well, who is your favorite child?

anne wojcicki

[LAUGHS] I love all my — you tell me first. I love all my children equally. And it’s true. Like, the more we have customers who are engaged in signing up, the more we have this opportunity to make discovery. So I don’t love one more than the other. Like, they’re both super exciting.

kara swisher

Do you think — you’ve had, kind of, a rocky road. We’ll get into in a second — but this idea of democratizing genetics — do you feel as if your idea was too early? Or did you need a pandemic to make people understand it? Because a lot what you were doing was very early, this concept. Not many people were talking about this.

anne wojcicki

It’s a good quest — I mean, I think we were a little bit early. Like, our mission statement says we help people access, understand, and benefit from the human genome. And I think about those first years, when I was first debuting the product. Like, I did spend a huge amount of my time just proving out that you’re capable of getting information, and that it’s not going to create harm. And I realize the health care world — I mean, you’re always thinking about, what are the worst things that could happen. And so we spent a huge amount of time really helping people understand that worst-case scenario is not actually going to happen.

kara swisher

Right, but we’ll get into some of that, because it can, obviously, and the people do still continue to have those concerns. We’ll get into that in a minute. So let’s go from the beginning, which is democratizing genetics. Explain what that exactly means. And also, are you democratizing genetics or commercializing them? Because as you mentioned, you’re using consumer data to help develop drugs. So explain how you look at it right now. What does that mean?

anne wojcicki

Well, I think that health care — you should have access. I think that people should be able to say, I want to get access to a certain kind of test, and then they should be able to get access. For instance, like, one thing that 23andMe has done that I’m really proud of is, we have a number of our customers who found out that they have the high-risk variant for breast cancer, and they never would have otherwise qualified for a traditional reimbursed test. There’s a lot of hoops that you have to jump through to sometimes get what you want in health care. And so what we did is, we’ve made it very easy for people to get access to information about themselves. I mean, it’s interesting — the human genome was first sequenced in 2003, and it’s inexpensive, and yet, it’s not widely adopted. And I think part of that is because of the way the reimbursement system works and how people think about prevention and information. And part of what, for me, that I really want to do is to enable people to get access to a technology that I think has a real benefit for the individual, and not necessarily as much as a real benefit for the entire industry.

kara swisher

But the consumer is not the only one getting access. You are, too, and you’re building a pharma business off of that. Talk about that trade. Because that, I think, makes people nervous. It’s the same thing as it does with Facebook, and we see that trade as not as good, as has been thought to be.

anne wojcicki

Well, I think part of what we have tried to do is create an opt-in system. And I should emphasize, like, everything about 23andMe is an opt-in. And so people elect to say, I want to participate in research. They can take the surveys that they want to take, and they can opt out at any time. And I’m really clear. Like, I want to always provide choice and transparency. I never want anyone to be surprised. And so even when we signed a large collaboration with GSK, which is a large pharmaceutical company, to say, we are going to go into a development program, research and development program, to go through all of the information that we have on genetics and see, can we find targets that have a genetic foundation and develop them into drugs, we emailed all of our customers at that time to say, do you want to participate? And here’s the link to opt in, or here’s the link to opt out. I never want somebody to be surprised.

kara swisher

So wait, but when you do this, obviously, people have these normal fears of their information being abused. And when it becomes genetic information, it’s a much bigger trade, I think.

anne wojcicki

Well, they can just opt out. You don’t have to participate in research. I mean, listen, frankly, I think the biggest offenders in privacy is the health care system as it is. I remember, like, even when I was giving birth, I had to sign a consent that would say, we can do anything we want with your data. I remember marking it up and saying, like, no! I don’t want you to. But, like, health care, you have the California Privacy Act, you have GDPR. Health care is exempt from that. I think that’s crazy. Like, when did I consent for my information to be shared? There’s these health information exchanges. So there’s a lot of benefit that comes from sharing the data, but I feel like right now, there’s a lack of transparency. And so 23andMe — like I said, I’m very committed to that choice and transparency.

kara swisher

So given the history of tech companies — and you’re health care company, but tech company in general, and you’re in Silicon Valley — of not making people aware earlier on the fact that they’re not just the consumer — you’ve heard that — they’re not just the consumer, they’re the product, that kind of thing. How do you fight that feeling that so much of information is that consumers are captive to all of these various data miners, I guess — I don’t know what else to call them.

anne wojcicki

Look, I think, I mean, when we talk about our slowdown that happened a couple of years ago, I absolutely think that was impacted by things like Cambridge Analytica and Golden State Killer. So I think that we absolutely get influenced by the whole industry. And the only thing we can try to do is lead by example, and continuously reiterate choice and transparency to our customers.

kara swisher

OK, so has the move into drugs always been part of the vision? One of the things when you sold it to VCs, as I recall, was these tests. It was, sort of, focused in on the test.

anne wojcicki

I mean, we always talked about, there’s this potential to really change health care with data. And I look at that as, like, I want to understand the human genome. Like, how do you elucidate, really, human biology? And if I can have a better understanding of it, then I can really start to think about, how do I prevent successfully? And then, how do I actually design therapies in a way that is more data-driven, that is going to have a higher likelihood of success? And so what I proved out over time is that people can get this information. It’s safe for them to get it. They can understand it, and then they can self-report. People take surveys. They’re interested in taking these surveys. And that we can then do all of these genetic — we can do all this research that can genuinely find really interesting, novel genetic associations.

kara swisher

So in the new world of drug development, how are you working with the FDA? Now, you’ve had a long and storied history with the FDA. For those who don’t know, in 2013, the FDA demanded 23andMe immediately stop giving its customers health data until it received clearance from the agency. Two years later, you began giving customers some health information again, with FDA backing, but certainly not as much. Talk a little bit about that long relationship, and how it is now.

anne wojcicki

Well, they definitely — look, there was definitely change. Because I mean, one thing that people don’t always recognize about 23andMe is that we had actually engaged with the FDA prior to that warning letter. And it was originally, sort of, reiterated. Like, you are not a medical device, and we are not going to regulate this space. And so world changes. We also started getting more into the medical world. And it was really clear. Like, we did not speak the language of the FDA. And you know, what I learned is, it’s like the DMV. When you go to the DMV, you don’t negotiate whether or not you need a vision test. You just do it. And there’s parts of the FDA that you need to have something similar. Like, there’s a form of obedience. When they tell you that you need to do something, you just need to do it. And I think what I’ve learned is, they do have a global picture that is bigger than what I can see. So one, there’s a lot of respect for the fact that there’s a lot of bad actors that are out there generally. Second is that they do have a job of protecting public safety, and the onus is on us to prove out that something is safe. I find that the FDA can be quite rational when you’re speaking in data. And so if you have a new idea, it just has to be proven out. So I think that’s where it’s really coming up with a reasonable plan that is going to prove out that something actually works. And there’s plenty of things — again, we’ve all seen the bad actors. Like, there’s definitely bad actors that come.

kara swisher

Let me go into that. Obviously, the Theranos trial — you knew I was going to get into this — is unfolding as we speak. We both know Elizabeth Holmes. I think you know her better than I do. But this is a criminal fraud case against Elizabeth Holmes. Her company’s blood test, which did not work, was brought to market, skirting the FDA. Are you watching the trial? I’d love your reaction.

anne wojcicki

I haven’t watched it. I just have been busy. I mean, I definitely watched the movies. I’ve read about it. And obviously, I did know it, and we have that — I’ve seen all the various press. If you know her, you’re compared to her. I mean, yeah, her name comes up all the time. [CHUCKLES] Her name comes up all the time. And look, I think, to me, the number-one takeaway with Theranos is, frankly, the scientific literacy in this country. So one thing that just struck me— I would go to these conferences. And Elizabeth would present, and it drove me and a lot of the scientists in my company, that there was no one with a scientific background who was asking her the hard questions. And so —

kara swisher

Why didn’t you pipe up, Anne? [CHUCKLES]

anne wojcicki

We used to say all the time — we were — listen, there was one thing — within the company, there was always this sense of mystery. People in the company talked about all the time. Like, we just don’t — I remember, actually, my head of medical at the time was like, there’s no way it works. What she’s saying just is not — yeah, it’s just like, there was this whole world within the medical world was saying, listen — we just don’t believe. Like, how can this possibly work? And then, where’s the data to prove it? Again, going to this FDA question that you’re talking about, people want to see the data. You have an obligation to society to prove out how something works. And so it’s one thing when people would ask about 23andMe — I was like, we have proven out in ad nauseum how things work. We have 200 publications. When there’s a controversial idea about us, we publish on it to prove out. So then, I feel armed. I can go to a scientific meeting or I can talk to others, and I can say, I actually have the data. You show me your data. And so this was a case where I was disappointed by the world. Like —

kara swisher

No one would say anything. So you would be at these investor conferences, right?

anne wojcicki

Not just investor conferences, but all these various hoopla conferences. And there’s a lot of big names, and people would interview, and it never got into the deep science. And how does this really work? And it was, sort of, seen as, well, it’s a lot of trade secret. But I mean, look, I just think that in general, for all companies in the health care space, people need to push on them about, exactly how is the science working? And where are the publications? Like, where’s the backup? That’s the key. And so I just encourage that industry and people who are investing and looking at this area, there’s a lot of companies that promise what is happening, but where really are those publications?

kara swisher

Yes, but she had such a good picture of her posing with a drop of blood, and it looked so cool. [LAUGHS]

anne wojcicki

Listen, the idea is amazing. I mean —

kara swisher

So is invisibility. [CHUCKLES] So do you think it will lead to stricter government oversight over biotech? Do you think this is a moment or not?

anne wojcicki

Well, I mean, what’s interesting is, it’s unclear who regulates diagnostics. So there’s this laboratory-developed test world, and then 23andMe is under FDA.

kara swisher

So they can skirt it.

anne wojcicki

They can skirt it a bit. And so there’s something actually that is being discussed, called the VALID Act, which would potentially pull in — again, I’m not an expert in this, but it would pull in some of these laboratory-developed tests into the FDA purview. So look, I think that there’s a really interesting world that’s coming of new types of diagnostics. So what is that right kind of regulatory path for all of this? So look, I think diagnostics are an amazing industry, and I do think that there’s an obligation to prove that it works.

kara swisher

So the trust and scrutiny thing — do you think it will have a long tail of trust or it’s just an outlier?

anne wojcicki

Look, I think there’s a lot of companies out there that are — I mean, look, I think the reason why we have an agency like the FDA is because there’s a lot of companies that have products that don’t necessarily work. And so Elizabeth’s just one of — I mean, she’s different, because she was — there was an — again, I — she’s in court, but —

kara swisher

Allegedly.

anne wojcicki

There’s the alleged fraud. So there’s the alleged intentional manipulation of data and fraud. That said, there are other companies out there that I see, where I think they have products that don’t work.

kara swisher

Can you name them?

anne wojcicki

No.

kara swisher

OK, just asking.

anne wojcicki

[LAUGHS] But I think that it’s — I mean, look, I just think that there’s a lack of regulation in some areas, which is why you have something like the VALID Act.

kara swisher

Yeah. So in August, The Times interviewed female founders in Silicon Valley who talked constantly about being compared to Elizabeth Holmes, and facing additional bias and scrutiny. Have you experienced that? Do you see that happening?

anne wojcicki

I mean, I think — look, I get the Elizabeth question all the time, but it’s usually pretty easy to shut down. Like, I have a ton of data, and I just, like, don’t — you know, health care has always been an industry with a lot of- - there’s a lot of snake oil. And so the reason why — it’s important to prove out everything that you’re saying. So yeah, it comes up quite a bit. And I mean, look, there’s all of the very typical — like, again, you’re compared to another woman. It definitely impacts — listen, there’s absolutely this world of women getting more criticized on it because of Elizabeth. So 100% here. But I think —

kara swisher

And none of the men.

anne wojcicki

Yeah. I mean, look, the way that I try to combat it is, one, I don’t — it is what it is. And the best thing for me to do is build out a better network of support, like, women. There’s a number of women who’ve left 23andMe and are CEOs of their own company. Like, that’s pretty awesome. And the more that there’s a community and the more there’s a balance, and the more that women are out there mentoring other women, and, like, we’re creating the right kind of community and right kind of balance, you’re going to not get as many questions that are just about, like, how are you not like Elizabeth? And how do you manage having children while you run a company? Like, the number-one thing we need to do is just like solve the problem.

kara swisher

I have not — officially, I have not asked you that question. [LAUGHTER]

anne wojcicki

Well, listen, I can start breastfeeding at any moment. I mean, I joke. There’s all kinds of ways — the best thing that we can do is support each other and change the world. Like, change the community. And so that’s what I really spend a lot of time thinking about and focusing on.

kara swisher

We’ll be back in a minute.

If you like this interview and want to hear others, follow us on your favorite podcast app. You’ll be able to catch up on “Sway” episodes you may have missed, like my conversation with Dr. Anthony Fauci, and you’ll get new ones delivered directly to you. More with Anne Wojcicki after the break.

One of the things that does deserves scrutiny is how you and companies like you deal with privacy. So what do you say to people who think, OK, I want insight into my genes, but I’m not comfortable having that data in the hands of a private company. I think about that a lot with my personal data right now. Every time I open an app, I’m like, what are they getting here in my phone? I think quite a bit about it. But when it comes to genetic data, it’s a valid question for people to understand. What happens to that data?

anne wojcicki

Look, the reality, I think, goes to some of the things that the FDA thinks about. What’s the risk, versus what’s the potential reward? And in my mind, there’s a huge potential reward from understanding the human genome. I think that the potential for really understanding how you prevent human disease, how you can better manage it, and how you come in and treat it — I never want to be in chronic disease management, I want to be in chronic disease prevention. So just in my mind, there’s a huge, fascinating opportunity to understand.

kara swisher

But should there be more regulation to keep data private that isn’t largely left to companies?

anne wojcicki

I mean, there’s the Genetic Information Non-discrimination Act.

kara swisher

That’s a law preventing employers from discriminating against you because of your genetic information.

anne wojcicki

Yeah, and I think there are some privacy discussions. And we have a coalition that we’ve put together of companies that are all coming together and setting a standard. And again, Genetic Information Non-discrimination Act could absolutely be extended to areas like life insurance and long-term care. I think those are, sort of, ripe discussions to be had. We also — we’re really clear, we do not participate in law enforcement.

kara swisher

All right. So I was going to ask that, because genetic databases are a goldmine for law enforcement. And in 2018, police used publicly available genealogy database to track DNA of the Golden State Killer, which you referenced. Do you get a lot of requests from law enforcement? And how do you deal with them?

anne wojcicki

Well, we’ve been really — it was funny, one of our science advisors in the early days said — he’s like, oh, you know, this is a great business idea for you. You could have America’s Most Wanted. And I said, that’s great. That’s not for 23andMe. Like, we’re not doing that.

kara swisher

Oh, you could find those people genetically?

anne wojcicki

Well, he was just saying, you could be an assistance to crime discovery. And I said 23andMe has a single mission. It’s about the benefit, and we’re not involved in law enforcement. We’ve had requests from law enforcement, and we’ve been able to fight them all. You know, look, there’s people out there who want to have their genetic information uploaded to different groups, and 23andMe does allow people to download their DNA and do what they want with it. But it’s not a business area that 23andMe is ever going to get into.

kara swisher

Right. So one of the things your website says, “We will closely scrutinize all law enforcement requests, and we will only comply with court orders subpoenas, search warrants, and other requests that we determine are legally valid.” Would you ever turn over customer data to law enforcement? What would be the moment you would do that?

anne wojcicki

I mean, look, you would have to reallym— I mean, I would do everything I can to really prevent that. We have not had — we’ve not gotten into that situation. And I think that with over 11 million people, we’re now at a point where I think we’re relatively well established.

kara swisher

You have never yet given over information to law enforcement?

anne wojcicki

No.

kara swisher

OK. In 2019, officials of the Pentagon warned members of the military that, quote, “direct-to-consumer genetic tests are largely unregulated and could expose personal and genetic information, and potentially create unintended security consequences and increase risk to the joint force and mission.” What do you say to that?

anne wojcicki

I think that the government — for whatever reason, there’s this obsession with China. We have no interaction with China. We are not doing any research there. We have some stuff on the therapeutics side. There’s a company called WuXi that, again, many pharma companies work with.

kara swisher

This is an investor in 23andMe. They hold less than 1% of your company.

anne wojcicki

There’s nothing related to genetic data. There’s an information war that’s going on with respect to understanding the human genome. And China absolutely recognized that, and they want to win it.

kara swisher

Yes, they’re sprinting ahead in the war for genetic information.

anne wojcicki

They are sprinting ahead with — and they have Beijing Genome Institute, they are sequencing huge numbers of people, they collect medical — I mean, they’re doing a lot. And so the US, frankly, is just behind.

kara swisher

Is this a war we want to win?

anne wojcicki

Look, I think information is always valuable, and especially when it’s as important as the code of life. Like, I’m very focused on the prevention and the utilization and therapeutic development. And like, the U.K. also has the UK Biobank. They have incredible initiatives going on in genetics. And I think the U.S. absolutely needs to be finding a way to help people understand what the risk reward is, and that we need to have significant efforts really understanding what the human genome means.

kara swisher

So we’re losing this genetic race to China.

anne wojcicki

Oh, absolutely. Absolutely. And we spend more of our time — I absolutely honor all of the privacy discussions and the questions on choice. But at the same time, there’s a huge world of people who want to participate, and want to be part of this, and want us to make a real dent in the information war. Like, what does the human genome mean? And we should absolutely embrace that and put real money into understanding what the human genome means.

kara swisher

But one of the things you have said is, anyone who tells you that a hack is not possible is lying. When you think about protections against hackers, obviously, China has shown up in a lot of hacking recently, along with some other countries. How do you balance the idea of a threat to creating what you’re talking about, with attacks by China and other entities?

anne wojcicki

I don’t believe you can live in a world of fear. I mean, I think that we absolutely have to figure out how we are going to do everything possible to prevent an attack. So in some ways, the most important thing to do is to understand that you can never live in a world of zero risk, and that — it’s what Andy Grove said — the paranoid survive. So you have to be hypervigilant and hyperparanoid about it, so we’re highly aware, we think about it all the time, we think about how we structure the database in ways so that the genetic information is stored separately from the pheno— the self-reported information and any identifiable information. So it’s super important how we structure it. And the most important thing that we can do is be transparent with our customers, make sure people understand risk. And I think that, again, it’s all about risk-reward. I think the benefits are there.

kara swisher

So what are the implications of us losing a genetic genome race with China?

anne wojcicki

Well, I think it’s not known. But I think, what’s the value of having information? You know, what’s the value of the types of information that Facebook has? Like, it never would have occurred to me when Facebook started that they would influence elections. So I think the reality is, I can conceptually grasp the idea that understanding your human genome is really important. And all the different reasons why and exactly how you’re going to be able to manage it — I can absolutely identify therapeutics, prevention, other lifestyle components. But I think information about something as fundamental as humans and how we operate is really important to at least be on par.

kara swisher

And we are not.

anne wojcicki

Well, I think we should excel.

kara swisher

And in what format would that be?

anne wojcicki

Well, look, the reality is, it’s a data question. You need a lot of data. And to really understand what this means — I mean, there’s so much interesting potential of how you could eliminate some human disease. And again, I think a lot about the prevention side. It’s going to be important, especially in this world of CRISPR and the ability of groups that are thinking about synthetic biology, like, you want to understand how the human genome works.

kara swisher

Right. Speaking of which, talk about the pandemic heightening concerns about the sharing of biometric information. There is a lot of the misinformation coming out that has to do with bio-tracking, bio-manipulation. Bill Gates put a chip in this vaccine, and now he’s tracking me. And there’s all this resistance to taking vaccines, having yourself tracked, my body — you know, I don’t trust the scientists. Were you surprised by all this? And what has to happen to push that back? Because it’s an idea of total paranoia, as opposed to just normal paranoia.

anne wojcicki

Yeah, I mean, look, we spend a lot of time, obviously, in the house, thinking about misinformation. And you know, it’s interesting, like, I remember when H1N1 came out, and there was all those long lines to get the vaccine. Like, and it wasn’t that long ago, and I mean, it’s really just a remarkable change. And I think that there is that question that the tone from Trump in those early days really set us all on a totally different type of course. And I do think one of my biggest takeaways — and again, it’s been part of the ethos of 23andMe since the beginning — is that health care has to move from a hierarchical system to something that people can actually relate to.

kara swisher

Meaning, we’re telling you to take this.

anne wojcicki

Well, I think the white coat, any package insert is impossible to read. Drugs are really hard to say. It’s a whole language you don’t understand. Like, most people leave their doctor’s office feeling stupid. And I think that has to change if you’re ever going to fix this misinformation. Because people gravitate to Gwyneth Paltrow and Goop, because she makes it accessible, and she doesn’t talk down to you. And I think that if we’re going to solve misinformation, I think one of the most important things the health care world needs to do is actually have more of a partnership with people and build that trust. Like, people don’t believe in the hierarchy anymore.

kara swisher

Has it gotten worse since the pandemic?

anne wojcicki

Oh, of course. There’s been an undercurrent where people don’t really trust. And now, I think it obviously exploded, and it exploded in part because it was — that door opened up with Trump’s resistance to actually acknowledging everything that was happening. But I do think that the path forward is more of a world where — frankly, which virtual care has started to help. Like, I want to find a physician that I can relate to, that’s going to actually spend the time talking to me. And you’re starting to see this explosion with all kinds of very personalized systems that are going to appeal to you and what you want, and then you’re going to relate.

kara swisher

All right. The last question — talking about the future of genetic testing, you said that you think the world your children will live in will be entirely different from the one we are living in now. What does that mean for the world your children will live in?

anne wojcicki

I mean, one thing I’ve always — I tell my kids all the time, health care is the sum of what you’ve done every day. It’s cumulative. And I think the thing that’s really exciting is when I look at the world of wearables, and the ability to track yourself, and actually measure how you’re doing, how much you’re sleeping. People want a path to try to be healthier, and it’s hard to know what are the decisions that they should actually make. And I think with all of this information, you’ll be able to start changing your life. Like, I showed my sleep patterns from my iPhone to someone on my health R&D team. And he goes, whoa, you really got some erratic sleep. And there’s risk factors, like you’re at higher risk for diabetes and other things. And it was only, kind of, that awareness when I said, like, holy cow, I should change this. And so getting the data really does, I think, help drive better decisions. And I think that I have an opportunity with my kids of really knowing what their risks are. And I think that the combination of genetics, plus all of these various ways of phenotyping, of collecting information about you and how you’re living your life, is really going to create a different type of health care experience.

kara swisher

Is there a point where there’s too much data, where there’s no decisions left?

anne wojcicki

I mean, the thing that I always loved about genetics is this intersection between genes and environment. And whether it’s a good choice or it’s a bad choice, you’re always going to have choice. And you know, I think then, you just have more informed choice.

kara swisher

And so both yours and my two-year-olds will be what?

anne wojcicki

Well, one, you should get your two-year-old genotyped. [LAUGHTER] We could see if we’re related. That would be so cute!

kara swisher

No. Not really. Not you, not Rupert Murdoch, none of you are related to me. [LAUGHTER]

anne wojcicki

I mean, look, I think about, with my two-year-old, that opportunity to give her the best chance of being healthy, you know, when she’s 80. And you know, I think about things. Like, you know, my dad has atrial fibrillation, and I think about, OK, there’s genetic risk factors for this. If you’d known, are there things that you would change? Like, would he potentially not have been such an avid marathoner? And so I think about those types of long-term decisions. Are there ways I can help her really make informed choices about what she — actions that she wants to do or things that she’s interested in? So I think genetics is absolutely going to be part of my two-year-old’s health care in her whole life.

kara swisher

Until she lives until when?

anne wojcicki

Oh, I’m not in that world of, like, oh, I want to be 120. Like, I think you want to thrive when you’re older. You want to be like an awesome kicking-it 90-year-old.

kara swisher

Anne.

anne wojcicki

Yes, Kara.

kara swisher

Thank you so much.

anne wojcicki

It’s so fun. It’s always fun. [MUSIC PLAYING]

kara swisher

“Sway” is a production of New York Times Opinion. It’s produced by Nayeema Raza, Blakeney Schick, Caitlin O’Keefe, Matt Kwong, and Daphne Chen, edited by Nayeema Raza, with original music by Isaac Jones, mixing by Sonia Herrero and Carole Sabouraud, and fact-checking by Kate Sinclair and Kristin Lin. Special thanks to Shannon Busta and Liriel Higa. If you’re in a podcast app already, you know how to get your podcasts, so follow this one. If you’re listening on The Times website and want to get each new episode of “Sway” delivered to you, along with more proof that I’m not related to Rupert Murdoch — I’m not so sure about Tucker Carlson, though — download any podcast app, then search for “Sway,” and follow the show. We release every Monday and Thursday. Thanks for listening.

Anne Wojcicki is sitting on a treasure trove of genetic data. Wojcicki, a co-founder and the chief executive of the genetic testing company 23andMe, has led it through 14 years in which it has collected data from millions of customers through at-home DNA spit test kits. In 2018 the company announced a collaboration with GlaxoSmithKline to use this anonymized, aggregated data to develop pharmaceutical drugs — and attracted a $300 million investment from the pharmaceutical giant. And in June, when Wojcicki took the company public, it was valued at $3.5 billion. In some ways, it’s a standard Silicon Valley play: Lure customers in with the promise of democratizing information, then quickly moving to monetize that information. But what are the implications when the information at stake is your DNA?

[You can listen to this episode of “Sway” on Apple, Spotify, Stitcher, Amazon Music, Google or wherever you get your podcasts.]

In this conversation, Kara Swisher presses Wojcicki on the ethical, privacy and security questions intertwined with the 23andMe business model. They discuss what the rise of genetic testing might mean for today’s 2-year-olds and how the United States is faring in a “genetic information race” with China. And they dig into the ongoing Theranos trial — specifically, whether the case against Elizabeth Holmes will rein in a Silicon Valley health tech sector that, in the past, ran a little wild.

(A full transcript of the episode will be available midday on the Times website.)

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Credit...The New York Times

Thoughts? Email us at sway@nytimes.com.

“Sway” is produced by Nayeema Raza, Blakeney Schick, Matt Kwong, Daphne Chen and Caitlin O’Keefe and edited by Nayeema Raza; fact-checking by Kate Sinclair; music and sound design by Isaac Jones; mixing by Carole Sabouraud and Sonia Herrero; audience strategy by Shannon Busta. Special thanks to Kristin Lin and Liriel Higa.

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