TWC Lesson 6: BioBusiness Revolution - Healthcare and Biomedical Sciences

Brief Overview/Summary 

The lesson started out with the interpretation of a quote by Albert Einstein – “There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle”.

The idea which this quote conveys is that one may choose either one of two approaches to living – either go through life jaded and uninterested, or living with curiosity and fascination about all that is happening around one. The latter envisages one being open to change, being capable of and receptive to learning. Whereas the former depicts a falling star mindset, the latter is illustrative of a rising star mindset.

Another Greek proverb aptly sums up an underlying philosophy of the present topic on BioBusiness Revolution – that of having a future-oriented mindset – to be forward thinking in planning ahead to ensure the sustainable growth of society, and not merely be concerned with reaping the gains from current development.

Prof Shahi defines BioBusiness to mean any commercial activity that is based on an understanding of life sciences and life science processes. Relevant areas include the biomedical sector, agri-veterinary biosciences as well as environmental and industrial biosciences. Through a research designed to investigate the extent of industry dominance of BioBusiness, it was discovered that BioBusiness constituted an astounding 25% of global GDP and employs some 40% of the world’s labour force.

Prof then went on to note that healthcare as an aspect of global BioBusiness is the most prominent, in that it represents an area with great growth potential. This is as worldwide incomes are rising and with greater affluence, there will be increasing demand for greater access to and more sophisticated healthcare. The growth in global market size of healthcare is going to outstrip the growth of the same sector in the United States, which in 2001, constituted 52% of global market size.

The lesson then proceeded on a discussion of the major opportunity areas of BioBusiness. An underlying imperative was the need to capitalize on Summit Opportunities, to find a way to make Cloud Opportunities feasible and a reality and to shift away/reduce reliance on Valley Opportunities.

The various key areas of the BioBusiness industry highlighted were those of healthcare, pharmaceuticals, beimedical biotechnology, herbal and traditional medicine (e.g. neutraceuticals), medical devices and the process of diagnosis. Some of the notable trends in BioBusiness-related innovation include the exponential increase in the number of new patents being generated (from 660 drugs approved in 1977 to 3372 potential drug candidates in1997, according to a 2000 report by the US Patent Office) as well as rise in Multicellular Organism innovation (e.g. in the area of cloning) and Recombinants innovation. It is envisaged that new emerging innovations in the life sciences and biotechnology will revolutionize the BioBusiness landscape, which currently accounts for less than 0.5% of global BioBusiness. The promising possibilities in outcomes of such innovation were aptly captured in a video titled “The Future of Healthcare”. As Prof accurately sums up the BioBusiness industry’s outlook: “We are living in exciting times!” Indeed.

Interesting Observations and Ideas 

Reading 1 provided an overview of technology-related opportunities in healthcare and the biomedical sciences and I note some of the key points addressed in the paper:

1. There is substantial opportunity and potential to develop and apply innovative and entrepreneurial solutions in response to changing public health and healthcare service realities in the region.

2. New paradigms in healthcare and wellness have created new opportunities and growing interest in such areas as alternative and complementary medicine, and in nutraceuticals and functional foods.

3. New developments in information and communication technology and in medical devices for disease and wellness monitoring, create the opportunity to establish innovative service delivery approaches that are more cost-effective and can result in great improvements in health outcomes.

4. Advances in biotech-based drug design and development technology in the post-genome era promise to lead to increased success and efficiency, as well as lower development cost for new drugs. The increasing availability of novel technologies developed by biotech players is helping to drive collaboration and strategic alliances between big pharma and biotech players internationally and in the region.

5. The Asia-Pacific region promises to be a major growth market for diagnostics over the next several decades. Also, a growing base of world-class diagnostic companies in the region is working to develop innovative and promising new diagnostic products and technologies.

6. The biopharmaceuticals sector is generating growing interest in the development, testing and manufacturing of vaccines, recombinant protein drugs and monoclonal antibodies.

7. New opportunities are also being created in the outsourcing sector – especially in relation to contract research and contract manufacturing services. Asia-Pacific players stand to capture a significant piece of the out-sourcing pie.

Reading 2 was a report on biotechnology, innovation and intellectual property prepared by a team of international experts on the subject. The paper identified the need to transition away from the old model of IP (“Old IP”) towards a “New IP” era. What this posits is a greater focus on collaboration and cooperation among the various brokers and stakeholders, instead of increased protection, leading not only to greater levels of innovation, but better access to new products and services. The paper postulates that the best innovative activity occurs when everyone – researchers, companies, government and NGOs – works together to ensure that new ideas reach the public, but are appropriately regulated and efficiently delivered to those who need them.

The report then goes on to identify what actions are needed to make this transition: greater trust between industry, government, researchers and NGOs; more and better communication over IP and science and technology policy, and the crucial role the media has to play in this respect; new models which provide better ways to develop and deliver biotechnology products; enhancing science, technology and engineering, especially in low and middle income countries, to enable them to profit from innovation efforts; cross-cutting thinking – the need to work across discipline and bring together the various actors to generate mutual understanding of how IP actually works in context; having a fundamental grasp over what we want from innovation and devising an accurate measure of it.

Reading 3 presents UK’s strategic vision for its bioscience industry in 2015. It identifies various challenges currently facing the industry and recommends solutions to tackle these challenges.

Specific recommendations provided to tackle the critical challenges, in order for UK to achieve its vision of being a global leader in bioscience by the year 2015 (currently, the US takes the lead), are as follows:

1. Build mutually advantageous collaboration between the NHS and industry to maximise patient benefit.

2. Create a public and regulatory environment that is supportive of innovation.

3. Ensure sufficient and appropriate funding is available to fund the long and costly process of technology and drug development at all stages.

4. Build a strong bioprocessing sub-sector within UK bioscience to act as an enabler to bioscience innovation, and to anchor the bioscience sector.

5. Develop, attract, and retain a high quality scientific and managerial talent base with appropriate technological expertise.

6. Create the Bioscience Leadership Council to oversee implementation and continue sector-wide dialogues.

The report proposes that in making this vision a reality, the UK will be able to realise two significant benefits: Improved national health, through improved clinical performance and early access to innovative medicine; and increased national wealth, where Gross Domestic Product will be enhanced by maintaining and supporting a high growth, high margin, high value-added, knowledge-based industry.

Reading 4 emphasises the need for disruptive innovation in healthcare in the United States, which he opines is the most entrenched, change-adverse industry in the country. The author’s main contention is that the current healthcare system is convoluted, expensive and often deeply dissatisfying to consumers and that there is a need to allow the natural process of disruption to proceed to enable to emergence of a new system that is characterised by lower costs, higher quality, and greater convenience than could ever be achieved under the old system.

Disruptive innovations essentially work by enabling a larger population of less-skilled people to do in a more convenient, less expensive setting things that historically could be performed only by expensive specialists in centralized, inconvenient locations.

The progress of disruptive innovation is described as follows: while dominant players in most markets focus on sustaining innovations – on improving their products and services to meet the needs of the profitable high-end customers – those improvements soon overshoot the needs of the vast majority of customers. This then makes the market ripe for upstart companies seeking to introduce disruptive innovations – cheaper, simpler, more convenient products or services aimed at the lower end of the market. Over time, those products improve to meet the needs of most of the market, a phenomenon that has caused many of history’s best companies to plunge into crisis.

An apposite example of a disruptive innovation healthcare identified by the report was that of an English entrepreneur who has developed a system for customizing eyeglasses quickly and efficiently – it is a disruptive technology as it enables patients to do for themselves something that historically required the skill of professionals.

However, the author notes that oftentimes, established institutions/professions are quick to discredit these disruptive innovations for fear that these alternatives threaten their livelihoods. Further, regulators, afraid of putting patients at risk by adopting these nascent technologies, are likely to delay/withhold approvals of these innovations.

In response to the healthcare predicament, the author proposes several solutions:

1. Create – then embrace – a system where the clinician’s skill level is matched to the difficulty of the medical problem.

2. Invest less money in high-end, complex technologies and more in technologies that simplify complex problems.

3. Create new organisations to do the disrupting.

4. Overcome the inertia of regulation.

5. The need for collaboration in leadership at regional and national levels, not to regulate the existing system, but to coordinate the removal of barriers that have prevented disruptions from happening.

Rebekah Chua’s presentation on ‘Sci-Fi to Reality’

Rebekah posed the question of whether or not as a parent, we would want to employ the technology the advanced future technology envisaged to become aware of our unborn children’s predisposition to diseases.

It was discussed that should parents acquire knowledge of such predictions, they would conduct themselves vis-à-vis their child in such a way as to limit the child’s potential, out of fear that their child would fall prey to said diseases. However, a counter argument which Prof raised was that for certain diseases, should two parties have a predisposition to the said disease, the lifespan of their child would be greatly reduced. In these circumstances, it is difficult to argue against awareness. Notwithstanding the possibility of such occurrences, however rare the chances are, there remains the predominant and controversial concern over how such knowledge would drive parents to opt for adoption. The ethical and social consequences are significant.

I personally do not think that abortion would be that pressing an issue, at least not in Singapore. There are exigent and strict laws in place which makes abortion of unborn children a criminal offence if abortion is undertaken past a certain stage of development of the foetus. As such technologies to test DNA of the child to predict its predisposition to diseases are likely only to be employed when the foetus has matured beyond a certain stage (i.e. when essential organs are at least formed and functional I would presume), such a provision would apply to safeguard against frivolous acts of abortion.

Luo Xindi’s presentation on ‘Veti Gel’, which provides for the sealing of open wounds (clotting of blood) and may be self-administered, raised the question whether we would be prepared to use the gel should it be made available on the market. The consensus reached by majority of the class was that, given the relative ambiguity as to the long-term side-effects of application of the gel, it would be wiser to employ its use only as a last resort while under normal circumstances, especially when faced with small wounds, it would be safer to stick with traditional remedial methods. I agree that given it is uncertain what, if any, adverse long-term side effects may arise from continuous usage of the gel, until further research and tests have been conducted on the medication to ensure that it is as safe for use as possible, I would not want to use the gel unless there are no other viable alternatives available.

Irfan Nusrulhaq’s presentation on ‘Elixir of Youth: Telomerase’ posed the question whether the class would subscribe to telomerase and to the concept of immortality. Personally, I would not want to be immortal. I believe that what makes life exciting and fulfilling is in part because we are aware that it is limited. We only have a certain amount of time alive and that drives us to make the most of it; to seek meaning in what we do and to experience contentment and satisfaction when we realize various milestones/achievements. I think that if I knew it is possible for me to live forever, I would be very much less productive of my time. Ambition and dreams would fade as one expects to be able to experience/achieve anything one fancies to at some point in time, given that we have forever. Hence, personally, I would not approve of the introduction of any sort of technology that would deliver immortality to the human race.

Key Take Away Points 

1. There is great promise in the current BioBusiness and Biomedical sector revolution. One particular area of innovation that is particularly noteworthy is the potential of tele-consultation. As shown in the video on the Future of Healthcare, I note that the advent of tele-consultation envisages extensive patient benefits, among these: the saving patients’ waiting time and costs of transportation (which could be an onerous burden for those living in rural areas) in consulting a doctor; lesser patients suffering from detrimental consequences of missing their medication with the wireless ‘reminder’ system; patients being able to track their own progress and with greater information of their own condition, would be more motivated to take responsibility/play their own part in caring for their own health.

2. The video on childhood obesity is particularly striking. The World Health Organization predicts that by 2015, 2.3 billion people will be overweight, with 700 million obese. The situation of childhood obesity is also on the rise, with an estimate of 22 million overweight children in 2010. Particularly shocking is the example of Mexico, where the obesity index has risen by 300% in the last 30 years from 2010 and 70% of adults and 30% of children aged between 5-11 years are overweight as of 2010. Several reasons are identified in the clip for the prevalent global obesity trend. The growing affluence of low and middle income countries coupled with globalization resulted in an adoption of Western lifestyles and eating habits. Fastfood is becoming the diet of choice in many countries such as India and China and is often marketed as good food. Since fastfood is relatively affordable to the masses, the problem of obesity afflicts all levels of society and is does not just affect the wealthy. Another reason postulated is the changing concept of play – which increasingly contemplates very little physical activity and more electronic gadgets. This reinforces the idea of how the forces of globalization and technological advances in the various sectors which have a direct impact on our lives, may produce adverse consequences if not properly understood and managed.

Personal Ratings for Session

I would rate this lesson a 8 out of 10.