Health crises and emergencies such as Covid-19 have brought into sharp focus the critical need for preparedness. The unprecedented pandemic has led to a dynamically changing environment across the healthcare industry, posing challenges that call for innovative solutions.
Prior to the pandemic, major progress was being made in improving the health of millions of people. The world has made remarkable strides in increasing life expectancy and reducing some of the common killers associated with child and maternal deaths, according to the United Nations.
At the same time, more efforts were being put into fully eradicating a wide range of diseases while addressing many persistent as well as emerging health issues. Ensuring healthy lives and promoting well-being at all ages is now considered essential to sustainable development.
One of the most remarkable stories to emerge from the pandemic was the worldwide mobilisation to get vaccines into the arms of hundreds of millions of people. From research to drug development, trials, production and distribution, the speed and scale of the effort amazed everyone, including industry professionals.
People are now more aware of innovative medicine and the value of conducting clinical trials, said Dr Kengkran Louvirojanakul, chief executive officer of the Pharmaceutical Research and Manufacturers Association (PReMA), a Thailand-based, non-profit organisation representing members from research-based pharmaceutical companies.
The pandemic presented many challenges to the traditional way clinical trials were conducted as so many resources were diverted towards acute care, said Dr Catherine Donovan, head of medical affairs with Bayer Pharmaceuticals Asia Pacific.
Lockdowns and social distancing also made it difficult for patients to physically attend clinical trial sites, she noted.
Fortunately, many new technologies such as telemedicine and remote monitoring have made it more convenient for patients to take part while making clinical trials more efficient. These have been positive changes that should be here to stay, said Dr Donovan.
Clinical trial activity across the pharmaceutical industry grew throughout the pandemic, with 5,500 new planned trials being launched in 2021, up 14% from 2020, according to IQVIA, a global provider of analytics to the life sciences industry.
The world's 15 largest pharmaceutical companies invested a record US$133 billion in research and development (R&D) in 2021, representing an increase of 45% since 2016 and close to 20% of their recorded sales, said Dr Donovan.
HEALTH RISKS
After more than two years of the pandemic, many parts of the world have achieved herd immunity thanks to successful mass immunisation programmes. Many countries, including Thailand, are confident they can now make the transition from pandemic to endemic.
But even if the Covid emergency is receding, the burden of poor health overall continues to increase and systems are struggling to keep up, cautions Farid Bidgoli, general manager for the pharmaceutical multinational Roche in Thailand, Myanmar, Cambodia and Laos.
Ageing populations, rising incidence of non-communicable diseases (NCDs) and affordability issues are all prompting increased rationing of care. Covid-19 has exacerbated these challenges, he pointed out.
Each year 15 million people around the world die before age 70 from chronic diseases which include cardiovascular diseases, cancers, diabetes and obesity, according to Non-Communicable Diseases Key Facts 2021 by the World Health Organization (WHO).
Heart failure remains the number one cause of death affecting more than 60 million people worldwide, 50% of whom will not survive five years after diagnosis, while one in five patients will die within two years, said Dr Donovan of Bayer.
Meanwhile, the overall burden of cancer continues to soar with almost 20 million patients diagnosed worldwide in 2020. The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, she pointed out.
Prostate cancer is the second most diagnosed malignancy in men worldwide. In 2020, approximately 1.5 million men were diagnosed with the condition and over 370,000 died from it worldwide, she added.
GREAT EQUALISER
The digital revolution has been playing an increasingly vital role in healthcare, to the point where deploying digital technologies is no longer optional but essential. This reflects the growing importance of personalised medicine that caters to each individual patient's health conditions and care requirements.
Digital health technologies can empower consumers to make informed choices about their own health and provide new options to healthcare professionals in terms of disease prevention, diagnosis and management, according to Medtronic, an American-Irish medical device company.
Augmented reality (AR) for diagnosis and health education, remote monitoring with portable connected medical devices to diagnose and treat patients outside of the hospital setting, genomic analysis to customise treatments and health sensors to enable patients to monitor their health through wearables, digital tattoos and smart clothes are notable breakthroughs, said Raneewan Ramsiri, vice-president and managing director of Medtronic (Thailand) Co Ltd.
More and more patients and caregivers are looking for therapies with better patient outcomes, and through developments in AI and data analytics, medical devices are advancing chronic disease management by empowering clinicians to personalise medicine like never before.
AI, if used properly, can help bring equity, expand access to medical care and, when properly trained, provide unbiased diagnoses and prognoses, according to Ms Raneewan.
"Technology is the great equaliser," she said. "We believe that healthcare technology drives better clinical, economic and societal outcomes, yet many people still don't have access.
"As we engineer breakthrough medical technologies, we also need to develop new ways for the world to access them."
Medtronic's technologies reach more patients in new and promising ways -- such as at-home screening for oesophagus, stomach, small bowel and colon disease using a pacemaker the size of a large vitamin tablet placed in the body through minimally invasive surgery and remote monitoring of implanted devices, she noted.
"All of these life-transforming technologies are just the beginning. With more than 49,000 patents in our total portfolio and $2.5 billion in R&D investments, our product pipeline is the strongest it's been in our company's history," Ms Raneewan said.
Mr Bidgoli of Roche said AI advances and growing digitisation of pathology are also a promising approach to meet the demand for more accurate detection, classification and prediction of patients with breast cancer,
Roche has introduced three AI-based, deep learning image analysis algorithms developed for breast cancer, which is the second most common cancer in the world with an estimated 2.3 million new cases in 2020 and the most common cancer in women globally.
"Artificial intelligence technology shows promise in advancing pathology imaging, which can benefit cancer patients through more precise diagnosis leading to targeted treatment. AI tests can predict the best cancer therapies for patients," said Mr Bidgoli.
In collaboration with PathAI, a provider of AI-based platform technology for data-driven pathology analysis, the Roche programme expands pathologists' access to AI-powered technology to support companion diagnostic and drug development programmes, he added.
Roche also accelerated its digital transformation during pandemic. An example is LungAndMe, a digital solution available on multiple online platforms that won the Thailand Technology Excellence Award for Digital–Pharmaceuticals recently from the Asian Business Review.
The Roche Group's sales reached $16.5 billion in the first quarter of this year, compared to $15 billion in the same period last year. The pharmaceutical division generated $11.2 billion from January to March, up from $10.6 billion during a year earlier.
Investment in R&D remains Roche's priority. In 2021, the group invested $13.8 billion in R&D, through research, diagnostics and pharma development, data analytics and genomic insight teams in 17 countries.
Large amounts of data produced in research can be analysed by AI, leading to new insights into understanding disease, finding targets and modelling the interaction between a target and a molecule, Dr Donovan told Asia Focus.
Bayer is pursuing digital transformation across its entire value chain from research, development and commercial operations to product supply, she added.
During the pandemic, digitisation allowed clinical trials to continue despite social distancing, lockdowns and resources being diverted to fight the pandemic.
Bayer is also using data and AI-driven solutions to better characterise and classify diseases and the appropriate patient populations. The company is also collaborating in cardiovascular and oncology therapeutic areas with external partners such as the US-based Broad Institute, a joint project of MIT and Harvard.
The adoption of digital technologies gives rise to more empowered patients, who, through increased access to relevant data, are able to contribute to shared decision-making with their doctors. It's a cultural shift that has been characterised as the democratisation of healthcare, Dr Donovan noted.
Bayer's pharmaceutical sales in Asia-Pacific, including China and Japan, reached $6 billion last year, driven by innovative medicines and an established portfolio including women's healthcare products. Bayer Group's overall businesses grew over 7% in 2021, generating revenue of $19.3 billion, according to Dr Ying Chen, head of commercial operations with Bayer Pharmaceuticals Asia Pacific.
The company is investing another $1.3 billion in Leaps by Bayer, its investment arm, to support additional investments in companies developing innovative technologies in healthcare and agriculture, added Dr Donovan.
HEALTH LITERACY
Dr Kengkran of PreMA emphasised that health is not merely about curing diseases and carrying out treatments, but its definition should be amplified to cover the prevention of diseases and various aspects of individuals taking care of their health.
For five decades, PReMA has been working to ensure health security for Thais through medical research and development, innovation and collaboration.
"Health security should focus on the prevention and control of disease rather than only the treatment aspect," he told Asia Focus.
Also essential is health literacy, said Dr Kengkran, so that individuals have the opportunity to understand when, how and to what extent they can look after themselves.
In addition, timely access to innovative medication and healthcare services is important as it promises the quality and outcome of treatments, he pointed out.
According to the WHO, health literacy is achieved when there are changes in personal lifestyles and living conditions encouraged by knowledge, personal skills and confidence to take action to improve personal and community health.
"Health literacy means more than being able to read pamphlets and make appointments," the WHO says. "By improving people's access to health information and their capacity to use it effectively, health literacy is critical to empowerment."
Improving health literacy among populations allows people to play an active role in looking after their own health, participating in community health activities and pushing governments to work to their full potential to address health equity, the WHO added.
While the pandemic demonstrated the healing power of science, it also accentuated inequities worldwide. The outbreak has also stimulated the urgency of creating sustainable societies committed to achieving equitable health now and for future generations without infringing ecological bounds, the WHO highlighted on World Health Day 2022 in April.
In line with the UN Sustainable Development Goals, Bayer Pharmaceuticals has set a goal to fulfil the needs of 100 million women in low- and middle-income countries for modern contraception by 2030, Dr Chen told a recent virtual media briefing.
The company has also worked with Mercy Corps Indonesia, a local non-profit organisation, on programmes to educate women living in rural areas in Banten, West Java and East Nusa Tenggara and provide them with women's healthcare, modern contraception and family planning advice.
In India, it partnered with the Federation of Obstetric and Gynaecological Societies of India (Fogsi) and launched the "Preserve the Uterus" campaign. Since 2019, more than 3,800 healthcare practitioners have been trained through over 50 sessions that address the concerns about unwarranted hysterectomies among women in India.
Bayer Pharmaceuticals has also run local support programmes to educate and aid women living with hormonal disorders, like endometriosis -- a painful condition affecting 10% of women of reproductive age worldwide -- many of whom do not seek early diagnosis and treatment due to various misconceptions.
"We are committed to patient programmes to shift the treatment paradigm from traditional illness-based and hospital-bound to more sustainable patient-centred preventive care," said Dr Chen.
Roche, meanwhile, is striving for continuous improvement in safety, security, health and environmental protection to support sustainable development, according to Mr Bidgoli.
"This can be achieved by changing behaviour, by adapting equipment to the most recent standards or developing new, innovative processes. However, a sustainable effect can only be obtained within a longer time frame," he told Asia Focus.
Since 2015, Roche has reduced its energy consumption by 19%, reduced general waste by 26% and water consumption by 28.5%, he added.
