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Vol 25, No. 12, December 2021   |   Issue PDF view/purchase
COLUMNS
Navigating Through Current and Future Health Challenges
With 2022 on the horizon, Lu-Ching Lau, Director for External Affairs, Policy and Communications, Singapore and Malaysia, MSD, discusses three key areas where greater cooperation between public and private sectors can create synergistic benefits.
by Lu-Ching Lau

As we look forward to 2022, we see a continuing global evolution of the pandemic and concerted focus on vaccines and anti-virals production, development, and distribution all in close parallel as countries enter into an endemic phase of COVID-19. With that as the current context, it would also be important to look at other insidious health threats brewing in the background that can affect and progressively impact human health and the economy.

During this pandemic, patients battling other critical illnesses such as cancer have had treatments impacted by lockdowns and robust infection control measures. Patients may have been constrained by their ability to seek timely care, resulting in deferred diagnoses and delayed treatment.1 This situation requires a conscious collective effort by all caregivers towards ensuring that appropriate healthcare needs continue even as ongoing infections from COVID-19 are addressed. COVID-19 has also had many unintended consequences. One such example would be the increasing rates of antimicrobial resistance in hospitals with serious long-term health and economic implications.

During such a crisis, we have also seen an increase in public-private partnerships amongst governments and private companies. Such partnerships create sustainable platforms and effective preparations to better navigate through current and future health challenges.

There are three key areas already underway, where greater collaboration and dialogue between industry, medical professionals, community, academia, and governments can create synergistic benefits.

First, is the opportunity to make better use of private sectors’ resources and expertise, from research to vaccine and therapeutic manufacturing and distribution, as well as with ongoing vaccination programmes that require coordinated efforts to enhance vaccine confidence.

While vaccines are a critical part of the overall solution, emphasis is also placed on emerging therapeutics such as oral anti-virals that act by reducing the virus’ ability to replicate, thus slowing down the disease progression. They have the potential to treat infected patients at the onset of symptoms, and therefore prevent hospitalisation. There are several antiviral drugs already in various stages of development, such as MSD's and other companies' oral antiviral therapeutics, which have both shown a reduction in the risk of hospitalisation in different study protocols.

MSD, in the United Kingdom, most recently announced the first global authorisation in the world of their oral antiviral medicine for the treatment of mild-to-moderate COVID-19 in adults with a positive SARS-CoV-2 diagnostic test and who have at least one risk factor for severe illness. While treatments already exist for patients, they usually target those who already have severe forms of the diseases and have to be injected. Oral antiviral drugs, alongside other forms of medicines, will be a major step forward in the fight against COVID-19, adding options for earlier treatment to limit disease progression, and helping to reduce the burden on our communities and healthcare system.

Second, as the world looks to newer vaccines and anti-virals to tackle the COVID-19 pandemic, the steady rise of antimicrobial resistance (AMR) continues to be a significant health threat. At current rates, about 10 million lives a year could be lost as a result of AMR by 2050,2 surpassing even the current number of global cancer deaths each year. In addition, a recent report3 shows that drug-resistant infections cost global healthcare systems up to US$150 billion annually, equivalent to about 10 per cent of total healthcare costs.

With rates on such an upswing, clinicians have also reported increasing reliance on last-resort therapies.4 New antimicrobials are urgently needed to address growing resistance, yet relatively few are in development. Greater and more sustained allocation of resources and novel financing mechanisms are needed to bolster future antimicrobial development pipelines. In this aspect, the UK NICE’s de-linked funding model, which moves away from a cost-per-dose approach, can incentivise further investment into research and development to enable a broader pool of effective antimicrobials.

The third is to ensure that Singaporeans can continue to have broad and sustainable access to innovative oncology therapies. The development, manufacturing, and ongoing global distribution of COVID-19 vaccines reinforce the need for medical innovations across the value chain to save lives globally. However, prevention and treatment of COVID-19 must also be in concert with similar programmes for other diseases, such as cancer.

Patients need to have continued access to innovative medicines and therapies as they are developed at pace with scientific developments. Such access to medicines and treatments will need to also cover the “sandwich class” in our population, which means wider safety nets in our health policies for greater health equity. Cancer treatments need to include a holistic strategy beyond just outcomes-based and treatment cost. These can also include indirect costs on the value they bring to society e.g., impact on productivity and economic benefit to the workforce, improved mental health of patients and caregivers, and cost of caregiving itself in the prime of their lives. A recent survey of family caregivers in Singapore revealed that half of them were in the economically active group and were aged below 50 years. One in five caregivers had given up their jobs to care for aged loved ones, and one in four reported a worsening of their financial position after taking on a caregiving role.5

Lessons learnt from the ongoing pandemic not only prepare us to better navigate current and still evolving challenges but also help us consider effective ways to accelerate Singapore’s economic recovery in tandem. Our people are the most important and scarce resource that Singapore has, and it would be important to invest in health holistically to differentiate ourselves from the rest of the world.

As a leading global biopharmaceutical hub, we have the vision to build advanced manufacturing capabilities alongside innovative and cutting-edge research and development. This supports the Singapore Government’s objectives to build preparedness and resilience in our society and economy amidst the pandemic.

References

  1. Vintura. (2021). Every day counts – The impact of COVID-19 on patient access to cancer care in Europe. Retrieved from https://www.efpia.eu/media/602636/every-day-counts-covid19-addendum.pdf.
  2. Tangcharoensathien, V., Sattayawutthipong, W., Kanjanapimai, S., Kanpravidth, W., Brown, R., & Sommanustweechai, A. (2017). Antimicrobial resistance: from global agenda to national strategic plan, Thailand. Bulletin of the World Health Organization, 95(8), 599.
  3. Kfoury, J., La Mola, F., Young, M., & Ravishankar, S. (2017). Asia-Pacific in the Eye of AMR Storm: Nurturing Innovation To Fight Antimicrobial Resistance. L.E.K. APAC Life Sciences Centre of Excellence, L.E.K. Consulting. Retrieved from https://www.lek.com/insights/sr/asia-pacific-eye-amr-storm.
  4. Mendelson, M., Brink, A., Gouws, J., Mbelle, N., Naidoo, V., Pople, T., ... & Swan, G. (2018). The One Health stewardship of colistin as an antibiotic of last resort for human health in South Africa. The Lancet Infectious Diseases, 18(9), e288-e294.
  5. Ng, G. T. (2006). Study report of Singapore family caregiving survey. Singapore: National University of Singapore.

About the Author

Lu-Ching Lau is Director for External Affairs, Policy and Communications, Singapore and Malaysia at MSD. Prior to MSD, she held various senior leadership roles with a focus on policy, external/public affairs and government relations. She started her policy career with the Singapore Prime Minister’s Office.

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