Personalised healthcare plans progressing across APAC

The FutureProofing Healthcare initiative, led by a panel of 15 healthcare experts across the Asia-Pacific region (APAC), launched the Asia-Pacific Personalised Health Index last month.

Lim discussing the new index at a panel session.

This first-of-its-kind, data-driven policy tool measures the readiness of 11 health systems across the region (Australia, mainland China, Japan, India, Indonesia, Malaysia, Singapore, South Korea, Taiwan, Thailand, and New Zealand) to adopt personalised healthcare – enabling the right care to be tailored to the right person at the right time.

Personalised healthcare can improve health system efficiencies by helping decision-makers prioritise efforts and resources, and initiate policies and frameworks that support healthcare innovation. An ideal personalised healthcare system is one that leverages data, analytics and technology to generate meaningful insights, inform decision-making, and drive innovation that supports both individual and population health and empowers patients to manage their own health.

“While progress towards personalised healthcare is varied, the index shows that the APAC region is making strong strides in the right direction – and outlines a clear path for countries to accelerate this transformation. It is encouraging to see many countries already putting in place strategies, policies, and enablers to drive more personalised care, such as electronic health records, health data registries and artificial intelligence. Roche is committed to working closely with policymakers and other partners to help build the infrastructure essential to realizing sustainable, personalised healthcare ecosystems.”

The findings indicate that Singapore performed highest overall of the geographies measured due to a combination of high levels of digital maturity, comprehensive national strategies, a strong digital infrastructure and expansive innovation capacities leading to top scores in both the Health Information and Personalised Technologies categories. Taiwan (2nd), Japan (3rd) and Australia (4th) also performed well in overall readiness.

However, the index also revealed that even higher-performing countries have room for improvement. Challenges around urban-rural disparities and building digital infrastructure impact lower-scoring territories, several of which are at the very early stages of personalised healthcare. Performance in the index varied most on the Policy Context measure, owing to factors like limitations on access to data for health research and a lack of capacity to deliver personalised health-related services in the workforce.

The index also revealed the lowest average performance for countries is on Personalised Technologies (measuring use of artificial intelligence (AI) in health and uptake of wearable health technologies etc.), indicating an opportunity to improve.

“Personalised healthcare has the potential to improve the lives of millions of people across Asia-Pacific. We have already seen countries racing to adopt policies that facilitate digital health solutions like telemedicine during the current pandemic. But it is clear that more work is needed across the region to realise these benefits,” said Jeremy Lim, Director of Global Health and Associate Professor in the Saw Swee Hock School of Public Health at the National University of Singapore, one of the public health experts involved in the development of the index.

“The Personalised Health Index builds a clearer picture of the current readiness of health systems, and enables countries to build on their strengths, identify key areas of opportunity for improvement and identify best practice from other countries on individual measures. It helps jumpstart conversations about what action is needed today to shape resilient, personalised and sustainable health systems that work better for future generations.”

“The launch of the Personalised Healthcare Index is an important step in our efforts to enable policymakers in building health systems that provide better outcomes for all. Roche is excited to support the development of this unique policy tool, which leverages publicly available data to provide a holistic view of personalised health in our region," said Rachel Frizberg, Area Head Asia-Pacific at Roche Pharmaceuticals.

Although there are significant disparities between countries measured, the results also show that the transition towards personalised healthcare is underway and gaining momentum across most of the region.

The index and FutureProofing Healthcare initiative, supported by Roche, aim to help stakeholders across health ecosystems understand local, national, and regional strengths and needs, equip country leaders to embrace emerging changes in healthcare, and enable data-driven decision-making that can build future health systems that are fit-for-purpose. The Personalised Health Index measures performance against 27 different indicators of personalised health across four categories called 'vital signs': policy context, health information, personalised technologies, and health services.

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The index findings and policy recommendations have been published in a white paper, Getting to Personalised Healthcare in APAC, coordinated by the Copenhagen Institute for Futures Studies. View the results of the Personalised Health Index and read the white paper.

Singtel and AIA Singapore customers to benefit jointly-offered digital wellness initiatives

Singtel and AIA Singapore have partnered to promote consumer wellness, encouraging people to live more active and healthier lifestyles in this digital age. This collaboration is the first of its kind between two industry leaders in communications technology and life insurance in Singapore.

Both companies will team up to digitally engage their combined base of more than 5 million customers and reward them to get active and stay healthy. In addition, Singtel and AIA also plan to co-create innovative insurance products relevant to customers’ increasingly digital lifestyles.

In the coming months, Singtel will unveil a wellness digital platform that allows customers to earn mobile data rewards with every step they take and also offers content related to health, fitness and nutrition. The platform will sit within the My Singtel app which has more than 1 million active users a month. At launch, customers will also be able to earn lifestyle rewards from inaugural partner, AIA.

“We are pleased to work with AIA on our wellness drive to inspire Singaporeans to lead more active lifestyles. Keeping fit has never been easier with the use of fitness apps, smartphones and wearables to track our health and physical activity,” said Yuen Kuan Moon, CEO, Consumer Singapore, Singtel.

Source: Singtel and AIA. From left: Chua Sock Koong, Group CEO, Singtel; Yuen; Teow; and Ng Keng Hooi, Group Chief Executive and President, AIA, at the Singtel-AIA partnership signing ceremony held on April 3.

“As more of our customers go digital to manage their wellness, we are excited to go beyond connecting their fitness devices and be an integral part of their wellness journey by rewarding them with mobile data incentives, lifestyle content and services. We also look forward to welcoming other like-minded businesses to shape the future of wellness with us.”


Patrick Teow, CEO, AIA Singapore, said, “There is great synergy and passion in AIA Singapore and Singtel on the importance of healthy living, and we are united in our commitment to make a positive difference in the lives of Singaporeans. This collaboration builds on the success of our award-winning AIA Vitality wellness programme that taps into digital innovation to inspire Singaporeans to make real changes to their health. As AIA marks our 100 years in Asia, we are confident that, together with Singtel, we can multiply our efforts to help more people live healthier, longer, better lives.”


Wellness for the consumer is a fast-growing industry in Singapore with the digital fitness market estimated to grow by 30% by 2022*. As a nation, 54% of the population participate in sports regularly, with walking as the most popular form of activity, ahead of jogging and swimming**.

The AIA Vitality Weekly Challenge was launched in 2017 to further inspire AIA Vitality members to get more active and get rewarded weekly, by easily converting healthy actions into tangible rewards through a mobile app.  

AIA Vitality members currently enjoy Singtel mobile data rewards when they achieve their AIA Vitality Weekly Challenge. They can redeem their weekly rewards for a Singtel 1 GB seven-day local mobile data pass. The pass can be gifted to family and friends for use on eligible Singtel prepaid and postpaid plans. To date, AIA Vitality members in Singapore have taken more than 178 billion steps.

*Statista

**Sport Singapore, Participation Trends 2015

Singaporeans are terrible at sleeping

- Singaporeans sleep just over six hours of sleep on both weekdays and weekends, against the recommended eight

- Four in 10 Singaporeans admit their sleep has worsened in the last five years, with 65% experiencing daytime sleepiness

- Perceived high costs of sleep consultation and treatment, and downplaying the seriousness of sleep problems hinder Singaporeans from seeking professional medical help

Singaporeans are among the world’s worst sleepers, getting just 6.3 hours of sleep on the weekdays and 6.7 on the weekend, lower than the global average of 6.8 and 7.8 hours respectively and the daily recommended eight hours. This finding was announced by Royal Philips, a global player in health technology, in the report*, The Global Pursuit of Better Sleep Health.

Philips' annual global sleep survey, carried out in conjunction with World Sleep Day (March 15), surveyed over 11,000 adults in Australia, Brazil, Canada, China, France, Germany, India, Japan, the Netherlands, Singapore, South Korea, and the US to capture attitudes, perceptions, and behaviours around sleep.

Results showed that while awareness of sleep’s impact on overall health is on the rise, achieving good sleep health remains elusive. Besides being one of the top two nations having insufficient sleep, 70% of Singaporeans describe their sleep as ‘somewhat’ or ‘not at all’ well, and four in 10 (39%) say that their sleep has worsened in the past five years. The impact of this is demonstrated daily, with as many as 65% of Singaporeans saying they have experienced several episodes of daytime sleepiness throughout the week.

Stress was the main reason keeping Singaporeans up at night, with 61% of them losing sleep over worry or stress – higher than the 12-country average of 54%. Additionally, other factors that keep Singaporeans up at night include their sleeping environment (35%), distraction from entertainment such as television, social media (30%) and their partner’s snoring (14%) or sleep schedule (10%).

Eight in 10 (81%) respondents from Singapore say that they want to improve their quality of sleep. They are experimenting with a variety of methods, including instituting a set bedtime/wake-up schedule (28%), reducing their caffeine consumption (25%), playing soothing music (19%), and even sleeping in a different location from their partner (12%). Additionally, 11% of Singaporeans have also used connected care devices to track their sleeping habits, according to Philips’ Future Health Index (FHI) study^**.

“It’s worrying that Singaporeans are still ranked among the world’s poorest sleepers, despite public awareness around the importance of quality sleep for overall health,” said Ivy Lai, Country Manager, Philips Singapore.

“Philips is deeply rooted in its commitment to developing clinically-proven solutions that help people take control of their sleep health. Philips aims to provide solutions that meet the growing and evolving needs of consumers and healthcare professionals alike. To bridge the current gap in diagnosis and treatment of sleep disorders, last year we launched Southeast Asia’s first Sleep and Respiratory Education Center in Singapore to upskill healthcare professionals across the region, aimed at enabling better access to sleep and respiratory care.”

Balinese statue of a woman sleeping.

In seeking a better sleep, 43% say they would be willing to use online search engines to learn more about sleep and/or treatments to improve their sleep, 41% would be open to seeing a sleep specialist. Yet, 80% of Singaporeans have not sought help from a medical professional, mainly due to the perceived high costs of sleep consultation (48%) and treatment (43%).

“Sleep is a key pillar of good overall health, as equally important as having a healthy diet and getting regular exercise. While most are aware that sleep is fundamentally important, achieving the recommended eight hours of quality sleep is still an elusive goal for many people each night,” said Dr Mark Aloia, (PhD), Global Lead for Behavior Change, Sleep & Respiratory Care at Philips.

“The lack of quality sleep may not only induce low productivity and daytime sleepiness, but also pose serious health issues if not addressed. Those who suffer from prolonged poor sleep should consult their doctor to identify contributing factors and determine if they or their partner are at risk of underlying health issues such as obstructive sleep apnea.”

Obstructive sleep apnea (OSA) is characterised by repeated interruptions in breathing throughout the sleep cycle and prevents oxygen from reaching the lungs***. As many as one in three Singaporeans suffer from sleep apnea, and 91% have not been diagnosed^****.

Symptoms of OSA include choking or gasping for air during sleep, loud and persistent snoring and excessive daytime fatigue and poor concentration during the day. If left untreated, sleep apnea can have serious short and long-term health risks including heart disease, type 2 diabetes, stroke and high blood pressure.

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Take a one-minute quiz to assess your risk of obstructive sleep apnea (OSA)

Get additional insights on sleep

*This survey was conducted online by KJT Group on behalf of Philips from January 9–28, 2019 among 11,006 adults ages 18 and older in 12 countries (Australia: n=750; Brazil: n=1,001; Canada: n=750: China, n=1,001: France: n=1,000; Germany: n=1,003; India: n=1,000; Japan: n=1,000; Netherlands: n=750; Singapore: n=750; South Korea: n=1,000 and the US: n=1,000). The survey was web-based and self-administered in the primary language(s) of each country. These were non-probability samples and thus a margin of error cannot be accurately estimated.


**Philips Future Health Index (FHI) study, 2017 data.

***Philips: About Sleep Apnea

****Prevalence of sleep‐disordered breathing in a multiethnic Asian population in Singapore: A community‐based study, Adeline Tan, Yan Yi Cheung, Jason Yin, Wei‐Yen Lim, Linda W.L. Tan, Chi‐Hang Lee

CAGR of 5% for keto diet market

The keto diet has become popular as it reduces weight and body-fat percentages more rapidly than other diets for obese and overweight consumers, says Technavio.

The diet recommends adhering to an extremely low-carbohydrate, high-fat for regime in order to kickstarr a metabolic state known as ketosis, which makes the body more efficient at burning fat.

The research firm predicts that the keto diet market will register a CAGR of close to 5% by 2023. One of the key drivers for the market is the availability of keto diet products across online channels, specialty stores, supermarkets and hypermarkets.

However, a keto diet can have various side effects. The effects could have a negative impact on market growth, Technavio said.

The research has been mixed. A 2017 review noted that keto diets for type 2 diabetics are associated with a better control in glucose homeostasis and a reduction in antidiabetic medications but also warned that improvements seem to be short-term.

Details:

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The challenge of innovating fast enough to live comfortably to 100

Source: The Economist Events. Rashmi Dalai, Managing 
Editor, thought leadership, Asia, The Economist 
Intelligence Unit (EIU) (left) with Blackburn 
(right).

Will the speed of innovation, at its current pace, be enough to meet the longevity challenge? This question was asked in an on-site poll during The Longevity Summit – Is Asia ready for 100? in Singapore, and the majority (60%) of delegates said no.

More than 200 Asian business leaders, government officials and healthcare professionals gathered at the summit to discuss how best to engage Asia’s over-60 population in the productive economy and how stakeholders can foster healthier, longer-living societies. The need for change was clear.

A call for total change

Kanwaljit Soin, Founding President of Women’s Initiative for Ageing Successfully highlighted, "We have to change this linear version of life that exists currently, completely.”

Penny Wan, Regional VP and GM, JAPAC, Amgen, said that the current practice of waiting till people get quite sick before offering a solution is flawed. It would be better to predict and prevent, she said. "Find patients earlier, so they don't have to go through the debilitating consequences of a disease," she said.

"Innovate in how we do digital technology. Machine learning (ML), artificial intelligence (AI), and robotics are enabling us to do routine screening so we can predict and prevent a lot of the diseases especially in the chronic area. We could save hospitals and healthcare systems billions of dollars. It's no longer about adding years to life. It's really about adding life to those years."

Adapting to silver needs

Society will need to adapt to older people working for longer, on their terms. Wilf Blackburn, CEO, Prudential Singapore stated that “it is a myth that older people in Singapore don’t want to reskill and we need to demystify it".

Blackburn shared that in one case people working in a call centre were initially asked for data to train chatbots and later took over the training of chatbots themselves, some going on to train the trainers thereafter. Those others left in the call centre took on the more stimulating work of answering the complicated questions that the chatbots could not answer.

"Adopting practices in the working environment that are conducive to older people and to allow people to have flexible working hours is so important,” he added. "Practices that allow staff to have flexible work schedules, flexible processes where they work, where they choose when they work - certainly the older people appreciate that more."

Ecosystem needed

The consensus was that policy makers, financiers, tech companies and scientists need to collaborate if the region is to cope with and benefit from greater longevity.

"The topic of ageing is far too great for any sector to address on its own. We can't do it on our own, we can't do it on just technology. We need an ecosystem and we need different solutions," Wan declared. "Through focused and purposeful collaborations, we’ll be able to move from a health system of break-and-fix, to one of predict and prevent. Prevention measures lead to better health outcomes, lower costs and better quality of life for patients and their families.”

Blackburn also said that the new normal will require input from many constituents, and praised Singapore's SkillsFuture government reskilling programme for helping people to become productive assets in the workplace.

The need for more collaboration came through strongly in a panel titled Age of Innovation. Elizabeth Cha, Country Manager, Insilico Taiwan, talked about how AI and deep learning are being harnessed for molecular medicine. 

"We can do cross-comparisons between different communities and behaviours. We can get results quickly and get into validation earlier, find better medicare, or new uses for old medicine," she said.

"We need to find a new way to find the best medical care for the community, especially for longevity issues. Data is important, not just medical data – tissue typing, tests, but we need to analyse data from social behaviour," she added. Cha called on experts from multiple disciplines to collaborate to produce that data.

From left: Dalai; Roy; Wan; Kim; Cha and Tan.

What's hot in healthcare

When it comes to the solutions, Anne Kim, founder and Chief Executive, Alphavita Capital, said that the investment landscape for longevity had expanded from ageing to management of chronic diseases and the lifecycle of patients and customers. High net worth individuals and family businesses are interested in the phenomenon, she said, adding: "We are seeing more interest in broad investments in products, services and innovative business models leveraging technology today."

Specifically products that improve quality of life as people age are of interest, Kim said. In the services space the focus is on evolving business models for telemedical services and greater access to care; while the shared economy platform approach "to aggregate services and basically balance demand and supply of care" is also popular, she shared.

Finetuning the focus is important, however. Kim said that there is a lot more data needed to close the gap across the spectrum of care, which spans patients with chronic diseases, the sick, the dying, urgent care, and those who are frail. "We need to do more research what exactly patients need and what patients need to be served," she said. "The needs of men and women are markedly different."

Tan Hwee-pink, Academic Director, SMU-TCS iCity Lab, Singapore Management University, said that industry-led research projects at the university do involve AI, and identified a further challenge with following up on results. AI could identify seniors at risk for social isolation, or facing physical deterioration, for example. "If nobody knows what to do with that information it is as good as not having that information," he said.

Source: Prudential survey microsite.
Ready for 100 logo.

The Prudential Ready for 100 study

Prudential recently commissioned The Economist Intelligence Unit (EIU) to survey more than 1,200 residents in Singapore to find out if they are prepared to live long and well as life expectancy rises. Singapore, whose population has reached 5.6 million, will see 900,000 aged over 65 by 2030, and a rising number living to 100, the survey said.

Ready for 100: Preparing for longevity in Singapore found that Singapore residents often understand what they should do to live healthy lives, but may not practise what they preach. 

According to the report, rising longevity will only be a positive experience for Singapore residents if they strengthen four key areas of life:

Relationships

Three-quarters of respondents said they would be able to find some or all of the support they need in an unexpected life event. To avoid financial and emotional pressure from family members, the report recommended that people engage with "a more diverse set of communities and networks outside of their family".

Health and wellness

Singapore’s residents are largely aware of the importance of eating better and exercising regularly. They also have good intentions to do so, but urban living, a strong food culture - what Blackburn called an "eating culture like nowhere else" and conflicting definitions of what is “good” and “healthy” have created a gap between intent and action.

The study found that Singapore residents, on average, exercise below the recommended time per week and consume an excess of the recommended intake of sugar and processed grains. "This is contributing to rising rates of dementia, heart disease and diabetes," the study noted.

Financial health

Nearly eight in 10 residents do save, but it is challenging to save enough so that they do not have to work between the standard retirement age of 62 and 100. "As a result, residents need to reimagine how they plan their finances for older age. This includes investing as much in building their financial assets as they do in extending professional assets and careers," the report warned.

Work

The study notes that the Singapore government has mandated that employees cannot be forced to retire before the age of 62, and that eligible employees can be re-employed up to the age of 67. "However, to take advantage of these additional working years, ageing professionals need to have vision and courage to reimagine their careers and plan to work longer.

"Technology provides a number of opportunities for people to pursue new industries and provide education and reskilling opportunities, but it is only as useful as the initiative people take. Currently, a proactive attitude at work appears to be lacking. Only four out of ten residents say they actively seek new challenges at work," stated the report.

Changing behaviours

The psychology of persuasion - getting people to change their minds for the better - had some airtime during the summit. Nawal Roy, Chief Executive, Holmusk, has been engaging patients with digital tools to manage chronic diseases like diabetes for some years. "In chronic disease, engagement matters. Medication has value but if you are not able to engage with the patient on a regular basis you are not able to influence the outcome," he warned.

"We are banking on the fact that people who are unhealthy will do whatever it takes to become healthy," said a member of the audience. "If we took that away and see them at consumers and try to sell them something we would see better success."

Tan shared that older people are typically more resistant to advice from doctors, nurses, or staff from voluntary welfare organisations, whom they see as "big brother". "If (students) step in to speak to them they are more willing to speak to us," he said. "Seniors usually have a ringleader. Once you identify that ringleader, and if you get her on board (she will persuade the others)."

Roy said healthcare is "way behind the curve" when it comes to the science of psychology or behavioural science. "The good news is that it's changing at a very fast pace," he said.

Personas can help shape the narrative. He said there are those who are fully motivated, willing to change and able to change at one end of the spectrum, and those who are never going to change at the other. "In between you have different degrees of willingness and ability to change – that's the sweet spot," he said.

Roy also observed that solutions have to be recalibrated for different markets. "When you scale at the Asia level (that is a) problem even if you have a solution," he said.

Peggy Liu, Chair, Joint US-China Collaboration on Clean Energy, has found common denominators in getting people to change behaviours, from making it fun to catching them young.

Liu is focused on food as it is the the single largest source of greenhouse gases and affects climate change, and the best "Trojan horse" to changing the world's problems. She said the best time to change dietary behaviour is between the ages of five and nine, with one of the basic messages being to "eat a rainbow every day".

"You have to start at ages five to nine. Once you've passed nine you're pretty much hopeless," she said.

Liu's organisation has come up with the Food Heroes initiative, which focuses on microlearning, gamification, and play based education to educate people more effectively about healthy eating and food waste. Focusing on the children means that the adults in the family become involved as they shop for the "rainbow food" that the children request, for example.

"We're doing it all wrong, talking to people's heads, talking about statistics. It's all about their sense of self love and prosperity... tap into people's dreams," she said.

Liu is also proposing public-private partnerships on rewarding people for positive food behaviour with a Blockchain-based system.

Hashtags: #EconLongevity, #PRUReadyfor100, #PrudentialSG

New molecule could tackle hard-to-treat infections

Source: IBN. A diagram of the four-step killing mechanism of the polymer against drug-resistant superbugs.
Step 1: Binding of the positively-charged polymer to the bacteria cell surface;
2: Neutralising the positive charges of the polymer to enter the bacterial cell membrane,
3: Penetrating into the bacterial cyotoplasm, a fluid that fills the cell, and
4: Precipitating the cytoplasmic substances to kill the bacterium.

An international research team led by Singapore's Institute of Bioengineering and Nanotechnology (IBN) of the Agency for Science, Technology and Research (A*STAR) and IBM Research have developed a synthetic molecule that can kill five deadly types of multidrug-resistant bacteria. Similar solutions tend to have bad side effects but this molecule has limited, if any, side effects, the researchers said.

The new material could be developed into an antimicrobial drug to treat patients with antibiotic-resistant infections. The finding was reported* in Nature Communications.

According to the UK Review on Antimicrobial Resistance, superbugs kill around 700,000 people worldwide each year. By 2050, 10 million people could die each year if existing antibiotics continue to lose their effectiveness, as is expected to happen. 

“There is an urgent global need for new antimicrobials that are effective against superbugs. The situation has become more acute because bacteria are starting to develop resistance to the last-line antibiotics, which are given only to patients infected with bacteria resistant to available antibiotics,” said Professor Jackie Ying, Executive Director of IBN.

The research community is developing alternatives to antibiotics using synthetic polymers. However, the antimicrobial polymers developed so far are either too toxic for clinical use, not biodegradable or can only target one type of bacteria.

To address this problem, Dr Yi Yan Yang from IBN brought together a multidisciplinary research team from the US, China and Singapore to develop a new class of antimicrobial polymers called guanidinium-functionalised polycarbonates. These polymers have a unique killing mechanism that can target a broad range of multidrug-resistant bacteria. They are also biodegradable and non-toxic to human cells.

The polymer kills bacteria by entering the bacterial cell, which is not normally possible. First, the polymer binds specifically (piggybacks) to the bacterial cell. This allows the polymer to be transported across the bacterial cell membrane into the cell contents, where it causes precipitation (creation of solids from the liquid) of the cell contents (proteins and genes), killing the cell.

The team tested the polymers on mice infected with five hard-to-treat multidrug-resistant bacteria: Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureu (MRSA) and Pseudomonas aeruginosa. These superbugs can be found in hospitals and can lead to septic shock and multiple organ failure.

The tests showed that the bacteria were effectively removed from the mice, and no toxicity - negative side effects - was observed. The researchers then further tested the effectiveness of the polymers on mice with two types of bacterial infections caused by superbugs: peritonitis, an often-fatal infection of the stomach’s inner lining, and lung infections from Pseudomonas aeruginosa. The polymers eliminated the infections in both groups of mice with negligible toxicity.

Dr Yi Yan Yang, Group Leader at IBN said, “We have demonstrated the first example of a biodegradable synthetic macromolecule with broad-spectrum antimicrobial activity in mice, unique killing mechanism and no toxicity. Once the polymer finishes its job of killing the bacteria, it will be naturally degraded after three days and will not remain in the body. This antimicrobial agent shows great promise for the treatment and prevention of multidrug-resistant systemic infections.”

 “This study illustrates the potential for this new research field we denote as ‘macromolecular therapeutics’ to create entirely new classes of treatments for multiple diseases,” said Dr James Hedrick, Distinguished Research Staff Member, IBM Research – Almaden, San Jose, California in the US. “In 2016, we demonstrated the efficacy of synthetic polymers to combat deadly viral diseases. The current research for treating bacterial infections rounds out our ability to someday treat a spectrum of infectious diseases with a single, new type of mechanism without the onset of resistance.”

To determine whether the bacteria will develop any resistance to the polymer, the team collaborated with Dr Paola Florez de Sessions at A*STAR’s Genome Institute of Singapore and the Cell Engineering group of Dr Simone Bianco at IBM Research – Almaden to perform genomic analysis. They found that the bacteria did not show any resistance development even after multiple treatments with the polymer.

This study was also done in collaboration with the University of North Dakota’s School of Medicine and Health Sciences, and the First Affiliated Hospital of Zhejiang University’s College of Medicine.

IBN and IBM are now seeking collaborations with pharmaceutical companies to develop the polymers into a commercial treatment.

The Institute of Bioengineering and Nanotechnology (IBN) is the world’s first bioengineering and nanotechnology research institute. Established in 2003, IBN aims to improve healthcare and quality of life.

*Willy Chin, Guansheng Zhong, Qinqin Pu, Chuan Yang, Weiyang Lou, Paola Florez de Sessions, Balamurugan Periaswamy, Ashlynn Lee, Zhen Chang Liang, Xin Ding, Shujun Gao, Collins Wenhan Chu, Simone Bianco, Chang Bao, Yen Wah Tong, Weimin Fan, Min Wu, James L. Hedrick and Yi Yan Yang, A Macromolecular Approach to Eradicate Multidrug Resistant Bacterial Infections While Mitigating Drug Resistance Onset, Nature Communications, 9 (2018) 917.

Actxa Spur simplifies training in your heartrate zone

Actxa has released the Spur, an all-day activity tracker with continuous heart rate monitoring and heart rate zone indication markers. A convenient alternative to the traditional chest strap, the Spur intends to make training in the different heart rate zones accessible to everyone, not just athletes.

Fitness enthusiasts and professional athletes have, for decades, used their heart rate to determine the ideal intensity levels for their training. The more intense your workout, the higher your heart rate is.

The Spur measures resting heart rate with a built-in sensor at the wrist, and helps calculate and track Warm Up, Fat Burning, Cardio, Intense and Maximum heart rate zones, buzzing when the wearer has entered or exited each zone.

"It's great that many of us are walking 10,000 steps daily, but it's important to do it at a moderate intensity to improve our cardiovascular health," explains Joel Chin, CEO. "We also need to make sure our sessions aren't too intense on recovery days. With the Spur, you get the guidance and monitoring you wish for, to plan your training schedule, so your body gets both the workout and rest it needs for better health."

In addition to monitoring your heart rate, the Spur also tracks step count, caloric expenditure, active duration time and distance travelled. Personal goals can be set and tracked with the Actxa App. The Spur also monitors the quality of a wearer's sleep.

"We want to make fitness attainable for everyone. A healthy lifestyle isn't just for the technologically adept or the elite athlete with their fancy equipment. It needs to be accessible for the regular person on the street," said Chin.

Interested?

The S$99 Spur is available in June 2017, and retails for S$99 online from Actxa, and at authorised retail partners.

posted from Bloggeroid

Smart coach for diabetics aims to raise quality of life in the long term

Source: GlycoLeap website. Couple discussing content on a device.

A 'smart coach' service has been introduced to help people living with type 2 diabetes* to adopt healthier habits that can lead to a better quality of life in the long term. Diabetes, especially if it is not well controlled, can lead to problems such as blindness, kidney complications and nerve damage. It has also been implicated in Alzheimer's disease, which is sometimes called 'type 3 diabetes'.

Healthcare costs associated with diabetes continue to be a major concern worldwide. Diabetes affects more than 415 million people worldwide - a number that grows every year, said Holmusk, a digital health and data analytics company, noting that diabetes-related complications are a major cause of hospitalisation.

According to a 2016 article in the BMC Public Health journal, Singapore's healthcare spending for diabetes rose above S$1 billion in 2010, and is expected to soar beyond S$2.5 billion by 2050. A 2015 study by the International Diabetes Federation (IDF) found that Singapore has the second-highest proportion of people with diabetes among all developed nations - more than 10% of people aged 20 to 79. Three out of every 10 patients with diabetes develop the condition before age 40.

Holmusk points out that the high costs of diabetes - both for the individual and the healthcare system - and the personal nature of diabetes management, presents an opportunity for technologies that can provide scalable and engaging solutions for better diabetes management. The company has an advisory board where two members are medical doctors, and thought leaders in their fields.

"People are most familiar with the traditional model of making clinic appointments, travelling down to the clinic, and seeing the doctor for 15 to 20 minutes every few months. This model, which focuses on the clinic/hospital/doctor, will no longer be sustainable as the burden of chronic diseases rises - we need to move patient care forward, focusing on prevention, and into the patient's homes and community," explained Dr Yau Teng Yan, Chief Medical Officer, Holmusk. Dr Yau practised in primary care for over seven years, managing many patients with chronic diseases in the clinic.

The solution from Holmusk combines human expertise and mobile technology to nudge patients towards healthier habits. Called GlycoLeap, the subscription-based service tracks the user's behaviour with various tools and then delivers coaching advice from human dietitians via a mobile app. Just as a personal coach at a gym can give a person more incentive to stick with a gym programme and reach personal goals, GlycoLeap acts as a lifestyle coach to provide that added push to start and maintain a healthier lifestyle.

"GlycoLeap is transformative for people with diabetes, especially in the way it brings diabetes care out of the clinics and hospitals and into people's everyday lives," said Nawal Roy, CEO and Founder of Holmusk. "We want to contribute towards revolutionising the healthcare experience for people living with chronic disease."

GlycoLeap uses concepts from behavioural science to drive positive health outcomes for people with diabetes. Through small and sustainable lifestyle changes, users can achieve moderate weight loss and improve glucose control (as measured by HbA1c levels in the blood) within six-months of the GlycoLeap programme.

As part of the programme, users take photographs of their meals with the GlycoLeap app for rating by the GlycoLeap team of dietitians. Users are also provided smart devices, including a wireless scale, glucometer and fitness band to track weight, blood glucose and physical activity. This gives the coaching team a 360-degree view of each user's behaviour, allowing them to provide the right feedback and support at the right time on a daily basis.

Dr Yau commented that the GlycoLeap model is based on an outstanding user interface, ease of use and our natural need for human interaction. "Good design is vital. In developing a health intervention for the consumer, it has to look good and more importantly, be intuitive and easy to use. Consumers have high expectations of their apps and they take reference from well-designed apps like Facebook, WhatsApp, and Uber. So if your app doesn’t meet a minimum threshold of good design, no matter how many functions it has, people aren’t going to use it. Our earliest version of the app had a very minimalistic, modern-looking interface, but based on user feedback, we changed it to something a lot more personable and friendly," he said.

The devices in the GlycoLeap system are also designed to be as easy as possible to use. "For example, our wireless weighing scale is synced with your personal account out-of-the-box. Just step on it and your data flows into your account. There is zero setup needed. For those who are not ready or already have their own devices, we also offer them a purely app-based version of the product with the devices, at a lower price," Dr Yau said.

The human connection is also critical in health-related behavioural changes, he added. "We are social creatures at heart, and yearn to interact with other human beings - and not the computer! For us, our users stuck around for a much longer time only after we built in a two-way messaging interface which connected them with a real-life dietitian.

Source: Holmusk. In-app conversation.

"Our dietitians actively reach out to the users and ask questions if they need to clarify something. We see each food photo as an opportunity for highly-personalised health education, and to deepen the relationship with the user. Our goal is not to tell the user exactly how many calories or how many grams of fat they just ate, but rather to reinforce key concepts through direct and timely feedback. This approach opens up a deeper, more honest discussion with our users."

Dr Yau recounted that one user had been eating irregularly and did not like vegetables when she first joined the GlycoLeap programme. "After a little prodding from our health coach through the app, she also shared that she had a poor relationship with her doctor and was fed up that everything she did was ‘wrong’. At the beginning, her meals were full of carbohydrates and low in fibre. But over time, the accountability and the relationship she established with her health coach through our app led her to have a lot more balanced meals and include more vegetables in her diet. She went to her doctor recently, and her HbA1c (a marker of diabetes control) improvement far exceeded even our expectations," he said.

The GlycoLeap model also makes much more effective use of a dietitian's time, Dr Yau said. "Because of the intuitive dietitian coaching system that we've developed, our dietitians can see the user's diet and activity history at one glance and focus on where they can add the most value. This makes the process much more efficient.

"In the clinics, dietitians usually see six to eight patients a day, and spend 20 to 30 minutes per patient just trying to take a proper food history, before going into the more important counselling aspects. By taking the manual, time-consuming parts out of the way, a dietitian on our system is able to handle up to 200 clients on a given day. We have three full-time dietitians, and will hire more according to need."

Dr Yau said the main target audience for GlycoLeap would be people who are at the early end of the diabetes spectrum - those with prediabetes*, newly-diagnosed type 2 diabetes, and early type 2 diabetes.

"We've gone live with GlycoLeap for two months now, and are looking for the right channels to reach out to people who can benefit from this. Because it is a novel model of care, we anticipate it will take some time to educate the market, to understand how digital health can be an important and effective component of medical care," he said.

"It's really about prevention," he added, citing the IDF study on people under 40 developing the condition. "From the public health perspective, it's of greatest cost-effectiveness and importance to manage your condition well as early as possible, before complications start to set in. Also, this group of people tend to be younger, and are more comfortable with smartphones and mobile apps."

Dr Yau added that people with diabetes who also have other conditions such as hypertension can also benefit from GlycoLeap. "Hypertension and high cholesterol are common in the population, and our dietitians have the expertise to counsel them accordingly. With complex conditions, for example late-stage kidney disease, we set expectations that you should always listen to your primary medical team who knows your condition best, while we provide a supporting role," he said.

Holmusk currently provides users with a monthly PDF summary that they can discuss with their doctors. "We are exploring ways to integrate more deeply with the patient's health providers," Dr Yau disclosed. Plans are also in the works to develop tailored programmes for people with prediabetes - as well as other chronic diseases, such as high blood pressure and high cholesterol - in the next six months.

Another milestone will be the introduction of an artificial intelligence (AI)-backed chatbot to provide the first line of support to users. "You can expect to see that live in a few months time - a hybrid human-AI system will enhance our scalability while maintaining efficacy," said Dr Yau.

"After using GlycoLeap for six months, my HbA1c was reduced from 8.7 to 6.2%," said Singapore user Wen Shi. "The feedback provided by the dietitians on food rating has helped me realise what types of food are good at controlling my glucose."

Interested?

Watch the video introduction to GlycoLeap

GlycoLeap is currently available in Singapore, and expected to become available in Malaysia and Hong Kong by early 2017. The app is available for iOS and Android.

The service is available on a monthly subscription. Users begin with a six-month core programme that costs S$69 a month, and then move on to a maintenance programme at S$20 a month. There is no minimum period for the maintenance programme, and users may can cancel anytime.

*People with Type I (or type 1) diabetes are born with the inability to produce insulin, while people with type II (or type 2) diabetes typically develop the disease in later life and produce too little insulin, or cannot make use of the insulin they produce. Problems with insulin are reflected by consistently high levels of HbA1c in the blood. 

Prediabetes refers to elevated HbA1c levels which are high, but not high enough to be considered diabetes. The condition is considered to be an indicator of eventual diabetes if the person does not take steps to lower HbA1c, with lifestyle changes for instance. 

posted from Bloggeroid

More non-drug trreatments used to address depression

While depression is on the rise, the global drug market is seeing a decline as sufferers turn to alternative treatments, says research firm Technavio.

Its report on the global depression drugs market forecasts a CAGR of -6.64% from 2015 to 2019. "The prevalence of depression has become very high because of factors like genetic vulnerability, lack of proper diagnosis and treatment and a high degree of association with other disorders like diabetes, stroke and cardiovascular diseases,” says Faisal Ghaus, Vice President of Technavio. 

"Many patients are opting for complementary and alternative medicines, in combination with conventional treatments. These therapies can include relaxation techniques, massage, meditation, counseling, and art therapy. Homeopathic and naturopathic medicines have also been found to be helpful in treating depression. These effective alternatives are expected to erode the market share of drugs currently being used for the treatment of depression over the projected period.” 

Malaria may soon be detected with a simple breath test

Source: CSIRO. Tests such
as this one, which captures
exhaled breath for chemical
analysis, may soon be used to
detect malaria.

Australian scientists at CSIRO, QIMR Berghofer Medical Research Institute and the Australian National University have made a significant discovery that could lead to a simple and quick "breath test" for malaria. Current malaria diagnosis techniques focus on using microscopes to look for parasites in blood, using a method discovered in 1880. 

The researchers looked at the breath of volunteers who had been given a controlled malaria infection as part of existing studies to develop new treatments, and found that the levels of some normally almost undetectable chemicals increased markedly in the breath of the volunteers during the malaria infection.

"What is exciting is that the increase in these chemicals were present at very early stages of infection, when many other methods would have been unable to detect the parasite in the body of people infected with malaria," Dr Stephen Trowell, Research Group Leader at CSIRO said.

"In addition to its potentially better sensitivity, human breath offers an attractive alternative to blood tests for diagnosing malaria."

The study, published in the Journal of Infectious Diseases, was conducted in two independent studies where experimental drug treatments were being tested in volunteers who had been given a very small dose of infection.

Using a sophisticated analytical instrument, the researchers identified four sulphur-containing compounds whose levels varied across the time course of the malaria infection.

"The sulphur-containing chemicals had not previously been associated with any disease and their concentrations changed in a consistent pattern over the course of the malaria infection," Professor James McCarthy, Senior Scientist in Clinical Tropical Medicine at QIMR Berghofer said. "Their levels were correlated with the severity of the infection and effectively disappeared after they were cured."

"Now we are collaborating with researchers in regions where malaria is endemic, to test whether the same chemicals can be found in the breath of patients," Dr Trowell said.

"We are also working with colleagues to develop very specific, sensitive and cheap 'biosensors' that could be used in the clinic and the field to test breath for malaria."
In 2013, according to the WHO, there were almost 200 million cases and over half a million deaths due to this disease.

Mobile health will impact consumer healthcare industry in the long run

Market researcher Euromonitor International says mobile health (mhealth) is an emerging market segment to watch in the global consumer healthcare market.

According to Euromonitor, mhealth is about engaging consumers via mobile apps and devices with the purpose of modifying behaviour towards improved health outcomes. 

In 2014, over-the-counter (OTC) remedies such as sleep aids, eye care, dermatologicals and digestive remedies performed very well with US$36 billion in sales globally. Emerging market segment sports nutrition grew strongly in the mass market with US$10 billion in sales globally, but still represents the smallest category within the consumer health industry at 4.7% share.

The company said the global consumer health industry experienced 5.7% growth in current/fixed currency terms, with US$216.4 billion in retail sales globally in 2014. 

"The industry keeps growing at a healthy pace as significant corporate consolidation will transform the competitive landscape and the rise of mobile health will impact consumer behavior in years to come,” said Euromonitor's Head of Industry Research, Monica Feldman.

Guardian Health & Beauty launches interactive e-commerce portal

Guardian Health & Beauty, Singapore’s most established health and beauty chain, has just launched a US$1.3 million e-commerce portal for health and beauty that not only offers the entire range available at the Guardian stores, but also curated content, and virtual healthcare consultations.

Source: Guardian website.

Said Sarah Boyd, Chief Executive Officer (CEO) at Guardian Health & Beauty: "Singapore is the first to debut such a comprehensive e-commerce site across the Guardian Health & Beauty network in Asia. Our decision was motivated by the fact that consumers here are avid digital shoppers and are increasingly turning to online resources for their health and beauty needs."

"People are expecting to find products online. We're making sure we're present where our customers expect us to be present, especially for health and beauty," she added, noting that Google data in 2014 shows consumers in Singapore run an average of 11 million health and beauty searches monthly, including 2 million searches for vitamins and supplements alone.

“Singaporeans take a very proactive approach to their health. The per capita spend on vitamins and supplements is higher in Singapore than in any other country in the world. Our vision for the portal is to be a one-stop holistic content and services solution that caters to urban living with a host of convenient services and novel features."

The portal, www.guardian.com.sg, marks the first time that a large-scale health and beauty retailer in Singapore is offering short virtual health consultations through an exclusive partnership with MyDoc, an online health consultation platform. Time-pressed Singapore consumers are now able to schedule online appointments and have their health concerns attended to by experienced doctors and Guardian pharmacists over an online chat or video call. Personal health diaries with secure logins allow users to track their health histories and facilitate follow-ups.

Visitors to the portal can also enjoy:

· Access to over 500 different well-known health and beauty brands and over 3,000 different products, complemented by curated content in the form of health and wellness tips and advice regularly contributed by Guardian’s pool of pharmacists.

· Door-to-door delivery services for orders, with the option of choosing a preferred delivery date and one of four delivery time slots, including two evening slots – a first for the health and beauty sector in Singapore. Alternatively, purchases can be picked up at almost all of Guardian’s 148 stores island-wide, excluding the airside stores at Changi Airport.

· ‘Live’ customer service chats are available from Monday to Saturday between 9.30am to 6pm, and offer a convenient channel for public feedback and enquiries. The company notes that the service is a rarity even with other local online retailers.

“Our new e-commerce push is part of Guardian's ongoing efforts to evolve and rebrand – this is the start of a new journey and we will continue to stay responsive and adapt to the fast-changing health and beauty needs of consumers in Singapore,” added Boyd.

Providing additional perspective on the online health consultation service, MyDoc Co-founder Dr Snehal Patel said that the growth in digital and social media has fuelled the demand for quick and accessible medical advice. He shared a McKinsey study that said 75% of respondents from Singapore, UK and Germany would like to use digital healthcare services*.

“MyDoc uses the explosion in social media and Internet technology to help bring people closer to their health providers. No longer do people have to delay seeking advice because their busy lives make it difficult to schedule a visit to their clinic. 

"By making access to care easier and more seamless, people can benefit from more consistent management of their health conditions which have been shown to prevent painful and expensive hospitalisations. The partnership with Guardian is a natural fit for our service – just as Guardian is making purchasing healthcare items effortless, we are making obtaining advice easier than ever. We are excited to be part of this new push for truly personalised care,” said Dr Patel.

Guardian’s commitment to online retailing is underscored by its partnership with digital consultancy and educational institution Hyper Island, which acted as a consultant during the 18-month planning and development process. “Guardian’s platform changes the game and bridges the gap in the health and beauty landscape through several features and innovations not seen in any other health and beauty portal in Singapore,” said Hyper Island Co-founder and Academic Director Professor Jonathan Briggs.

*Healthcare's digital future, July 2014.

EmTech Singapore 2015 now open for delegate registration

MIT Technology Review’s EmTech Singapore event, has been conceptualised to discuss the convergence of technology, business, and culture. It is a showcase for the technologies that matter and how they’ll change the face of business and drive the new global economy. To be held 27-28 January 2015 at the Sands Expo and Convention Center, the event has opened for delegate registration. 

The key themes for EmTech Singapore for 2015 are: 

Digital Life

The Internet of Things (IoT), which marks a revolution in technological advancement, will be discussed alongside emerging platforms and a new era of computing. Topics also include wearable technology and the latest frontline innovation; how robotics is moving well beyond the factory; and how drones are interacting with humans and industry in new ways (agriculture, healthcare, and more).

Scott Farquhar, Co-founder and Co-CEO of Atlassian headlines this session alongside Marita Cheng, CEO, 2Mar Robotics Founder of Robogals; Jean-Christophe Baillie, Founder & President of Novaquark and Sonny Vu, Co-Founder of Misfit Wearables.

Healthcare & Life Sciences

Sessions under Healthcare & Life Sciences will examine the advancements that have occurred in the field of neuro-engineering; the future of genomics and medtech innovations that deliver cheaper, faster, more efficient patient care.

Speakers include Daniela Schiller, Assistant Professor, Neuroscience, Mount Sinai Hospital; Robert Nicol, Director of Sequencing Operations, The Broad Institute of MIT and Harvard; and Alex Dickinson, Senior Vice President of Strategic Initiatives, Illumina.

Space 3.0

Speakers for Space 3.0 will examine how satellite technology can impact everyday life; whether space tourism is a near future reality; and how Space 3.0 will exploit commercial applications. 

Steve Isakowitz, President, Virgin Galactic, Chris Boshuize, Co-Founder and CTO of Planet Labs Inc; Bonnie Dunbar, Director, UH STEM Centerm, University of Houston and Kay Soon Low, Director, Satellite Research Centre – Nanyang Technological University are speakers here.

Sustainable Innovations 

EmTech Singapore 2015 will examine how sustainable innovations are addressing real world challenges. These include responding to changing demands for renewables and low carbon technology; integrating emerging technology to feed a growing global population; plus next generation urban development and sensible cities.

Speakers for Sustainable Innovations include Leslie Dewan, Co-founder & Chief Science Officer, Transatomic Power; Carlo Ratti, Director, SENSEable City Laboratory, MIT; and Daniel Hastings, Chief Executive Officer and Director Singapore MIT Alliance for Research and Technology.

Associated with the EmTech conference is the hunt for 10 regional Innovators under 35 who exemplify the spirit of innovation in business and technology. Organised by MIT Technology Review since 1999, Innovators Under 35 competition has honoured Facebook’s Mark Zuckerberg, JB Straubel of Tesla, Silicon Valley veteran investor Marc Andreessen and Nobel laureate Konstantin Novoselov.

Nominations close 19 September 2014. Nominations for young researchers and entrepreneurs who are using technology to come up with creative and inspirational projects to provide solutions to global problems are encouraged. The 10 honourees are recognised not only for their advances in a field of research, but also for their capacity to make an impact on society as a whole, and to lead the future of technology. For details, visit the EmTech site.

*Pictures from EmTech.

EIU identifies six areas of growth for Asia

The Economist Intelligence Unit's (EIU's) "industry dynamism" barometer, commissioned by InvestKL, Greater Kuala Lumpur's investment promotion agency, has seen a bright future for six industry sectors across Asia: engineering services, environmental technology, food processing, healthcare, oil & gas, and wholesale & retail. 

The findings indicate that continued corporate investment in Asia will support longer-term opportunities. Speaking at the launch of six reports under the barometer umbrella, Zainal Amanshah, CEO of InvestKL, said that the findings "reinforce the importance of Asian cities as drivers of the region's growth." 

The six sectors are:

Engineering Services 

Rapid economic growth has translated into engineering opportunities for US$8 to US$9 trillion of new infrastructure needed between 2010 and 2020. Asia's engineering companies are growing at breakneck speed as they capitalise on these opportunities. Between 2005 and 2011, the approximately 120 engineering companies listed on the region's stock exchanges grew top-line revenues by an average of 20% every year. 

"Remarkable rates of economic growth make Asia the part of the world for engineering services firms, with this region accounting for 36.6% of global GDP in 2013, up from 26.8% in 2001," said Amanshah of the findings in this sector, which is also a key economic area identified by the Malaysian government.

Environmental Technology  

Policy support for renewable energy in Europe may have fallen, but is strong in Asia. Asia is experiencing record levels of cleantech investment – across the six years of this study, value of fixed assets per company increased by an average of 9% every year. The combined revenues of Asia's cleantech firms more than doubled from 2005 to 2011, while growth rates were at nearly 13% a year for the same period.

"The huge wave of urbanisation sweeping Asia requires a lot more investment in ensuring our urban environments and infrastructure are more efficient," Amanshah noted. "The opportunities for companies that can provide sustainable solutions limiting the environmental impact of our rising population are significant - to put them into context, this region already emits more carbon dioxide than the US, EU and Russian Federation combined."

Food Processing 

Rapid urbanisation is changing food consumption patterns, and creating opportunities for more efficient distribution, including upstream into rural supply chains. Asia's food companies are thriving as they leverage these opportunities. Between 2005 and 2011, the 400 or so food companies listed on the region's stock exchanges grew top-line revenues by an average of 23% every year.

However, companies will need to invest in innovation in order to tailor their products to the diverse local taste preferences across the region – global brands will have to localise their products, while Asia will be a source of new home-grown food ideas (such as the halal-certified food market). 

"We already account for more than half of the world's population. By 2040, we will add another 800 million people to our count – all of whom are rapidly getting richer," said the CEO of InvestKL. "Asia's spending on food is forecast to double between 2007 and 2050 in real terms – representing three quarters of the global increase over the same period."
 
Healthcare

In the hospital sector, Asia will need an additional 180 million new hospital beds in the next decade. In pharmaceuticals, Asia's market will grow more than 13% annually – from US$214.2 billion in 2010 to US$386bn by 2016.
 
In 2007, Asia and Oceania together accounted for 18.1% of global biomedical research. By 2012, that share had grown to 23.8%. Between 2005 and 2011, revenues at Asia's listed healthcare fims rose by almost 23% a year. Profits rose even more swiftly, by 31% a year.
 
Challenges on the horizon include competition that is intensifying as the number of firms entering the sector grows. Costs, especially labour-related, are rising rapidly. And regulations are getting much more stringent as a growing middle class demands greater safety, security and consumer protection. 

With populations and incomes rising, Amanshah noted that "health spending is growing even faster – Asia's share of world health spending is expected to rise from 21% in 2012 to 24% by 2017. Although parts of our region's population are still in need of basic healthcare services, more and more are beginning to require treatment for 'diseases of the affluent'." 

Oil & Gas

"ExxonMobil expects a significant rise in Asia's share of global energy consumption, from 38% in 2010 to 45% by 2040," said Amanshah. "Meeting this rising demand for oil and gas in this region will be challenging, even though some countries are net energy exporters (such as Malaysia and Brunei)."
 
Growth in the demand for gas will outstrip all other fuels, given its cleaner environmental characteristics and superior flexibility.
 
Most countries import more than they produce. BP calculates that Asia produced 8.3 million barrels of oil a day in 2012, or 9.6% of global production, but consumed 29.8 million barrels of oil a day, 33.5% of global consumption. 

Despite being a net energy importer, the Asia Pacific region still has plenty of potential for upstream development. The biggest opportunities exist in new gas fields, such as in Myanmar and Papua New Guinea. In order to extract gas from Asia's more complicated fields, regional oil and gas companies are investing more heavily in new technologies. In 2011, Asia's 50 listed oil & gas firms spent US$2.13 billion on R&D, up from US$368 million in 2004.

Given the landscape of opportunity in Asia, the region's listed oil and gas companies are reporting strong revenue growth. In 2004, revenue per company in the sector stood at US$2.9 billion. By 2011 that had grown to US$10.2 billion, an average annual growth rate of 20%.
 
But while growth is rapid, the industry also faces challenges in the form of increased competition and costs, and talent shortages. These issues contributed to the return on capital employed for Asia's listed oil and gas sector falling from 19% in 2004 to 8.3% in 2011.

Wholesale and Retail

"The population of Asia is predicted to be 4.6 billion by 2040, with average consumer wealth rising in tandem," said Amanshah. "To put the impact of this population increase in perspective, in 2001 Asia accounted for 26.8% of global GDP measured using purchasing power parity – by 2013, our share had risen to 36.6%. Significant urbanisation and penetration of modern retail formats are driving sales."
 
Asia's homegrown retail companies are growing. Between 2005 and 2011, revenues at Asia's listed retail and wholesale firms rose by an average of 21% every year. Most of this growth was organic in character. Between 2013 and 2018, the EIU forecasts that retail sales in Asia Pacific will grow by 10.2% every year, whereas globally retail sales will grow by only 6.9% a year. In 2013, Asia had 80m square meters of modern retail space, but this will rise to 135m square meters by 2018. 


Retail opportunities are highly varied, from mass market grocery chains and fast-food outlets to high-end fashion stores and luxury boutiques. The opportunities for online retail look especially good, with growth rates of close to 17% a year.  

While topline growth is exciting, a number of structural issues are making profits growth harder to achieve. Human capital with retail skills is in short supply, forcing companies to invest heavily in training. Wages are rising, with staff costs up from 3.5% of operating revenues in 2005 to 5% by 2011.

Further reinforcing the eastward shift of power is a study by McKinsey & Co quoted by the EIU in the reports, which notes that 420 cities in emerging markets (more than half of which are in Asia) are expected to contribute 45% of global GDP growth between 2010 and 2015. The report further notes that Southeast Asia will have many significant economic engines of its own, with urban population growth and productivity improvements rising faster than in rural areas, driving incomes up at a much faster pace. This combination of faster population growth and faster income growth led the EIU to conclude that it "makes cities the dynamos of the future".

The six papers, covering engineering services, environmental technology, food processing, healthcare, oil & gas, and wholesale & retail sectors, can be found here.