<![CDATA[The next coronavirus: how a biotech boom is boosting Asian defences]>

When Singapore biotech company Celligenics was established three years ago, its founders decided that it should be rooted in Asia so it could solve Asian problems.

The company, which specialises in small cell regeneration, aims to ease the problems faced by the region's ageing population, such as chronic conditions arising from diabetes.

"Diabetes is a growing problem in Asia and we are looking at conditions that diabetic patients suffer from, like non-healing wounds," said Kurt Wee, the chief executive officer.

Celligenics is among the many players " big and small " in the region's booming biotech industry that are increasingly using Asian ideas to bolster Asia's defences against disease.

Asia is likely to overtake Europe as the world's second-largest medtech market, behind the US, in the next few years, according to a 2018 study by consultancy firm McKinsey & Company.

The firm put the value of Asia's medtech companies at US$95 billion in 2017, predicting them to edge ahead of their European counterparts by 2023 and be worth more than US$137 billion, at which point they would account for 26 per cent of the global market.

"Put simply, the strong fundamentals of rising health care demand and wealth in the region will override short-term dislocations at country or subregional level, which are bound to happen," said the authors of the report, which included Amit Agarwal, the associate principal in McKinsey's Singapore outfit.

"The region is also increasingly recognised as a major source of product technology innovation as well as for its innovative business models and unique health-care ecosystem."

Commuters leave a railway station in Bangkok. Photo: AFP alt=Commuters leave a railway station in Bangkok. Photo: AFP

Edward Chow, an associate professor at the National University of Singapore's Cancer Science Institute, said Singapore's reliable corporate, intellectual property (IP) and legal environments made it attractive to biotech firms.

"[This is] combined with a stable government-business relationship and attractive tax structure [which] makes Singapore a very good home base from which to implement commercial efforts across all of Asia," Chow added.

Countries such as Singapore also roll out initiatives to help biotech start-ups, such as SGInnovate, a government-backed organisation that helps entrepreneurial scientists launch, build and scale their programmes.

"There is a lot of support in Singapore, in terms of capital, infrastructure and mentorship for new biomedical start-ups," Chow said.

Celligenics, for example, received funding from Enterprise Singapore, a statutory board under the trade ministry that supports small and medium-sized enterprises in the city state, which also looks at catapulting these businesses into regional markets.

The Singapore biotech company is now considering other markets in Southeast Asia and the Chinese market, among others.

But grants were just the bare minimum any country could offer, said Jeremy Lim, a partner at global consultancy firm Oliver Wyman's health and life sciences practice.

"Grants are helpful in attracting companies to come here but to retain companies, it is really fundamentally about access to talent much more than anything else," he said.

It was part of Singapore's "deliberate government policy" to send thousands of scholars to top universities abroad, as they were later bonded to government-linked institutions for research.

Consequently, Singapore had a large talent pool of highly qualified and highly educated workers, a key selling point for companies flocking here, Chow said.

This group of experts were also capable of engaging in all aspects of biomedical company development, ranging from innovative research to quality manufacturing to marketing and business development, he said.

The Lion City also invested about S$700 million in building an international research and development centre for biomedical sciences, the Biopolis, which now houses international names, including Procter & Gamble.

A man wears a protective mask outside the Exchange Square complex in Hong Kong. Photo: Bloomberg alt=A man wears a protective mask outside the Exchange Square complex in Hong Kong. Photo: Bloomberg

Nearby, Hong Kong and mainland China are also hotspots for different reasons.

Lim said Hong Kong had been attractive as a gateway into the mainland for companies eyeing a slice of the huge domestic market.

"China, on the other hand, has always been enthusiastic about anything that involves a lot of people and data," he said.

"If you look at biotech and health care, essentially everything is about data."

Lim cited the wearable health tech that monitors users' step counts and heart rates, saying such data could prove useful to companies researching health problems.

Chow of NUS added that a wealthier demographic on the mainland, coupled with a huge domestic market, meant there were many untapped opportunities for companies wanting to make a splash.

But Western companies looking for a home base to build their Asian markets saw Singapore as a more attractive environment, he added.

"From Singapore, biomedical companies can do business across Southeast Asia, China, Japan, Australia and India," Chow said.

Building on Chow's point on data, Dean Ho, head of NUS' biomedical engineering department, said there was an openness in the region to tapping data and artificial intelligence (AI) for health-care purposes, which had not always been the case.

In this region, countries had started using AI to realise "actionable improvements", such as accelerating the progress of anti-infection diagnostics and development.

Another example was how Singapore issued fitness trackers to its residents, a move Ho called "remarkably progressive", describing it as a practical way of helping more people get healthy.

"Singapore and Hong Kong have been ramping up funding to help the medtech industry for a while now. It's been building programmes to get people to innovate," he said.

"They are having these dialogues before the problem hits. This really catalyses a strong sense of preparedness."

The emerging biotech field in Asia had accelerated the region's ability to deal with viral outbreaks, Lim said.

This was especially so as countries in the region were often exposed to tropical diseases that would not normally be found in other markets such as Europe.

"We have a ton of cases from dengue to malaria, and there's a ready substrate when we look at infectious disease," Lim said.

Ho said it was this exposure to viral outbreaks that made societies here quicker to react and more resilient.

Cities in Asia have learned much from epidemics such as the severe acute respiratory syndrome (Sars) outbreak in 2003, which took more than 700 lives.

At that point, Singapore closed schools and went on high alert, while Hong Kong implemented an enhanced disease surveillance system and expanded laboratory diagnostic capacities. The Chinese city even established residential institutions for the elderly.

"So when it comes to things like developing an action plan to personnel management, countries have learned to kick things into action quickly," he said.

In terms of health-care systems, Asia's centralised control also meant a more effective allocation of resources, Lim said.

He added: "When you have the majority of your clinical assets under a single leadership, then you have the ability to pull data."

This compared to scenarios in which health-care systems were split into different parts, which Lim said made it difficult to produce "meaningful analysis" from disease cases.

A hospital employee in Wuhan, where the coronavirus is thought to have originated, dons protective gear. Photo: AFP alt=A hospital employee in Wuhan, where the coronavirus is thought to have originated, dons protective gear. Photo: AFP

Chow added that good inter-hospital relationships in Singapore had left it well positioned to mobilise health-care units and respond to various health-care needs, including the deadly coronavirus that has infected more than 31,000 people since originating from the Chinese city of Wuhan.

Asian biotech companies have also stepped up to the challenge posed by the virus.

Researchers from Singapore and Japan, for example, were among those in the first few countries outside China to isolate and culture the coronavirus, in what may be the first steps to developing a vaccine.

Biomed Global, a biomedical company that has a presence in Singapore and Malaysia, supplied regional scientists and clinicians with the right equipment to perform sanger sequencing " a type of DNA sequencing " on the virus to obtain a genome sequence.

When they have the genome sequence, scientists will be able to analyse the novel coronavirus and learn more about its origins. The company also deals with Asian-related ailments, and has collaborated with scientists to develop tests for dengue and respiratory diseases.

London-based multinational drug maker GSK, which was one of the first health-care companies to have a presence in Singapore, also announced this week it would be collaborating with the Coalition for Epidemic Preparedness Innovations (CEPI) to develop a vaccine against the novel coronavirus.

The drugmaker's operations in the region have made it easier for the firm to reach out to the Asian market.

"By establishing our hub here, we are able to manage the complex operations in Asia within the same time zone, allowing us to meet the strong demand for better health care in an agile manner," a spokesperson said.

Apart from its preparedness, biotech companies in the region are also looking more specifically at diseases that are more widely spread among Asian demographics.

The differences in microbiome between Westerners and Asians meant that medical solutions would differ.

"There are very huge differences in the outcomes of drugs when given to a Western population or Asian one," Ho said.

Chow cited how Singapore government-linked biomedical sciences institute A*Star had rolled out efforts such as the SG10K Consortium, that looked particularly at Asian genomes.

"[This is] critical to allowing biomedical companies to address disease variants that affect Asian ethnicities," he said.

Singapore-based cancer-screening start-up Lucence is one example, as its technology focuses on Asia-prevalent cancers such as lung, breast, colorectal, pancreatic, nasopharyngeal and liver cancers.

Asians are also using new ways to find out more about themselves, such as the Asian Microbiome Library, Southeast Asia's first and only stool bank library, headed by Lim.

It looks specifically at the gut microbiome, the bacteria, fungi and viruses in the gut, to study conditions such as autism, Parkinson's and obesity.

Having headquarters in the region would thus allow biomedical companies to source patient samples, Ho said.

"If it's for oncology, we need the actual biopsies. If it's for infectious diseases, we need the sample from patients," he said.

The access to samples is also the reason why Beijing is being praised for identifying and sequencing the coronavirus genome within days, and allowing scientists across the world to develop corresponding test kits and potential vaccines.

Ho said this was why drugs for fatty liver disease, for example, were often developed in Asia.

"This is the region where there are a lot of cases ... And it is where you have doctors who are skilled at these diseases," he said.

"Money alone won't be enough if you think that way. You need to be in a place where you can study the right population and work with the right people."

Ho said emerging markets such as Indonesia, Thailand and Vietnam would probably be high on the agenda for biotech companies as there was a growing demand for services in these countries, though Singapore and Hong Kong would remain the hotbeds for clinical trials.

With the rise of smaller players in the region, and given what Asia has gone through, Ho said countries here were "ready to fight emerging diseases".

Lim echoed the sentiment, saying the Chinese genome sequencing company BGI Group had in recent years taken huge strides, and was now comparable to top-tier centres hailing from the US and Europe.

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This article originally appeared on the South China Morning Post (SCMP).

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