The Gov Monitor
Singapore ramps up biomedical sciences effort with injection of S$36m into medical technology research.
A*STAR collaborates with CIMIT to enhance the environment for growing the medical technology industry as part of the drive to transform Singapore into a knowledge-based innovation-driven economy.
Local doctors, BMS scientists and engineers given the boost to create engineering solutions to medical problems.
The Agency for Science, Technology and Research (A*STAR) announced at the 14th Biomedical Sciences International Advisory Council (BMS IAC) meeting today that $36m would be pumped into new programmes to give Singapore’s growing medical technology industry a greater push. The new programmes include the collaboration between A*STAR and CIMIT (Center for Integration of Medicine and Innovative Technology) in Boston, USA, and A*Star’s Biomedical Engineering Programme. The programmes were endorsed by the BMS IAC chaired by Sir Richard Sykes, also the Chair of NHS London. Information about the medical technology industry in Singapore is at Annex A.
Under the A*Star-CIMIT collaboration, engineers, clinicians and/or BMS scientists in Singapore will be able to work with clinicians in Boston to come up with engineering solutions that have clinical and market relevance. This alliance is part of A*Star’s goal in fostering a vibrant medical technology innovation ecosystem in Singapore. It will not only create greater opportunities for impactful innovations in the area of medical technology but more pertinently, it will also provide an environment conducive to training innovators for the growing medical technology industry in Singapore.
A win-win relationship, this A*Star-CIMIT collaboration will result in the co-development of intellectual property between A*Star, the universities, hospitals and CIMIT in time to come. Some other foreseeable outcomes that this collaboration will bring to the growing medical technology industry, which already had an output of S$3 billion and employed more than 8,000 people in Singapore in 2008, include the creation of more high-level and high-skill jobs in the market, the creation of value to large medical technology companies in Singapore, and the gearing effect with local manufacturers as part of the supply chain. More information about the collaboration is at Annex B.
Biomedical engineering programme
Under the Biomedical Engineering Programme, grants have been awarded to eight new research projects helmed collaboratively by research engineers at A*Star and clinicians in local hospitals, and involving researchers from the universities and hospitals. These projects aim to develop and provide cost-effective, innovative and clinically impactful solutions for healthcare systems. With the active participation of clinicians who understand the needs of their patients, these projects will be highly relevant to patients and meet their needs. The intention is for these innovations to eventually be developed for the local, regional and international markets. More information on medical technology projects is at Annex C.
One of the research projects under the Biomedical Engineering Programme is the ArtsBCI (Advanced rehabilitation therapy for stroke based on Brain-Computer Interface) led by Dr Guan Cuntai from the Institute for Infocomm Research (I2R) and Dr Karen Chua from Tan Tock Seng Hospital (TTSH), in collaboration with Dr Ang Beng Ti from National Neuroscience Institute (NNI). This project makes use of the novel and award-winning technology of the Brain Computer Interface (BCI) also developed by Dr Guan, and improves on it to achieve a holistic and comprehensive system for advanced rehabilitation therapy for stroke patients.
ArtsBCI comprises components for hospital as well as home use. The component for home use, namely the portable ArtsBCI, will enable stroke patients to employ a holistic and personalised rehabilitation regime as and when they need it. ArtsBCI will be the first system to make use of a brain computer interface and robotics to detect brain signals as well as end effectors to allow stroke patients to have the ability to perform multimodal movement rehabilitation exercises, eg, the movement of the shoulder, elbow, wrist, hand and fingers.
In addition, it will also address swallowing dysfunctions in patients – a common problem after a stroke. Such rehabilitation will also allow patients to rebuild the motor neuron networks so necessary for their own movement in a comparatively shorter period of time. The project is now in its early stage of research.
The relevance of ArtsBCI to Singapore is high given the fact that there is an estimated prevalence rate of 4% of stroke cases in Singapore, and where about 50% of people who survive a stroke have to live with moderate to severe disabilities in movement, cognition and speech, which greatly affect their daily living and quality of life. The situation in other countries is not too different from that of Singapore. In the United States, stroke is the No. 1 case of severe or long-term disability. About 15m people suffer from stroke every year around the world. At least one-third of them will require rehabilitation from disabilities after a stroke.
Another project under the Biomedical Engineering Programme is AGLAIA (Automatic GLaucoma Diagnosis and Its Genetic Association Study through Medical Image InformAtics). When it is developed, AGLAIA will be the first of its kind of software system that will be able to detect and diagnose glaucoma in the general populace in a cost-effective and efficient manner. This is especially relevant because glaucoma is a major blinding disease which affects more than 60m people worldwide, with a further 100m who are glaucoma suspects.
It has significant impact on vision, quality of life and adds a substantial cost of treatment to the health care system. In Singapore alone, 3% of people older than 40 years of age have glaucoma, with more than 90% of these cases often going undiagnosed. Glaucoma also has a strong genetic basis, and people with a family history of glaucoma have four times higher risk of glaucoma.
A collaborative research project led by Dr Jimmy Liu from I2R and Prof Wong Tien Yin from Singapore Eye Research Institute (SERI), AGLAIA is an improvement over the ongoing project of ARGALI (an Automatic cup-to-disc Ratio measurement system for Glaucoma AnaLysIs), which is also developed by I2R and SERI. ARGALI uses a specialised image processing software to analyse photos taken of the retina to detect glaucoma. The improved version of AGLAIA aims to be a more robust system that will capture more parameters indicative of early glaucoma damage in the eye.
This technology will be especially welcome because glaucoma in its early stage is hard to detect since patients with early glaucoma generally do not exhibit any symptoms. With AGLAIA, patients in the early stages of glaucoma may be diagnosed easily, thus allowing for early treatment which could prevent any further progression of this disease.
AGLAIA will also be able to explore the genetic factors related to glaucoma through an integrative genome-wide association study approach using information collected from 15,000 participants through various eye cohort studies performed in Singapore and Australia. This will help to identify certain genetic factors that could possibly be associated with the onset of glaucoma. Currently, AGLAIA is also in its early stage of research.
Said Mr Lim Chuan Poh, Chairman of A*Star and Co-Chair of the BMS Executive Committee, “Our Biomedical Sciences Initiative has been intended to impact four major industrial sectors of pharmaceuticals, biotechnology, medical technology and health care services. Given what we have done to build up our biomedical capabilities in the last eight years, we are now in a better position to leverage on our strengths in engineering to integrate both the capabilities to boost the medical technology industry.
This will not only attract more medical technology companies to anchor their activities here, but will also open up more employment opportunities for Singaporeans in this space. The companies are also interested to be here because of our conducive business environment and very importantly, the growing Asian market and the need to better customise their products and services to this market.”
Said Ms Yong Ying-I, Permanent Secretary of Health and Co-Chair of BMS Executive Committee, “I am glad that our BMS journey has brought clinicians and engineers closer together to improve health for the general population, and with the view to keeping healthcare costs affordable. This also speaks volumes of our capability in knowledge creation, which is a key to anchoring MNCs and industry in Singapore.”
Progress of BMS efforts
The BMS IAC commended Singapore’s BMS efforts in the area of Translational and Clinical Research (TCR), which have facilitated close collaboration between basic scientists and clinicians to translate research findings into medically relevant applications that benefit patients. The on-going systemic study of screening for gastric cancer under the Gastric Cancer TCR Flagship Programme has recruited more than 2,400 high-risk individuals1 as of Sep 2009. To date, the screening detected early gastric cancer in 10 of them.
This study created new knowledge that could potentially impact early detection and treatment for gastric cancer, a major killer in Singapore and the region, which is curable if detected early. The Eye Disease TCR Flagship Programme has filed two patents to date. While only less than two years into their funding, the TCR Flagship Programmes have demonstrated great promise from combining the clinical strengths and multidisciplinary research expertise of Singapore’s hospitals, specialty centres, universities and research institutes.
Following the announcement at the BMS IAC press conference in 2008, progress has been made in enhancing the infrastructure for clinical research and clinical trials. Two Investigational Medicine Units (IMUs) have been established at the NUHS and the SingHealth Campuses to develop investigational medicine capabilities and support for early phase clinical trials, and the Singapore Clinical Research Institute (SCRI) was set up to develop the infrastructure, core support and scientific leadership of Singapore for clinical research with a focus on Phase 3 and 4 trials to strategically dovetail and complement the two IMUs. As of Sep 2009, the two IMUs are running 46 on-going clinical trials while SCRI is running 26 on-going trials.
In terms of economic outcomes, the manufacturing output for BMS was S$19 billion in 2008, up from S$6.3 billion in 2000. Employment has also more than doubled to about 12,500 jobs in 2008 from under 6,000 jobs in 2000. Today, over 100 global biomedical sciences companies have leveraged Singapore’s world-class manufacturing capabilities, excellent clinical and scientific infrastructure, connectivity to Asian markets and pro-business environment to carry out strategic business operations ranging from regional headquarters, to cutting-edge research and manufacturing.
These include companies such as Abbott, Roche, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Wyeth, Siemens and Becton-Dickson. In addition, Singapore also secured six major biologics investments over the last few years totaling about S$2.5 billion from Roche, Lonza, GlaxoSmithKline, Novartis and Baxter, which could potentially create about 1,300 new jobs. Building upon this success, A*STAR’s Singapore Stem Cell Consortium, BTI and EDB engaged Lonza in further discussions which culminated in the recent establishment of a Cell Therapy Manufacturing Facility in Singapore, the first one set up by Lonza outside the US and Europe. More information on the updates of the BMS effort is at Annex D.
Said Sir Richard Sykes, “I have been with the BMS IAC since its inception and I believe that Singapore’s commitment to research in the biomedical sciences is unique on the global stage. Firstly, because Singapore is able to take a long-term view – which is essential in order to build up a successful research enterprise – and secondly, because of Singapore’s highly pragmatic and sensible focus on investing in research areas and capabilities that will create economic value for the country as well as improve healthcare outcomes for patients.
Each year, the IAC has seen Singapore make great strides towards achieving these twin goals and there is clear and compelling evidence that the BMS industries are responding to these initiatives in a very positive way. In addition, the progress made in biomedical and clinical research, coupled with Singapore’s existing strengths in engineering, has now created an exciting opportunity for Singapore to increase its contributions in the area of medical technology, and this will consolidate Singapore’s position as an outstanding biomedical sciences and healthcare hub.”