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SingHealth Duke-NUS invests in ‘the seeds of the future’
INTERVIEW SingHealth DukeNUS invests in ‘the seeds of the future’
It launched a new institute that opens doors for maternal-child care research.
For SingHealth Duke-NUS, taking care of mothers and their kids should go beyond giving medical treatment by also optimising their mental, socioeconomic, and educational wellness. This goal was amplified after launching the Maternal and Child Health Research Institute (MCHRI) at the KK Women’s and Children’s Hospital (KKH).
MCHRI, the culmination of SingHealth Duke-NUS Academic Clinical Programmes for Paediatrics’ and Obstetrics & Gynaecology’s 10th year, is eyeing to advance the reproductive, metabolic, and mental health of women and their children through life-course strategy and creating the latest medical technology that will better manage pregnancies with genetic disorders.
Healthcare Asia sat down with Associate Professor Ng Kee Chong, the recently appointed director of the MCHRI and the current medical board chairman of the KKH, to know more about the formation of the research institute, its goals, and what it contributes to the maternal and child health community in Singapore.
Ng prides himself on being part of Singapore’s only women’s and children’s hospital, which has a rich 160-yearold history. The hospital also holds a Guinness Book world record with the most deliveries in 1966 at 39,835 births. According to Ng, KKH delivers more than one-third of the deliveries in Singapore every year. He added in the last five to ten years, they have worked through the Ministry of Health and charitable institutions to reach out to the community and develop an ecosystem to care for women and children better.
What are the medical highlights you can share for KKH, leading to the formation and launch of MCHRI?
KKH has the largest child development unit in Singapore that helps improve care for child development and children with special needs such as attention deficit and learning disorders. We also work very closely with the community to try to improve care in the whole continuum. The second highlight is in psychosocial trauma support. We partnered with [the Temasek Foundation] to help improve psychosocial trauma support care for children in the community by working with the family service centres. We are also proud of the region’s first human milk bank, which opened two to three years ago. It currently provides pasteurised breast milk for babies who are unable to get breast milk. That helps to improve general health and prevent things like necrotising enterocolitis.
How does KKH contribute to the MCHRI, and what will you continue to provide to meet the goals and mission of the MCHRI?
What we are adopting is what we call a life-course approach to this whole continuum of care. Essentially, we are looking at maternal and child health as a whole continuous circle of life. The woman grows up to be healthy in society, marries
MCHRI aims to advance the reproductive, metabolic, and mental health of women and their children (Photo: Associate Professor Ng Kee Chong)
We want to optimise the value of people by optimising their health
and sets up a family, becomes pregnant and gives birth to a child. Then, the child goes up healthy, becomes an adult, and then contributes back into the family life. The life-course approach refers to how we manage the health of the mother, the child, and the rest of the family. The husband-father is also important in the whole unit, as elements of health can affect them through various social and cultural issues also, not just medical parts. What we do not want to do is just “medicalise” health. Health is not just giving medicines but is also revolving around social aspects, economic aspects, and educational aspects, which are very important to consider. We want to look at it in the different dimensions so that we can appreciate the complexities of the health of the mother and child, and see how we can then improve and optimise the maternal-child health through these various aspects.
We are not just working with the Ministry of Health as a hospital, but we also engage with social agencies. The key ones we work with are the Ministry of Social and Family Development, as well as the Ministry of Education. They are important elements if we want to optimise the health of mothers and children. In the end, our key goal is to essentially do three things: be Asia’s centre of excellence for maternal and child health, translate research to improve general health for mothers and children, and strengthen human capital. Singapore is not very rich in resources, but it has its people. So, we are aiming to optimise the value of people by optimising their health.
The three arms of the SingHealth Duke-NUS MCHRI
MCHRI aims to advance the reproductive, metabolic, and mental health of women and their children KKH looks at maternal and child health as a whole continuous circle of life
are, first, to establish a multidisciplinary research community to conduct high-impact clinical, translational, and population health research to meet maternal and child health needs. The second is to establish strong, synergistic partnerships with our partners and key stakeholders; not just healthcare professionals but also sociologists, psychologists, educationalists, and other people in the Singaporean and international community. The last area that is very equally important is to attract future talents and groom the next generation of maternal and child health investigators and researchers for Singapore and beyond. We want to collaborate with everybody as we move forward.
What do you see as areas of development needed for the field of maternal and child care in Singapore and Asia?
If we look at the area of needs, it can be divided into four key domains: preconception and reproductive health; metabolic health; neurocognitive, developmental, and mental health and wellness; and cancer and critical diseases. It applies to us both in Singapore and internationally. Of all these domains, I think the two things that are very important for maternal and child health, especially in this day and age in Singapore, are mental and metabolic health.
We are very competitive and all caught up in a rat race. Our women are marrying later, having children later, and having a small number of children because both parents are working very hard. No longer is family support usually two adults and there’s not much social support. The self-efficacy of parenting and being confident as a parent, especially for first-time parents, is quite lacking. We want to see how we can optimise this. Parents themselves are stressed because of various economic issues, whether they are bringing up a child correctly, COVID-19, and so on. What we want to do is address some of the mental and emotional well-being of mothers. We have a very high rate of prenatal and postnatal depression, so we want to see how we can improve screening and also help them in the early phase. Children are also very stressed with schooling and we want to see how we can better improve their emotional well-being. With the internet and social media, there is also increased pressures like cyberbullying that must be monitored.
As for metabolic health maternal pregnancy-wise, up to 20% of our pregnant women have diabetes and metabolic diseases. We need to address how they should learn to take nutritious, metabolically good food and how they can continue to exercise and keep themselves fit. Meanwhile, children tend to have more and more screen time with less exercise. When I ask my patients what games they play, they tell me what latest computer game they are playing, which is not what I asked them. I am asking what physical games they play, but they tell me they are addicted to this latest computer game. All these are not good things that we should try to address and see how we can help our next generation grow up stronger.
Another way of looking at factors affecting maternalchild health is the three C’s. The first C is cyber wellness, the effects of digitalisation, computers, and social media. I mentioned cyberbullying and the effects of social media on the general health of women and children. Health information in social media is also not necessarily good. There is so much fake news out there in the media regarding health. It also affects all four of the domains I enumerated. The second C is COVID-19. We are now at the endemic phase. We need to live with COVID, like [Prime Minister Lee Hsien Loong] said. But, what is the impact of COVID on maternal-child health? Parents are stressed mentally and economically. The virus is a generational change affecting us. It will leave our whole way of living our lives and how we remain healthy for them in the maternal-child health field. The last C is climate change. It is relevant to maternal and child care because climate change affects the food supply, which mothers and children need to be healthy.
What upcoming plans or projects from MCHRI can you share at this point? What can consumers, patients, and healthcare partners expect from MCHRI soon?
From what was shared, one of them was the memorandum of understanding for an ongoing collaboration that we signed with Menarini Biomarkers Singapore. We want to develop technology to identify foetal cells in the first trimester of pregnancy to better manage pregnancies with chromosomal or genetic abnormalities.
We also have piloted the [Integrated Maternal and Child Wellness Hub] in Punggol, where we bring in a very focused developmental assessment of the young kids to oversee their development.
Another project we are working on is looking at how we can improve parenting self-efficacy by sending out nudges and guiding parents through the first 1,000 days of pregnancy up to two years of age. We hypothesise that having those very targeted nudges can help improve their parenting self-efficacy and can help make them more confident as parents.
Lastly, we are collaborating with the UN Foundation and other agencies on this project called Healthy Early Life Moments or HELMS, which is looking at how we can improve the whole metabolic and mental wellness of women from preconception to giving birth through behavioural modifications and timely health advice. If we succeed, we plan to build this into our national system in a very calibrated way.
Do you see any partnerships or collaborations with anybody outside of Singapore?
We have a rich history of collaboration from KKH, and we want to use the MCHRI to collaborate further. One collaboration is the Integrated Platform for Research in Advancing Metabolic Health Outcomes of Women and Children or IPRAMHO. We have a network consisting of ASEAN countries where there is a conference held every year to share and support one another in terms of medical collaboration.
Other factors affecting maternal-child health are the 3 Cs: cyber wellness, COVID, and climate change
FEATURE PROFILE What’s so special about Pondok Indah Group Hospital getting HIMSS EMRAM
It is the only hospital group in Indonesia to achieve level 6 validation, the highest level of assessment.
The level 6 validation is an achievement of the hospital’s commitment to patient satisfaction
To date, only three hospitals in Indonesia have successfully achieved Healthcare Information and Management Systems Society’s (HIMMS) Electronic Medical Record Adoption Model (EMRAM) level 6 validation, namely: Pondok Indah Hospital - Pondok Indah, Pondok Indah Hospital - Puri Indah, and Pondok Indah Hospital - Bintaro Jaya, all three are under the umbrella of the Pondok Indah Group Hospital. Meanwhile, in the whole of Southeast Asia, there are only four other hospitals that are validated with levels 6 and 7. Two of them are located in Singapore and the other two are in Thailand.
The HIMSS EMRAM has become a global standard for the implementation of digital health transformation. Once a healthcare institution is given this accreditation, patients are assured that the hospital is digitally mature; therefore, they can focus on their healing processes without worrying about doctors making inacurate medical findings and decisions, as well as their medical history being comrpomised.
HIMSS is a non-profit organisation that aims to reform the health ecosystem worldwide through the power of information and technology. For more than 60 years, HIMSS has operated in North America, Europe, the UK, Middle East, and the Asia-Pacific with the EMRAM methodology used to assess the digital maturity of hospitals with the aim of building and optimising digital work environments, improving the performance of health services, and providing the best experience for every patient.
In an exclusive interview with Healthcare Asia, Pondok Indah Group Hospital CEO Yanwar Hadiyanto said that HIMSS EMRAM level 6 validation is a form of achievement of the hospital’s commitment to increasing patient satisfaction through continuous improvement of service quality. “The point is how we can provide a better solution than others.”
Pondok Indah Group Hospital was able to get this nod from HIMSS by providing access to important data and information when needed, which would help doctors make decisions regarding patient care plans based on their medical history, minimise the risk of errors in patient care, and maintain confidentiality and security of patient data.
Digitisation carried out
The first digitisation carried out by the Pondok Indah Group Hospital is the integration of patient medical information, which allows data to be accessed at any time by doctors, nurses, or other authorised medical personnel, through the electronic medical records. The results of patient
The point is how we can provide a better solution than others
diagnostic examinations, such as laboratory and radiology, can also be accessed in real-time in the system.
“The history of vaccination and administration of drugs is also recorded digitally in the electronic medical record. Patients can seek treatment at the three hospitals under the auspices of the Pondok Indah Group Hospital because their medical records can be accessed from the three hospitals,” said Yanwar.
Then all requests from healthcare providers for prescribing drugs and supporting examinations (laboratory and radiology) are also carried out digitally through the system, thereby reducing the risk of multiple inputs significantly.
“Similarly, the patient’s medical history, current condition, and risk assessment scores—such as risk of falls, risk of skin abrasions, decreased consciousness—will be recorded in the system, making it easier for doctors to determine a patient’s treatment plan,” Yanwar added.
The hospital also uses RFID/ QR code scanning technology for drug administration, storage and administration of breast milk (ASIP) in the nursery and NICU, as well as blood transfusions to reduce the risk of human error and improve patient safety.
Finally, they provide notifications for patients with certain conditions, for example, those with drug allergies or the pregnant are alerted of the risk of contraindications.
Mature digitisation
Yanwar said that his party was not only focused on being mature in terms of digitisation but also in responding to technological developments and innovations, both related to information technology and medical technology. “We want to really make sure to present the most appropriate technology, not just the latest technology,” said Yanwar.
Pondok Indah Group Hospital carries out digital transformation on an ongoing basis and adopts a digital hospital information system, and integrates hundreds of medical equipment and technology into patient information systems and electronic medical records.
“In its digital transformation process, Pondok Indah Group Hospital has integrated supporting services, such as laboratories, pharmacy, and radiology with patient medical records integrated in various kinds of software and hundreds of medical devices; and it implemented IT security to ensure 95% to 100% of medical documentation is carried out automatically, digitally, structured, and supported by clinical decision that has been systematiszed,” said Yanwar.
More technology launched
When COVID started to subside, Pondok Indah Group Hospital is again thinking about how to further its innovations. Therefore, this year they introduced optical coherence tomography orOCT, which is usually used for angiography patients for coronary arteries.
“This technology can produce better diagnostics before and after the procedure. We can find out what is the most appropriate course of action. For example, what is the shape of the plaque in the heart, how big is it, where should it be placed, and so on,” explained Yanwar.
Then they also introduced endoscopic ultrasound—an imaging technology through a small camera that enters the digestive tract. “Ultrasound is on the endoscopic camera for diagnostics and treatment of disorders or small tumors that are usually cancerous,” said Yanwar. For example, cancer in the bile or pancreatic ducts, which so far cannot be reached by ordinary technology.
Recently, Pondok Indah Group Hospital has also launched a robotic prostate biopsy, the latest biopsy technology with a high detection rate and accuracy. This technology is able to detect prostate cancer with significantly more precision than conventional biopsy methods. Another advantage is that this technology is also able to increase the accuracy of taking the right tissue according to the biopsy target up to 89.4% accuracy.
In the process of taking tissue samples, the biopsy technique will be guided by images from MRI imaging. “Snippets of MRI images suspected of having indications of cancerous tissue will be contemplated into a robotic platform that will perform digital scanning and combine them with real-time ultrasound images, and automatically determine the biopsy locations,” said Yanwar.
In contrast to conventional biopsy techniques using ultrasound imaging, the robotic MRI/US fusion-guided prostate biopsy technique can better differentiate abnormal prostate tissue. Yanwar said that this certainly contributes greatly in increasing the patient’s chances of survival, because most cancer lesions often cannot be visualised on ultrasound examination.
In addition, the procedure with robotic prostate biopsy is also an action that has minimal risk of infection when compared to conventional biopsy techniques which have an infection risk of around 3% to 5%. The lack of accuracy of conventional biopsy techniques in determining the point of biopsy location can also lead to a 30% chance of false negative, as well as the risk of bleeding and sepsis.
“With this robotic technique, doctors can also reduce or eliminate tissue trauma in patients. In addition, real-time ultrasound images for biopsies become more focused, so the wound becomes smaller and the risk of infection is reduced close to zero,” said Yanwar.
Lastly, Pondok Indah Group Hospital will soon launch a sports medicine and injury center this year. This facility will not only be used for injury, but more broadly, for example, for post-operative rehabilitation.
We want to present the most appropriate technology, not just the latest technology
Yanwar Hadiyanto, CEO, Pondok Indah Group Hospital
HEALTHCARE TECH OneOnco allows patients to kickstart cancer support system for $1
It is a digital-based oncology solution for those looking to begin their medical care.
There are a lot of stigmas attached to cancer. Many people may say that it is an illness caused by smoking, unhealthy sexual relations, or even a curse. Scientifically, a doctor will explain that it is a genetic mutation or a hereditary disease. There are several other interpretations, which is why, in the field of medicine, the study of cancer or oncology is seen as something multidimensional and multifactorial. This is also the reason why, in Indonesia, almost every oncology treatment is separate from each other. PT Kalbe Farma, therefore, took the initiative to launch OneOnco, an integrated oncology service that aims to unite all stakeholders in the oncology field in Indonesia.
“The goal is that when these stakeholders work together, the output given to these patients will be detailed, comprehensive, and of course, better. Stakeholders, in this case, include academics, doctors, communities, hospitals, insurance, patients, patients’ families, and caregivers,” Selvinna, Head of OneOnco, PT Kalbe Farma told Healthcare Asia in an exclusive interview.
Surfing at OneOnco
Patients who surf at oneonco.co.id will go through four phases. The first is teleconsultation, a collaboration between Kalbe and Klikdokter, that enables the patient to consult through chat services.
The second phase is early cancer detection. Kalbe has partnered with hospitals and health facilities to enable more affordable prices, starting at IDR 15,000 ($1.01). “Our ecosystem makes it possible to order the screening service, of course, it’s easier because the website is already connected to the health facility, you can make a booking, you can even pay directly without having to come to the hospital in person, which of course makes your expenses less,” Selvinna said.
The third is the doctor directory feature, which allows patients to choose amongst 743 Kalbe’s partner doctors who specialise in oncology, including 175 referral hospitals.
Finally, the availability of information about cancer that is completely valid and non-hoax. OneOnco not only provides guidance from reliable sources, such as oncologists and cancer psychologists, but also from cancer survivors through the testimonials they leave on the platform.
One thing that Selvinna clarified is that they did not find the need to make OneOnco’s chat service available for 24 hours. This is because cancer is not an emergency disease, Selvinna said. “It’s like if you’re itching now, you don’t need to scratch right now. So if you are sick right now, you can take medicine
When stakeholders work together, the output given to patients will be detailed, comprehensive, and better
OneOnco creates an ecosystem for doctors and patients, because not all have an access to each other
OneOnco strives to be the most accurate reference in Indonesia
first but the examination can be done on the next day.”
But, how quickly do they respond to their consulting chat service? Healthcare Asia tried to surf on its own and created an account at oneonco.co.id and started looking for online doctors. The time spent from searching to getting the first chat response from the doctor was approximately three minutes. During the chat, waiting for a response to each question took approximately 1 minute.
The doctor that Healthcare Asia spoke to in the service revealed that his shift online is for three hours, after which, another doctor would replace him to cater patients who are sending messages.
Answering doubts
OneOnco creates an ecosystem for those who want to serve, i.e. doctors, and those who need to be served, i.e. patients, because not all have an access to each other. Even for the doctors and other medical service providers, collaborating and getting partnerships is not an easy thing, Selvinna said. “That’s why we created a platform where service providers, service recipients, and many other parties can meet. How did they meet? First of all through information first.”
According to data from The Independent, fake news about cancer on Facebook is one of the 20 most shared hoaxes. In Indonesia, one of the problems of oncology is also the deluge of false information and the lack of valid and correct ones, Selvinna said. This causes a lot of anxiety about cancer circulating in society. OneOnco, therefore, strives to be the most accurate reference in Indonesia. “Many people are afraid when he feels there are signs of cancer in his body. Early detection at OneOnco is an easy initial solution for these people, for example, to get a second opinion of what they are worried about,” Selvinna said.
OneOnco also has a channel where cancer survivors can share inspirational stories. Through this, patients and survivors can relate to each other. According to Selvinna, this is one of the important features of their service because it is important for patients to feel motivated and that they are not alone—this becomes a crucial supporting factor for healing. “There is no hope that does not mix with fear, there is no fear that does not mix with hope,” said one of the inspirational story headlines on the OneOnco platform.
The platform also has special vaccinations information for cancer survivors who are confused whether, for instance, they can get their COVID vaccine. “They revealed that they are often rejected for vaccines because the vaccinator is unsure about the results of the screening,” explained Selvinna.
Collaborating
Kalbe has four business units— the Prescription Pharmaceutical Division (with 23% contribution to the group’s revenue), Consumer Health Division (17%), Nutritionals Division (30%), and Distribution and Logistics Division (30%).
OneOnco has been around since 2018, but the platform was only officially launched in 2021 and has recorded a compound annual growth rate of 20%. From 2018, the company started collaborations both within and outside the Kalbe Group.
Internally, the company partnered with organisations that sell chemotherapy, import specialty products, and suppliers of kits for early detection of cervical cancer. The kit has now been produced domestically. Kalbe also tapped a laboratory that specifically examines genes for cancer.
Externally, Kalbe also collaborated with communities such as the Indonesian Cancer Foundation (Yayasan Kanker Indonesia/YKI), Cancer Information and Support Center (CISC), and Lovepink Indonesia. There is also a non-profit organisation related to cancer called Knitted Knockers Indonesia, which makes knockers or bra plugs for breast cancer patients which are distributed free of charge throughout Indonesia. Kalbe also works with a mental health application called Relief and, finally, collaborates with insurance companies.
OneOnco has now been able to reach around 10,000 viewers and users and targets an eight-fold increase this year.
“[We are committed] to provide comprehensive solutions, especially for cancer sufferers when surfing our platform,” Selvinna concluded.
Selvinna
OneOnco has a channel where cancer survivors can share inspirational stories
OneOnco is committed to providing comprehensive solutions for cancer sufferers
HEALTHCARE INSIGHT: NCD CARE Asia’s healthcare tomorrow: Pivoting back to non-communicable disease
Despite NCDs accounting for 41 million deaths annually, they are still healthcare’s ‘blind spot’, expert says.
The progress made on NCDs during the last couple of years has ground to a halt
About 77% of all noncommunicable disease (NCD) deaths are in developing countries—and those deaths, particularly in the 30 to 69 age bracket, have often been described as premature. With the recent global health crisis, experts now argue that the progress made on NCDs during the last few years has been backtracked.
The ‘Bringing NCDs back into the spotlight’ panel during the recent Future of Healthcare Week Asia focused on the extent to which NCDs were prioritised and tackled as a global health priority set by the World Health Organization, the United Nations General Assembly, and the Sustainable Development Goals 2030.
The panel consisted of Indonesian Cancer Foundation Chairman Aru Wisaksono Sudoyo, SingHealth Patient Advocacy Network CoChair Ellil Mathiyan Lakshmanan, Malaysian National Cancer Council (MAKNA) General Manager Farahida Mohd Farid, and Novartis Pharmaceuticals - Patient Engagement and Communications Region Head Ruth Kuguru.
NCDs are usually associated with ageing, cardiovascular diseases, cancer, respiratory diseases, and diabetes. The latter being particularly prevalent in the Asian region. NCDs account for about 41 million or about 71% of deaths globally every year. It has become more steadily prevalent due to increasing life expectancy, urbanisation, sedentary lifestyles, and changing diets, amongst many other issues and causes.
NCDs amidst a global health crisis
Kuguru said Novartis prioritises three disease areas: cardiovascular diseases, cancer, and vision impairment. Around 520 million people are living with cardiovascular diseases globally and have been disproportionately impacted over the last two years. As for cancer, many of the therapies that happen in a hospital setting are being delayed. Breast cancer is a highly prevalent form of cancer in the region, particularly in Hong Kong, Singapore, Korea, and the Middle East. Worldwide, at least 1 billion people have a vision impairment that could have been prevented or still needs to be addressed.
Indonesia, according to Sudoyo, is the fourth-largest economy with a sprawling area, even pre-pandemic, which poses a geological problem: water. “The amount of islands and the sheer numbers of our population is a very big barrier in disseminating [in general] here.”
He added that cancer was not generally thought of as a major problem in the country. The big problems that Indonesia has been facing include mother and child mortality, malnutrition, and environmental health.
Interrupted screening
Meanwhile, in Singapore, scheduled treatments and follow-up appointments have not been that much affected because of all the hospital protocols set. However, there was a lost opportunity for early detection because of the shutdown of screening services, particularly for cancer, noted Lakshmanan.
“The [SingHealth Patient Advocacy Network] worked closely with the Singapore Cancer Society to do several screening programs. Given the long-running nature of the pandemic, they are now putting in place different ways of getting people to come down for screening. For cases like rectal cancer screening, we mail the kits from pharmacies and patients can collect the specimen and mail it back outright,” he explained.
Malaysia has two scenarios, stated Farid. “The first lockdown was before vaccines were available. All the patients’ treatment appointments were on hold, people were not sure what to do, most of the hospitals were
NCDs account for about 41 million deaths globally every year
Only through collaboration can there be a difference in healthcare
inundated with cases, and there was a near-collapse of the hospital system.”
After June, when the vaccine was made available, most Malaysian patients’ treatments resumed. With the lockdown and interstate travel very restricted, they used technology to assist patients, so treatment is uninterrupted and timely. Most of the 75 hospitals that collaborated or referred to MAKNA increased by 48%, and the number of patients that were referred to MAKNA increased by 28%. If they did not have the technology, Farid said, they would not be able to get the kind of support at that particular time. They have three mammogram trailers that were repurposed to become mobile vaccination centres and went to the rural areas to cater to through an outreach program.
Re-escalating NCD services in developing countries
When Farid looked at the recent Malaysian 2021 budget and the 2022 budget presented by the new government, he saw it was reduced by more than 50% in terms of healthcare costs. “We were not part of the compensation when the policy was made or when the budget was presented. They’re still looking at trying to get a grip on how to handle the pandemic. As you know, our government is going to have a general election in 2022, so they are trying to look good. It doesn’t look like a long term solution for us.”
He added that the country is in health, economic, humanitarian, and political crises. The progress being made around NCDs before the pandemic has ground to a halt. He worries it is going backwards and they are looking at several years of trying to restore and recover that progress.
Singapore shares the problem of case backlogs because of the focus on dealing with the pandemic, Lakshmanan said. “We are now beginning to take measures to leave the pandemic. More hospitals are also improving their protocols so that they can get back to business but the priority of lessening the burden of COVID on the healthcare system remains. For the disease, several clinical trials are being done for the COVID pill to address the symptoms. If this thing can be accelerated, we can get back to where we were as soon as possible. There is a Multi-ministry Task Force working on this.”
Sudoyo remarked how Indonesia was recovering quite well, although the sheer number of the population made it a daunting task. “We are already 52% vaccinated at this first activation. We are now bracing for our third wave which might or might not happen at the end of this year due to the holiday season. Maybe after this, we will be able to think more clearly. But in many places like in our capitals, we are already on the first level of house protocol. There has not been any talk about it in the media.”
Role of patient organisations in NCD care
Lakshmanan suggested that patient advocates and leaders of patient organisations must go to the ground and get patients and caregivers to get involved. “They need to put up a united front to the healthcare authorities and institutions to focus on the commonalities and have these conversations with the regulatory bodies and healthcare institutions.”
“The role of [pharmaceutical companies] is to hopefully be catalysts or enablers for this. If there could be some framework set up where they can come in and help create the capacity and capability for the patient organisations to come together and to present this united front, I think it will go a long way in helping us improve outcomes, not only doing this pandemic but beyond it.”
Novartis, according to Kuguru, believes that it is only through collaboration that there can be a difference in healthcare. As a global organisation, they have committed to working with patients and caregivers across the life cycles of medicines.
One of the partnerships they have funded in the Asia Pacific region is called the Asia Pacific Patient Innovation Platform. It is a collaborative partnership with the patient community with patient leaders co-created to support the evolving capability needs of patient organisations and drive sustained improvements in health care outcomes. Kuguru shared they had a summit in March of this year, which brought together close to 900 patient representatives across 300 patient organisations, representing 36 countries. The other part is the ongoing collaboration with other patient groups such as Rare Cancers Australia. The third part is research and survey.
‘The blind spot’
Sudoyo closed the panel by saying how non-communicable diseases have been a blind spot, and it will take a village to bring them back from the blind spot to the spotlight.
“We saw what COVID did to people with other comorbidities, When I talk about the ‘village,’ it’s [compose of pharmaceutical companies], government payers, healthcare professionals and its healthcare system, and us consumers. [We must be] diligent at taking the learnings of the past two years, not forgetting them, and making some important shifts, such as seeing healthcare not as a cost focus system, but as a driver of [gross domestic product] and growth.”
