Health Turkey / November'15 by medikal teknik

Turkey’s Healthcare industry expands rapidly!

“Healthcare and Life Sciences Predictions 2020” REPORT

23rd Expomed to open in March 2016

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According to Country Cooperation Strategy report published by WHO;

Turkey’s Healthcare industry expands rapidly!

urkey occupies 779 452 km² at the cross-roads between Europe, Asia and the Middle East. Since the establishment of the Turkish Republic in 1923, the country has

strived to develop a secular democracy. It is the third most populous country in the EUR Region. In the last decade, stability characterized Turkey’s political life with a majority govern-

ment since 2002. Political stability has ensured the implementation of long term strategies and policies; provided a favorable context for coherent public sector action and health reform.

Estimated total population: 74 724 269 % under age 15: 25.3 Population distribution % rural: 28.2 Life expectancy at birth: 75.0 Under-5 mortality rate per 1000 Live births: 11.3 Maternal mortality rate per 100000 live births: 15.5 Total expenditure on health % GDP: 6.1 General government expenditure on health: 12.8 (as % of general government expenditure) Human Development Index Rank: 90 (out of 186 countries) Gross Domestic Product (GDP) per capita: US$4- 10,469 Adult (15+) literacy rate: 94.1 Adult male (15+) literacy rate: 97.9 Adult female (15+) literacy rate: 90.3 % population with piped water system in the house: 97.6 % population with toilet (indoor) in the house: 91

HEALTH & DEVELOPMENT Health Care Reform in Turkey (Health Transformation Programme) - The health status of people in Turkey has significantly improved in recent years. Improvements in the health status are mostly attributable to the successes of health reform, the socalled Health Transformation Program (HTP) with the tag line “People First”. The Government of Turkey is implementing the second phase of a major health sector reform that aims to improve the governance, efficiency, and quality of the health sector. A serial legal change was enacted within the frame of health reform with the new legislation re-structuring the Ministry of Health (MoH) and re-organizing functions of her units and affiliates. Re-structuring aims at strengthening the stewardship func-

tion of the Ministry and enhancing its role in health system policy development, planning, supervision of implementation, monitoring and evaluation. A new Public Health Institution has been established to support the work of the MoH on preventive health care services. Family Medicine Programme (FMP) HTP aims at strengthening primary health care services through the use of a family medicine system. At the end of 2010, the Family Medicine Programme (FMP), assigning each patient to a specific doctor, was established throughout the country. Community Health Centers (CHC), providing free-of-charge logistical support to family physicians for priority services such as vaccination campaigns, maternal and child

health and family planning services, were established. Both Family Health Centers and CHC are under the supervision of Provincial Health Directorates (81 provinces) which are responsible for planning and provision of health services at provincial level and accountable to the MoH. Social Security Institution (SSI) The fragmentary financing and service delivery system was replaced with strengthened financial and organizational structure. The Ministry of Health is the main provider of health care services. The Social Security Institution (SSI) has become a monopsony on the purchasing side of healthcare services, financed through payments by employers and employees and government contributions in cases of budget deficit.

The health services delivery system was dramatically expanded and improved through investments in infrastructure, equipment, and supplies as well as through training of staff. The proportion of total health expenditure to GDP was 5.4 % in 2002 and increased to 6.1 % in 2008. This slight change indicates that improving peopleâ&#x20AC;&#x2122;s health status depends on effective use of the funds rather than magnitude of it. The proportion of public health expenditure to GDP increased to 4.4 % in 2008 from 3.8% in 2002. On the other hand, public health expenditures constituted 14.7% (2002) of noninterest public expenditures and the figure increased to 15.2 % in 2008. Performance-Based Supplementary Payment A system called performance-based supplementary payment for family physicians and key hospital personnel was implemented in order to reward productivity, and the provision of high impact health services at primary level is ensured for family physicians. As Turkey has a low ratio of doctors

and nurses per population compared to other countries in the WHO European Region, the government attaches utmost importance to human resources for health. The total number of health professionals working in the MoH reached 482.000 in 2011, increasing from 256.000 in 2002. A human resources vision for the year 2023 was developed with all relevant agencies and institutions for the purpose of improving the status of human resources for health. The Strategic Plan of the MoH which covers the period of 2010-2014 was reformulated according to the legislative changes made in line with the HTP. The new Strategic Plan covering the period of 2013-2017 embeds the new European Health Policy, Health 2020, and reflects the principles outlined in the Tallinn Charter. Urbanization The health status of Turkey has improved in recent years â&#x20AC;&#x201C; As a result of rapid urbanization process since the mid-20th century, currently 76.8 % (in 2011) of the population lives in urban areas. Population growth has steadily declined since the 1980s

and the immigration rate slowed down in parallel to overall economic development. Socio-economic development in the last decade significantly improved living conditions and wealth as well as health indicators. Although significant improvements have been observed in the general health status of population, it still requires further efforts to ensure progress in some health indicators that still remain behind the average of the WHO European Region. In addition to giving special importance to maternal and child health care services and immunization programmes, ensuring higher accessibility to health care services also played role in improvements in health status. Major health indicators such as infant mortality and maternal mortality have been improved considerably. The IMR decreased to 7.7 per 1000 live births in 2011 from 31.5 per 1000 live births in 2002. The MMR decreased to 15.5 per 100.000 live births in 2011, from 64.0 in 2002. Increasing immunization rates and expansion of immunization programmes contributed to this decline.

Average life expectancy reached 72.0 for men and 77.0 for women in 2009. In recent years, higher emphasis was given prevention of important diseases by public health centers and primary health care institutions. Incidence of malaria cases was 0.1 per 100.000 populations in 2009 and only agent for autochthonous malaria cases was Plasmodium vivax.

OPPORTUNITIES • Health reform agenda, the “Health Transformation Programme”, has led to comprehensive improvements in the health system. Universal Health Insurance which has been in effect since October 2008 and Green Card Scheme that covers the poor have increased share of population

under health insurance and ensured higher access to health care services. Integration of three main security institutions to eliminate inconsistencies in the health financing system under the Social Security Institution has ensured development of single benefit package by the major health service purchaser and higher equity in access to services. • Government commitment to health reform with a people centered vision and higher investment in health has increased accessibility to health care services in equity and reduced out-of-pocket payments. CHALLENGES • Incompleteness of HTP’s remaining reform initiatives (DRG) in terms of

execution. • Promoting the decentralization of health care governance. • Improving health information systems including vital and health statistics that hampers monitoring and analysis of major health risks as well as long term policy development and planning. • Covering human resources (HR) gaps in health sector at different levels; eliminating inappropriate skill mix. • Ensuring good coordination and cooperation with refunding institution and with health insurance system to ensure financial sustainability and cost containment. • Approaching local and national political elections in 2014.

Sterilization Revolution!

Sterilization and washing in the same device!

Sümer A.Ş. has followed the developments abroad by its research and development team and application staff having engineering infrastructure and continued to manufacture high tech devices having this technology developed in line with these innovations and develop them so as to be most efficient for the human life and Turkish medicine sector since 1981.

he aforesaid products are in compliance with latest technology and were manufactured with the same quality as its Western equivalents and incorporate all specifications required by the EU Standards. The company conducts the projects supported by TÜBİTAK (Scientific and Technological Research Council of Turkey), KOSGEB (Small and Medium Industry Development Organization) and Ankara Development Agency. The company was granted with R&D award of 2011 and ASO (Ankara Chamber of Industry) Achievement Award of 2012 on 27.12.2012 by Ankara Chamber of Industry. The company continues to employ qualified labour force and tries to improve its R&D activities. The company renders service with a

large product range including Steam Sterilizers, Washer and Steam Sterilizers, Bottle Washer and Steam Sterilizers, Washer Disinfector, Formaldehyde and Steam Sterilizers , Warming Cabinets, Blood Bank Refrigerator, Medical Refrigerator in the areas of Neonatology, Sterilization and General Surgery as well as Mother Milk Refrigerator/Freezer ,Baby Bottle Warmer, Syringe Warmer and Human Milk Pasteurizer for the New-born Units of the hospitals. The company has the capacity to fully design an operating room. The company which can manufacture for special projects also renders engineering and consultancy services. Sümer SM-YKD Series Washer Disinfector manufactured in Turkey for the first time by the company particularly offers the functions of

washing, disinfecting and drying the glass materials, operating room instruments, glass containers, plastic and rubber materials and baby bottles. The device is in compliance with the 93/42/EEC Medical Device Directive and it also acquired the ‘’type test’’ certificate at the end of the tests performed by HYGCEN which is an Accredited German Institution. Moreover, SM-4 Series Washer and Steam Sterilizer of which patent belongs to the company and that was manufactured with latest technology in line with the 93/42/EEC Medical Device Directive as a result of the research and development efforts is a revolution in the area of sterilization. This device offers the combined washing and sterilization functions in the same device.

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SÜMER A.Ş. M.Office : G.M.K. BULVARI 7/11, KIZILAY / ANKARA- TURKEY Phone: +90 312 4182646 - 418 57 88 Fax: +90 312 425 49 83

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h s i k r u

ere is the short text quoted from â&#x20AC;&#x153;Colliers International Healthcare Overviewâ&#x20AC;?, which provides a brief snapshot of Turkish economy. The Turkish economy has demonstrated strong fundamentals over the past decade, achieving positive indicators, compared to its neigh-

bouring markets. The Turkish government increased its efforts following the global financial crisis to attract private investors into the services and infrastructure sectors through establishing initiatives and incentive programmes that support their PPP policies. Accordingly, the government provided various tax

and non-tax incentives to foreign investors, in line with those provided to domestic companies. These include customs and VAT exemptions on various imported or locally delivered goods, including machinery and equipment, as well as priority regions offering incentives such as free land and energy support.

An overview of Turkish economy from the Colliers International’s point of view

Investors are also able to benefit from R&D support and market research with the aim of encouraging exports and increasing the competitiveness of Turkish firms in international markets. Following the global financial crisis, the Turkish economy recovered from a –4.8% contraction in 2009

to achieve positive growth in subsequent years due to the aforementioned stimulating policies and procedures. The Turkish economy achieved GDP growth of 2.2% in 2012, surpassing developed economies such as Japan, Brazil, UK and even the EU average. As of the second quarter of 2013, the Turkish economy achieved actual growth of 4.5%, surpassing the IMF initial estimates which were set at 3.1%. The general government budget deficit was realized at 2.0% in 2012, satisfying the Maastricht criteria of 3.0% and outperforming 18 EU economies in the process. Since 2002 the GDP per capita in Turkey has tripled from USD3,492 to USD10,504 in 2012. The inflation rate was 7.4% in 2013, According to the Ministry of Economy in Turkey, declining from 10.6% at the end of 2011. The debt-to-GDP ratio in Turkey is one of the healthiest in the world, currently standing at a sustainable 36.1%, compared to higher ratios exhibited by several developed economies such as Germany, England and France. The unemployment rate dropped to 8.8% in 2013, compared to 10.1% at the end of 2012, in accordance with positive economic performance. According to the World Bank, Turkey has the fifth largest

qualified labour force amongst the EU countries, after Russia, Germany, England and France. In recent years, the Turkish banking sector has taken an increasingly large role in brokering major project finance deals, benefiting in many cases from its increasingly liquid balance sheets. Nevertheless, in spite of the declining interest rates to record low levels, the Turkish central bank interest rate is still high in comparison to most European countries as the Central Bank holds off

matching monetary-policy tightening, prevalent in other developing countries. In conclusion, following a temporary economic slowdown in 2009, the Turkish economy started recovering from 2010, and is expected to grow by a CAGR of 7.9% (real GDP) during the 2013 – 2015 period. Impact on Healthcare: The overall positive performance of the Turkish economy ultimately fares positively on its healthcare industry. Anticipated increase in GDP growth rates supported by the government’s efforts to establish a transparent market, will assist in strengthening the market fundamentals and encourage private sector investment from both; the local market and increased FDI in the coming years.

Turkey to build 34 city hospital complexes within 3 years Turkey’s Minister of Health Mehmet Müezzinoğlu; “The number of city hospital complexes, a new hospital concept in Turkey aiming to modernize health infrastructure, will be increased rapidly over the next three years.” and biggest hospital complex as a whole in the world. It is going to be come into service in August 2016.”

urkey’s Minister of Health Mehmet Müezzinoğlu said that new hospital concept in Turkey aiming to modernize health infrastructure, will be increased rapidly over the next three years,. Müezzinoğlu also said that 34 city hospitals with a total capacity of 43,000 beds throughout Turkey will be completed by the end of 2018. Totally 100,000 beds After the 34 new city hospitals and other hospital projects under the construction put into operation, citizens will take the advantage of healthcare services improved up to 100,000 beds capacity in 3 years.

Biggest in Europe and the biggest as a whole in the world Turkey’s Minister of Health Mehmet Müezzinoğlu visited “Bilkent Integrated Health Campus” construction area in Ankara, inspected and obtained information about the ongoing construction. Müezzinoğlu: “Bilkent Integrated Health Campus has 3,680 beds capacity and 1,300,000 square meters indoor space. It is the biggest hospital complex in Europe

City Hospitals will be completed by the end of 2018 Müezzinoğlu remarked that turkey is having another transformation with these huge healthcare projects. Also stated that 16 city hospitals with a 27,000 bed capacity being built in Ankara Bilkent, Ankara Etlik, Yozgat, Elazığ, Adana, Gaziantep, Konya, Manisa, İstanbul Başakşehir, Isparta, Kocaeli, İzmir Bayraklı, Bursa, Kayseri and Mersin will be put into service in years of 2016 and 2017, Müezzinoğlu said, “34 city hospitals

with a total capacity of 43,000 beds throughout Turkey will be completed by the end of 2018.” Stressing that with city hospital projects Turkey’s standard in the field of heath will increase one more step, he said thus Turkey will be able to surpass developed countries’ standards. Turkish manufacturers are going to be preferred Transportation services are going to be reprogrammed according to new giant health complexes; in related areas. Müezzinoğlu also stated that Turkish manufacturers are going to be preferred for the equipment provision of these giant projects.

TURKEY

One of hottest healthcare markets in the world!

ith an ever growing patient base and a solid healthcare reform programme, investment opportunities in the region are vast, says Frost & Sullivan. According to a news at News-Medical.net; Turkey is a rising star in healthcare investments. Driven by reforms and private investments, Turkey is steadily emerging as one of the hottest healthcare markets in the global arena. The country has doubled its healthcare spending in the last 10 years, reaching $62.3 billion, with its large population of 74.7 million and an increasing patient base. Turkey was a key area of interest at Frost & Sullivan’s Breakfast Briefing on growth in emerging regions, which was held in Milan, Italy. The briefing focused on investment opportunities in Turkey, as well as CIS Countries and Africa, across all industries. Philipp Reuter, Director South Europe and Turkey at Frost & Sullivan, who presented at the conference, comments: “In parallel to its economic growth, Turkey has gone through a significant socio-economic transformation in the past ten years. Between 2005 and 2015, the number of patients for various chronic diseases has doubled in the country,

reaching 9 million diabetes and 1 million cancer patients. A fast aging trend is also observed in the country, which will lead to a larger patient base after 2020.” Healthcare has been the greatest focus of the current Turkish government, who came to power in 2002 and immediately launched the country’s healthcare transformation programme, focusing on a national health insurance scheme. While the government’s healthcare budget doubled during the reform period, the coverage of public insurance has increased from 50 percent of 2003 to 100 percent in 2015. “Another significant outcome of the healthcare transformation programme has been the increasing quality of healthcare services in the country,” adds Hilal Cura, Healthcare Consultant at Frost & Sullivan, who also discussed Turkish healthcare at the Breakfast Briefing. “Between 2006 and 2010, the number of private hospitals increased by 86 per-

cent, while the rate of qualified beds increased from 12 percent of 2002 to 40 percent in 2011. In addition, the installed base number of MRI units increased by 12 fold, from 58 to 781.” As an emerging hotspot in the global healthcare market, Turkey has attracted significant global investments in various segments such as private healthcare services, medical devices and pharmaceuticals. After 2010, many healthcare companies have made Turkey their CEE/MENA headquarters, whereas Turkey’s largest private hospital groups were acquired by private equity groups. Currently, the top ten private hospital chains in Turkey comprise 30 percent of Tukey’s private healthcare services revenues of $10 billion, whereas the Turkish pharmaceuticals market is the sixth largest in Europe, with its $13.5 billion revenues. “Turkey has vast potential for all types of companies accross the healthcare spectrum. Having always been regarded as a R&D hub in the healthcare industry,” concludes Reuter, “the country is now a huge and mostly unsaturated consumer market with significant opportunities in the area of healthcare services, innovative medical device technologies, pharma and clinical diagnostics.”

Turkish Pharmaceutical Industry Exports to

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170 countries all around the world

stanbul Chemicals and Chemical Products Exporters Association (IKMIB)’s Chairman of the Board Murat Akyüz, made a brief statement about Turkish Pharmaceutical Industry. Being one of the leading powers of the Turkish economy, the chemicals industry grew significantly in the

last 10 years together with its subsectors. Being one of the top exporting sectors in our country, chemicals industry is breaking its own records. As İKMİB (Istanbul Chemicals and Chemical Products Exporters Association) we have been supporting the development of the chemicals industry in our country since our in-

ception. We continue our hard work in the chemicals industry which carries the major load in Turkey’s exports, to become even stronger in the foreign markets and increase our export volume. Value added Turkish pharmaceutical industry which is one of the top 20 pharmaceutical markets in the world

has more than 10% share in whole chemical industry. As well as implementing qualification standards successfully, high quality facilities enhance the export potential. The Turkish Pharmaceutical industry has a long standing culture of production as well as a strong infrastructure. The industry complies

with today’s international standards in terms of its production technologies, capacity and qualified human resources. Our production facility and product quality is mostly higher than USA and EU countries. It’s a pleasure to receive positive comments about our industrial quality and image abroad. In the last few years we manufactured more than 3,000 items of pharmaceutical products and the number rose to 8,000 items lately. We manufactured 73% of the pharmaceutical products in Turkish market last year. We exported only the 27% of our market capacity. Turkish Pharmaceutical industry exports to 170 countries. But the biggest obstacle in front of the sustainable export is domestic market price regulations. As a result of it companies serving to pharmaceutical industry are having hard time to reach their pricing goals. Despite all it is very hopeful that pharmaceutical industry accepted as a strategical industry and investments upon high technology on the field are being encouraged. A “Pharmaceutical Sector Council”

is formed by İKMİB to increase the pharmaceutical products export. We organized Industrial Trade Delegation visits to Nigeria, Ghana, Chile, Colombia, Ethiopia, Tanzania, Thailand and Vietnam during the last two years. And we received positive feedbacks. These activities will continue in the years to come.

Murat Akyüz, Chairman of the Board, Istanbul Chemicals and Chemical Products Exporters Association (IKMIB)

Fıratmed: A reliable brand for laboratory equipment

lastik’s brand FIRATMED producing medical equipment is producing urine collection container, pneumatic and PP urine specimen container, conic tube, stool container, stool container with screw cap, petri dish, polystyrene and PP test tubes, falcon tube, eppendorf tube, medium and non-medium transport swab, multi-purpose sample container , pipette tip, processing cassettes with or without cover and tube covers. FIRATMED having an experience in the plastic sector provides secure service to many healthcare centers. Fıratmed has started producing disposable plastic laboratory equipment of in vitro diagnostic equipment group by 3 types of equipment in the year of 2003. The company has become the catalog firm of the sector that produces laboratory equipment by 25 equipment in 2009.

16x100 CONICAL BOTTOM POLYSTYRENE TEST TUBE High transparency 10 ml volume High resistance for shatterproof Graduation indicator

STOOL CONTAINER WITH

PNEUMATIC SYSTEM NON-STERILE URINE SPECIMEN CONTAINER 100 ml volume Special area to write Specific design Non-sterile Screw cap

Sterile, non-sterile

SPOON Polypropylene Container with plastic spoon Special design 25 ml volume

60x15 PETRI DISH High quality High transparency High resistance for shatterproof Suitable for all filling machines Special design

50 ML CONICAL TUBE Polypropylene Graduation between 5 ml and 50 ml Leak-proof Sterile, non-sterile Footless

AUTOMATIC PIPETTE TIP 100-1000 ul Ependorf, Socorex, Gilseon Brand Compatible with Treff Polypropylene

A Robot That Breaks the Kidney Stones Has Been Developed

LMED Electronics which maintains its work in Ankara has produced a ‘İbn-i Sina’ named robot that brings a solution for kidney stones without applying to the scalpel. ELMED General Manager Ahmet Sinan Kabakcı has given some information about the robot produced with the support of TEYDEB (Technology and Innovation Funding Programs Directorate) and expressed that this robot is a first in the world and thanks to this robot kidney stone problems are not a frightening nightmare any more. Kabakcı, saying that they, as a company, developed high-technology and qualified products, told that ‘We

have conducted an important work in the field of medicine. We have developed a robot as a way of kidney stone breaking method through flexible urethroscopy and this robot is unique and a first in the world. When this operation is made manual, it is made under hard condition and with limited acts. However, we break the stones via laser light. Our robot provides the mentioned operation’s being conducted in a sensitive and comfortable way.’ Kabakcı, stating that the operation initiates after the kidney stone breaker device is connected to the robot, mentioned that ‘We connect the present device used in the opera-

tion to robot in less than a minute. The device is controlled remotely with the robot. First entrance is made and the other procedures after the entrance can be made by the robot. Some breakings can occur in especially the exit point in the operation in which a robot is not used and so operations can be cut. Robot prolongs the endoscope’s life. Thus, the stones, in 2, 3 and 4 cm dimensions, can be broken.’ Kabakcı, saying that the robot is essential for the patient and a doctor, stated that there are very few experts on kidney stone breaking and its training is very challenging but the operations in which a robot is

A robot that can break the kidney stones remotely has been developed with the support of TÜBİTAK (Scientific and Technological Research Council of Turkey). The robot, named as İbn-i Sina (Avicenna), has got the credits of American doctors in USA Urology Congress.

used can be easily taught and made after a short training process. Kabakcı, expressing that they will provide the robot’s breaking the stones itself after showing the stone to the robot in the forward steps of the project, told that ‘In the forwarder steps, the robot itself can break the kidney stones but it is not true to leave the robot alone, it will be under control of the doctors, all the time. We are ready for mass production of this robot. Now, 5 robots are in the production process. The 3 of them is in the last step.’ Kabakcı, saying that the robot has been used in Europe Urology Congress, organized in Stockholm in

April, explained that ‘We have used İbn-i Sina for the first time in a live operation in a university hospital in Stockholm as a high-technology product completely made in Turkey. The implementation made has been monitored by more than 2000 urologists, participating from the various countries in the world in the auditorium of the congress via live broadcast. The Robot Video, of which presentation is made in video presentation category in this congress, has received the third prize. While following the positive feedbacks of this successful congress, our robot project has been granted a first prize

in the category of Small Company Product Category of the 11. Technology Prizes Competition, organized by TÜBİTAK (Scientific and Technological Research Council of Turkey) – TTGV (Turkey Technology Development Foundation) and TÜSİAD (Turkey Industrialists’ and Businessmen’s Association). Our robot will be mantled in SLK Kliniken Hospital situated in Heilbronn province of Germany in the next days and will be used by Prof. Dr. Jens Rassweiled, one of the most famous urologists of Europe. These achievements have been the source of joy and pride.’

EMS-Innovative In Approach, Outstanding In Quality “We operate under the motto of innovative in approach, outstanding in quality,” say EMS officials.

ctually, EMS Emergency Mobile Systems and Hospital Materials Industry and Trade Inc. has turned out to be a global player in its area of specialization. In addition to special customer requests and project-based designs, EMS’s manufacturing line focuses on the following product groups: -Diverse range of ambulance production, including intensive care ambulances, snow track ambulances, wheeled snow track ambulances

-Ambulance equipment -Mobile Health Care Vehicles (Van, midibus, bus, truck, container types) - Mobile Command Control Vehicles -National Medical Rescue Teams Tool (Designed for operation in disasters and extreme cases) - Mobile Laboratory Vehicles - Mobile Screening Vehicles -Ambulance stretchers -Stretcher platforms -Medical devices - Medical materials

By keeping the pulse of the sector, EMS has been participating in major medical fairs and exhibitions for years. This month, EMS participates in the Arab Health Exhibition and Congress (27-30 January 2014 Dubai International Convention & Exhibition Centre) to display its emergency mobile vehicles, equipment and systems. EMS puts emphasis on R&D in order to serve its customers in efficient manner. The ambulances, medical products and equipment manufactured by EMS comply with the international technical standards. According to EMS officials, innovation and dynamism have become a way of life for us in order to survive in the competitive markets. They noted: “Innovation is a major business priority; simply put, companies become more competitive when they have a clear process that produces a reliable stream of new and innovative products. As known, permanent change is the rule of the game in the global markets.” “Competitiveness at the domestic level has been replaced with competitiveness on a global scale. Technology and competitive power would always be the two keys for the survival of the sector. Therefore, in line with growing demand from abroad, we have been diversifying and expanding our export markets. We think that the Arab Health Exhibition and Congress would pave the way for a series of new business opportunities.”

Age of the genomic information Health and Pharmaceutical Industries make big impact by using Genomic Information difference over the time. For example, pharmacogenetics give valuable information for usage of antidepressants or chemotherapy dose adjustment in drug treatment, physicians and institutions that use them are creating differences. In time disease that can not be signified for today, will become treatable in the light of genomic information.

enomic science is developing rapidly and molecular basis of diseases are becoming clearer. Thus, we are able to diagnose most diseases at the molecular level more clearly; clinicianâ&#x20AC;&#x2122;s approach for treatment becomes more scientific. While both cost and length of the treatment get shorter, the patientphysician relationship is becoming stronger. The meaning of genetic information becomes clearer with Human Genome Project. Location and structure of our genes are identified and an important amount of data about their metabolism is obtained. The advancement of DNA technology, finding the presence of the gene that causes the disease and analyzing it changed our approach to the disease in the terms of diagnosis. Diseases can be diagnosed even in postnatal life, after determining potential susceptibility to disease; we are able to give our support to individuals under preventive medicine, and physicians to help them plan their life. The results of genomic information showed that life programs can be planned based on the occur-

rence of illness and it can be prevented and can be delayed in some cases. Tailor-made drugs Treatments of the rare genetic diseases are very difficult and the development of tailor-made drugs for specific individuals is very important. Such disease causing genetic variations may differ from individual to individual, and therefore the treatment can be different. However, determining the effective treatment or medicament for disease, it must be correctly diagnosed. So the genetic data obtained up to now must be properly reviewed and evaluated. Pharmacogenetics With the development of DNA and RNA world; not only diagnosis but also the treatment perspective is changing too. Especially the wide world of RNA is a world to be illuminated very well. With the new generation of RNA-based drugs, disease that are difficult to treat, their treatment will get easier. Pharmaceutical industry that uses of Genomic information will make a

Life style; formed by genetic data Genomic data makes a difference not only in the clinical sense but also in our daily lives. For example, from the data of nutrition genetics we can learn which nutrition can be used for our benefits. We can organize nutrition programs based on this information. Similarly, genetic information can determine the athletic performance and what type of exercise is more fitted for our body types. With the information that we gain by genetic analysis which are to be done once in a lifetime, , we will have a chance to experience information that we can use in the rest of our life. Omics Technologies Metabolism and our way of life are influenced by the differences in the DNA, such as not having same effect to the same drug. Emerging technologies in the -omics help us for determining these characteristics. So following this technology and using the drug treatment to translate it to chemical information will provide economic benefit to industry.

Turkey to quintuple health tourists

orld’s 6th top medical tourism destination; Turkey is having a massive increase in health tourism recently. According to the report published by TURSAB (Association of Turkish Travel Agencies) 583,000 tourists from all over the world preferred Turkey for medical procedures, with a quintuple increase over the last five years. About 188,000 came for surgical procedures, from hair transplant and liposuction to operations for serious ailments, generating over $2.5 billion in revenues and representing a growing fraction of tourism receipts.

60% Cheaper In consideration of a report released by Reuters; Turkish health tourism is

drawing global attention. Health professionals and patients say surgery costs, including travel and accommodation, can be up to 60 percent below comparable programs in Western Europe. For example; cardiac by-pass surgery costs; $39,000 to $43,000 in Spain while it costs $8,500 to $21,000 in Turkey. Hair transplant operations which cost €10,000 in European countries, costs only €5,000 in Turkey. 35,000 of 76,000 health tourists from Gulf Countries had hair transplants in Turkey. The government aims to double medical tourist numbers to half a million annually over the next two years and raise revenues to $7 billion by attracting them to higher-margin healthcare.

$25,000 revenue expected The Ministry of Health hopes to reach the $25 billion in medical tourism revenue by 2023, and expects 15-20 percent growth in the sector by the end of the year. Parliament passed new regulations to make private investment in the healthcare sector easier; a move it hopes could unlock billions of dollars of investment over the next few years. Private equity investors favor Turkey’s fast-growing services industries, including healthcare and education, because of a near tripling of nominal, per capita gross domestic product over the past decade and a young population of 75 million.

583,000 health tourist preferred Turkey for healthcare services over the last five years

Tax-Free Health Zone Turkeyâ&#x20AC;&#x2122;s status as a medical tourism destination could add to the allure. Though the idea is still on the drawing board, the government is considering airport-accessible, taxfree health zones which would aim to attract up to 85 percent of their patients from abroad, while offering tax incentives for investors. Under the new law, which facilitates public-private partnerships, the state will rent city hospitals built and run by the private sector for 25 years. Ministry of Health budgeted $2 million for healthcare infrastructure R&D projects in 2014 to empower Turkey in the region.

Cooperation with Iran Iran is a main healthcare services provider in the region, particularly serving to Iraqi and Azerbaijani patients. After the embargo quitted, Iran is in the spotlight of Turkey. Iran and Turkey is expected to make cooperation about plastic surgery, oncology and organ transplantations. Patients from Gulf Countries poured in Turkey for thermal tourism, in vitro fertilization, orthopedic operations, physical therapy and rehabilitation programs and gynecology. After Iraq, Dubai, Tunisia; health tourists from Egypt and Libya derived Turkey to be the favorite healthcare services provider for Arabic Countries.

Top 9th in the world by number of plastic surgeons Thanks to over 1,200 plastic surgeons serving to Turkish healthcare system. According to health tourism report 2014, Turkey is ranked the top 9th in the world by number of plastic surgeons. Jully and August are very busy periods for plastic surgery operations in Turkey. Antalya is the most popular city within this perspective.

ISEK – Istanbul Health Industry Cluster

SEK – Istanbul Health Industry Cluster (www.i-sek.org) is a collaboration of various industrial companies with the related university research centers, public institutes and NGOs in Istanbul Metropolitan Region. Industrial companies differ from large-scale corporations to SMEs and start-ups with a focus on medical devices and biotechnology as well as pharmaceutical fields. ISEK comprises 97 firms, 16 universities (relevant research centers), 13 NGOs, 2 public institutions and 1 hospital. The missions of the ISEK are determined as • Increasing the dialog and improve cooperation among industrial companies and universities and developing and strengthen the existing academic research and service infrastructures to meet the urgent and specific needs of the local health tech industry, • Providing joint labs, support spaces and other common purpose infrastructures for pre-competition research needs, • Focusing on new entrepreneurs: establishment of a set thematic preincubators, advanced incubators and

specific pilot production infrastructures, • Providing support services to project teams in capacity building, technical consultancy, technology transfer, intellectual property; either in house or via effective referral to its supporting partners and • Organizing events (seminars, meetings and workshops) to facilitate collaborations by bring people together in focused events and develop and offer new training programs to help, expand and improve the regional industrial workforce • Developing shared exhibition/

demo areas and specific national/international marketing strategies for the whole cluster • Assisting in the development of regional healthcare industry innovation districts and physical infrastructures, including industrial parks dedicated exclusively to health tech. Within the context of Medica 2015, we will introduce 5 member companies. The activity fields of these companies are given below: Argenit; established in 2009, develops digital microstructure imaging and analysis systems (www.argenit. com.tr) Durmaz; established in 2010, develops x-ray imaging platforms (www.durmazteknoloji.com.tr) Hayriya; established in 2012, develops wearable body sensors (EKG, EEG, EMG) and provides services in neuroscience, biofeedback and biomechanics (www.hayriya.com) Medimiks; established in 1993, offers R&D services and products to molecular pathology, molecular biology and genetics laboratories (www. medimiks.com) Szutest; established in 2005, provides CE Marking services and accredited by Turkish Accreditation Institute (www.szutest.com.tr)

23rd Expomed to open in March 2016

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ighly anticipated medical show of Eurasia is set to take place in March 24-27, 2016 in Istanbul’s Tüyap Fair Convention and Congress Center with the organization of Reed Tüyap Exhibitions. The show will put suppliers face-toface with key medical sector both in Turkey and emerging neighboring

Eurasian markets. 711 exhibitors from all over the world represented their brands in the latest edition over an area of 60,000 sqm. 2015 edition was visited by 35,997 attendees, 4,899 of whom were from the overseas. The upcoming Expomed expects to host over 800 Turkish and international

exhibitors and more than 40,000 professional visitors. Labtechmed simultaneously takes place with Expomed The must-see laboratory equipment and technologies show offering a wide range of products and services is being simultaneously organized with Expomed.

Thanks to the VIP Elite+ Programme both the exhibitors and the hosted professional visitors will make the best of Expomed and Labtechmed shows. All visitors on this programme are closely vetted to ensure that only serious business professionals are accepted.Â

the ideal distributors in the targeted regions, it will also let the willing companies find the right brands to represent in their distribution range.

Visitor focus country: Iran Expomed and Labtechmed shows are welcoming special buyers from Iran. With its emerging potential this year Iran is going to be the visitor focus country. Executives, managers, buyers and decision-makers of hospitals, clinics, laboratories, blood banks, and also healthcare authorities in Iran are going to be visiting the shows running from 24th to 27th of March 2016 for the purpose of business transaction.

As in the previous editions a busy side event programme awaits both the exhibitors and the visitors of the shows running simultaneously during Expomed and Labtechmed that will add a plus value to the shows. Attendees will be able to obtain indepth information about the latest developments in the field of medicine. More information yet to come in the days ahead. Check www. expomedistanbul.com and www. labtechmed.com for further information about the programme.

A satisfying seminar and panel programme throughout the exhibition

Germany is the country of host Having a great experience and knowhow in the field of medical engineering Germany is the country of host of the upcoming Expomed and Labtechmed exhibitions. 19th edition of Labtechmed is ready to bring the exhibitors together with the visitors in Istanbul coming from all across the world targeting to be the meeting point of laboratory industry. Hosted buyer programme offers great business opportunities throughout the shows

A dedicated lounge area for distributors Exhibitors looking for distributors in Turkey and also in Eurasia will be able to use the special lounge area located in the fairground to hold prearranged B2B meetings with their potential distributors. This will not only enable the exhibitors to find

FDI (Foreign Direct Investment) inflow to Turkey up 36 percent, reaches USD 11.8 billion Turkey attracted USD 11.8 billion of foreign direct investment (FDI) during the first eight months of 2015. Corresponding to a 36 percent increase over the same period of 2014, Turkey’s investment appeal remained strong despite the turmoil in some of its neighboring countries, and the upcoming general election.

ccording to data from Turkey’s Central Bank, in August alone, USD 1.9 billion has been channeled into the country, with the chemical sector being the main beneficiary. The top recipient sectors in the January-August period were respectively, manufacturing, financial services, and energy. In the given period, 46 percent of the country’s current account deficit was financed by FDI inflow. Commenting on the country’s FDI performance during the first eight months of the year, the Investment Support and Promotion Agency of Turkey (ISPAT) President, Arda Ermut, said that Turkey maintained its status as a safe haven for foreign investors. “Having established itself in its region as a safe haven for investors, Turkey’s investment appeal rests on the economic accomplishments of the last 12 years. As we can observe from the FDI figures, the turmoil in some of our neighboring countries and upcoming elections has not deterred foreign investors, who have confidence in Turkey and its poten-

tial. We are optimistic about exceeding last year’s FDI total,” the ISPAT President stated.

World Bank elevates Turkey’s growth forecast According to an article published in the Akşam newspaper; The World Bank has revised Turkey’s 2015 GDP growth forecast to 3.2 percent up from 3 percent, reflecting the country’s stronger than expected secondquarter growth. The institution’s 3.5 percent forecast for the years 2016 and 2017 remained unchanged in the Global Economic Prospects’ October revision. Driven by domestic consumption and private sector investment, the growth in Turkey’s economy reached 3.8 percent in the second quarter following first-quarter growth of 2.5 percent. The Turkish government’s medium-term program predicts a growth of 3 percent this year.

Turkish lira and stock market jump after election result BBC news website reported that Turkish lira and the Istanbul stock market rose sharply after the surprise win by the ruling Justice and Development Party (AKP). The lira was up almost 4% against the US dollar to 2.8 in afternoon trading after falling by 25% this year. The main share index in Istanbul was 5.5% higher in late trading. A coalition government had been expected, so the prospect of a potentially more stable administration has boosted confidence. Turkey’s economy is expected to expand about 3% this year, below the government’s official target of 4%. Inflation, which hit 7% in August, is a growing concern for policymakers.

“Healthcare and Life Sciences Predictions 2020” REPORT

What we know today and estimate about tomorrow Trends in healthcare and life sciences

• Average life expectancy in OECD countries in 2012 was 80 YEARS, an increase of 5 years since 1990: Japan has the highest at 84, with UK 81, US 79, China 75 and India 66 years • Meet the over 65s – by 2018 they will number some 580 million –10% of the global population – or one in every: 4 Japanese, 5 Western Europeans, 10 Chinese • Developed markets remain the

main spenders on healthcare – 77% of global spend in 2014. Developing markets are forecast to increase their share from 23% in 2014 to 32% by 2020 • Growth in average annual healthcare spending 2014 - 2018 is expected to range from 2.4% in Western Europe to 4.9% in North America; and from 8.1% in Asia and Australia to 8.7% in the Middle East and Af-

rica • Generics will take a larger share of total global medicine spend, increasing from 27% (USD 261 billion) in 2012 to 36% (USD 421 billion) by 2017 • In 2013, across the G7 markets, there was a companion diagnostic deal nearly every working day – 226 deals, up from only 8 deals in 2009

The Deloitte Centre for Health Solutions published a report named “Healthcare and Life Sciences Predictions 2020” We’d like to share some key points and a summary of the report.

• The number of people with diabetes globally is 382 million, around I in 4 are Chinese. There are more diabetics in China than the combined populations of Germany and Portugal • Total global pharmaceutical spending is expected to increase by 6.9% a year from USD 1.23 trillion in 2014 to USD 1.61 trillion in 2018. Oncology is expected to remain the main contributor among therapeutic areas • Med tech industry sales are expected to increase from USD 363.8 billion in 2013 to USD 513.5 billion in 2020. In-vitro diagnostics will be the top segment

Ten Predictions for 2020 Provocative insights – both evolutionary and revolutionary External environment shaping predictions • Health consumers in 2020 Informed and demanding patients are now partners in their own healthcare • Healthcare delivery systems in 2020The era of digitised medicine – new business models drive new ideas • Wearables and mHealth applications in 2020 Measuring quality of life not just clinical indicators • Big Data in 2020 Health data is pervasive – requiring new tools and provider models • Big Data in 2020 Health data is pervasive – requiring new tools and provider models • Regulatory compliance and patient safety in 2020 Regulations reflect the convergence of technology and science • Research and Development in 2020 The networked laboratory – partnerships and big data amidst new scrutiny • The pharmaceutical commercial model in 2020 Local is important but with a shift from volume to value • The pharmaceutical enterprise configuration – the back office in 2020 Single, global organisation responsible for insight enablement • New business models in emerging markets in 2020 Still emerging, but full of creativity for the World • Impact of behaviours on corporate reputation in 2020 A new dawn of trust

HEALTH CONSUMERS IN 2020 Informed and demanding patients are now partners in their own healthcare prediction Individuals are better informed about their genetic profile, the diseases they have and might have, and the availability of healthcare. Expectations of healthcare and better outcomes for themselves and loved ones are at their highest. The ‘quantified self’ has embraced prevention and is devoting time, energy and money to staying healthy. When ill, patients demand specific treatments; they are also willing, in part, to pay. Patients are true consumers, they understand they have options and use information and data about themselves and providers to get the best treatment at a time, place and cost convenient to them. The 2020 world • Healthcare organisations now engage with patients through social media, regularly gauging their needs and driving them to appropriate products and services for their budget and healthcare requirements. • Online patient communities have grown exponentially and are rich sources of crowd-sourced data, with rating systems for drugs and healthcare provision. • Advanced analytics on patient chatter in these communities gather health information, providing a better understanding of which treatments deliver the best outcomes, allowing real time tailoring of pharmaceutical messages and services. They also provide early alerts on diseases, such as influenza. • Businesses and governments work with communities of patients, hospitals and payers to identify best practice and cost-effective treatments.

• New provider and industry models, including mutuals and other forms of collaboration and cooperation, help decrease costs and improve care. HEALTHCARE DELIVERY SYSTEMS IN 2020 The era of digitised medicine – new business models drive new ideas Prediction The home is where much of the medical care takes place. It is no longer confined to clinicians in the clinic or hospital. The ubiquity of digital communication means that many doctor-patient contacts are now virtual and deliver care to the patient in their home. Specialist hospital treatment is reserved for trauma and emergency surgery; local day care organisations deal with most elective surgery, while chronic and long-term conditions are managed in the community. Care is provided via accountable care (type) organisations for a defined patient population, which take on the population risk. New funding models include year-of-care tariffs, pooled budgets, capitation or personal health budgets.

The 2020 world • Web-based portals that enable regulatory compliant (and reimbursable) video interactions between patient and clinician are now supported by a wide array of web-integrated wireless monitoring devices. • Healthcare productivity has been revolutionised including reducing travelling and waiting times, and inconvenience by providing routine contacts through telemedicine-enabled clinical e-visits, supported by digital diagnostic tools which facilitate physical examinations at a distance. • Robotic or robotically enhanced surgery is commonplace, utilising robotically enhanced surgery platforms to access detailed radiological information while allowing the sur-

geon enhanced visualisation of the surgery with his/her 3D goggles. • Key technologies have become established: For example, 3D printing of medical devices and organs; ‘scar-less’ surgery with entry via the oesophagus rather than skin incisions; and nerve cell transplants that improve t h e func-

tionality of heart- failure, stroke, and paralysis patients. EVIDENCE IN 2014 The rise of connected health “Technology alone, such as the smartphone, is not a silver bullet for healthcare. Instead, success lies in the convergence of digital health and human interaction. It also relies on developing partnerships which harness technology, while providing trust-based, patient-centred care; and balances person-to-person engagement with the efficiencies provided by technology.” Sara Siegel, Deloitte Partner, Healthcare Strategy and Consulting WEARABLES AND HEALTH APPLICATIONS IN 2020 Measuring quality of life not just clinical indicators

Prediction Wearables shape the quality of life of today’s consumer, capturing and tracking how people live with and manage their condition. Consumers and providers integrate information from multiple devices seamlessly to create a comprehensive view of the individual. Wearables are now adopted widely (beyond keep-fit and health fanatics) and specialist medical (bio-sensing) wearables are affordable. The new clinician/patient partnership is based on improved awareness, self-management and prevention strategies, replacing the paternalistic approach of old. The 2020 world • The tipping point for broad adoption of wearables has been reached – wearables are used voluntarily and are recommended as part of prevention and wellness protocols. • The next generation of wearable devices are interoperable, integrated, engaging and outcomes focussed. The technology has become much cheaper and more sophisticated and the data quality has improved. • Wearables now continuously monitor a broad range of physiology – from posture to brain activity. • Biosensing devices analyse and compare with other devices and ‘interact’ with the medical literature. • Extensive use in clinical trials allows tracking of quality of life, not just efficacy and safety. • Treatment plans now include ‘wearables’ as a prescription – monitoring the sickest patients and helping to better control healthcare costs. • Wearables have made the home an extension of the hospital, allowing those who have received care to rapidly transition home. • Patient reviews and ratings evaluate the new health apps and technologies, based on an agreed industry standard for app integration.

• Biosensing devices are as much the realm of start ups as non-traditional health companies, creating a big new industry, with the winners still emerging.

Evidence in 2014 The rise of bio-sensing technology

“The wearables industry is growing rapidly, fueled by a mix of both innovation and hype. These devices have the potential to revolutionise healthcare through remote monitoring, disease management and early detection. However, wearables will have to transform from fitness tools of the healthy to valid, reliable accessories for even the sickest among us.” Harry Greenspun, MD, Director, US Center for Health Solutions. Deloitte Services LP Big Data in 2020 Health data is pervasive – requiring new tools and provider models Prediction For many countries healthcare data has become a national infrastructure priority and attracts significant funding (similar to the building of highways in the US in the 1950s). As a result, patients themselves, clinicians and healthcare officials use healthcare data to transform diagnosis and treatment to improve outcomes and healthcare productivity. Pharmaceutical companies now collaborate fully with patients and healthcare systems using data to develop better treatments, launch them faster and price according to improvement in health outcomes.

The 2020 world • Healthcare systems recognise the value of existing and new data sources (for example, Electronic Health Records, patient provided data) and have created governance to allow data access and sharing, formed data partnerships and are changing how care is delivered on the basis of data insights.

• Use of healthcare data becomes a measure of national economic development. • Pharmaceutical companies have built, bought and hired new capabilities (data management/analytics) and partnerships (with payers and hospital systems) to use Big Data across the value chain from discovery to value pricing. Data has blurred boundaries between traditional research and development and commercial functions. • New data driven competitors disrupt the research & development (R&D) model with a focus on data and outcomes as opposed to the science only. • Genetic testing is accepted as actionable information. R&D in 2020 The networked laboratory – partnerships and big data amidst new scrutiny Prediction In 2020, research and development (R&D) has few boundaries; the R&D model is networked, built around academic and other partnerships. The share of ‘in-house only’ discoveries is at an all time low. R&D activities are widely distributed, with pharmaceutical companies co-ordinating and

integrating at the centre. The focus is on understanding disease biology and genetics; current standards and cost of care; and treatment pathways. Networked R&D combines pharmaceuticals and technology with increased patient engagement to prevent and treat disease. Company R&D strategies compete on returns from high value, low volume, western markets and lower value, high volume emerging markets. The 2020 world • Pharmaceutical companies collaborate with stakeholders earlier in the R&D cycle and access the best R&D earlier. • Technology has changed the nature of R&D – with diagnostic biomarkers used in real time monitoring via wearable devices, and the convergence of technology and biology blurring the boundary between medical devices, continuous diagnostics and augmentation. • ‘Investigator-less clinical trials’ – in which clinical trial sites are replaced by local clinics, remote monitoring and virtual clinician visits – have resulted in a significant reduction in the cost of clinical trials and the generation of more meaningful data through continuous monitoring.

• DNA sequencing now costs less than USD 50 per genetic profile, allowing extensive screening and effective targeting of trial patients and personalisation of drugs and interventions. • Patients search out trials to participate in, forcing pharmaceutical companies to compete for patients, especially in well characterised, small patient group trials. • Regulators are now comfortable with step-wise launches and focus on safety, efficacy and quality of life.

Evidence in 2014 The move to Global Business Services (GBS) “Pharmaceutical companies are facing an increasingly challenging environment, with cost containment increasingly a factor of life as patent cliffs, reimbursement pressures, longer development cycles and time to market, as well as competition from generics erode the ability to maintain and improve profit margins. GBS provide a flexible platform to help simplify, standardise and reduce the cost of an enterprise and support effective decision making across increasingly complex layers of local, regional and global functions.” John Haughey, Deloitte Partner, Life Sciences Consulting Lead

New business models in emerging markets in 2020 Still emerging, but full of creativity for the World Prediction While the traditional pharmaceutical markets in the US, Japan and Western Europe remain the main markets for drug companies, new markets requiring new business models are gaining pace. The focus on Brazil, Russia, India and China (BRIC) is now being challenged by new emerging markets in Latin America, Vietnam, Indonesia and Africa. These are proving an even bigger surprise, incubating new business models and leading in the development of new drugs. The pharmaceutical industry has responded to the various healthcare delivery models being adopted by different emerging countries and are tailoring their strategies accordingly. The focus is on access, affordability and outcomes – with an emphasis on local and being more than just the pill. The 2020 world • Insights and learnings from emerging markets have led to the emergence of new business models, creating a step change in the operating

and commercial models of traditional markets. • New markets in Africa and Asia have emerged – where formerly only generics companies played. • Indonesia and Nigeria are leading the way in addressing the sheer size, geographical spread and inherent challenges of young populations with high levels of unmet need, prevalence of infectious diseases and poverty. • Management teams are diverse and routinely include locals from emerging markets. • Pharmaceutical companies have established dual brands, for certain emerging markets, allowing more locally tailored pricing models, while preventing parallel trade. • Diabetes and specific cancers are now the foremost healthcare issues in these emerging economies, challenging all stakeholders to develop solutions. • Translational medicine, including gene sequencing, has allowed emerging markets to leap-frog the West in some elements of research. With Brazil and China the main sources of drug innovation, providing a major contribution to the solutions for ageing and co-morbid populations globally.

Aziz Sancar dedicated The Nobel Prize to Turkish People

Mapping how cells repair damaged DNA and safeguard the genetic information made him won the Nobel Prize in Chemistry

he Royal Swedish Academy of Sciences has decided to award the Nobel Prize in Chemistry for 2015 to 3 scientists. One of them is a Turkish professor; Dr. Aziz Sancar, works for the University of North Carolina in USA and The title of the research is “Mechanistic studies of DNA repair” The cells’ toolbox for DNA repair The Nobel Prize in Chemistry 2015 is awarded to Tomas Lindahl, Paul Modrich and Aziz Sancar for having mapped, at a molecular level, how cells repair damaged DNA and safeguards the genetic information. Their work has provided fundamental knowledge of how a living cell functions and is, for instance, used for the development of new cancer treatments. Each day our DNA is damaged by UV radiation, free radicals and other carcinogenic substances, but even with-

out such external attacks, a DNA molecule is inherently unstable. Thousands of spontaneous changes to a cell’s genome occur on a daily basis. Furthermore, defects can also arise when DNA is copied during cell division, a process that occurs several million times every day in the human body. The reason our genetic material does not disintegrate into complete chemical chaos is that a host of molecular systems continuously monitor and repair DNA. The Nobel Prize in Chemistry 2015 awards three pioneering scientists who have mapped

how several of these repair systems function at a detailed molecular level. In the early 1970s, scientists believed that DNA was an extremely stable molecule, but Tomas Lindahl demonstrated that DNA decays at a rate that ought to have made the development of life on Earth impossible. This insight led him to discover a molecular machinery, base excision repair, which constantly counteracts the collapse of our DNA. Aziz Sancar has mapped nucleotide excision repair, the mechanism that cells use to repair UV damage to DNA. People born with defects in this repair system will develop skin cancer if they are exposed to sunlight. The cell also utilizes nucleotide excision repair to correct defects caused by mutagenic substances, among other things. Paul Modrich has demonstrated how the cell corrects errors that occur when DNA is replicated during cell division. This mechanism, mismatch repair, reduces the error frequency during DNA replication by about a thousand fold. Congenital defects in mismatch repair are known, for example, to cause a hereditary variant of colon cancer. The Nobel Laureates in Chemistry 2015 have provided fundamental insights into how cells function, knowledge that can be used, for instance, in the development of new cancer treatments.

Another Turkish Doctor is awarded Assoc. Prof. Dr. Tülay Güran received one of the prestigious awards in Europe named “Younginvestigatoraward” from ESPE Marmara University Assoc. Prof. Dr. Tülay Güran, received the Young Investigator Award from ESPE (European Society for Paediatric Endocrinology) Dr. Tülay Güran is from Mardin Turkey, just like Nobel prize for chemistry 2015 winner scientist Prof. Dr. Aziz Sancar. “Younginvestigatoraward” is given to the best projects selected among hundreds of investigators under age of 40 all around the world. Assoc. Prof. Dr. Güran stated that she is pleased to represent Turkey by courtesy of this award. Award is presented during the yearly congress of ESPE in Barcelona in front of 3000 delegates by ESPE Science Committee President Jan Lebl Assoc. Prof. Dr. Güran said that it was another pleasure to receive the award from Jan Lebl as a Turkish doctor. Assoc. Prof. Dr. Tülay Güran After İstanbul University Faculty of Medicine she studied for a post graduate degree at Marmara University as a paediatrician. Later she is updated her post graduate degree to master’s degree at Marmara University Faculty of Medicine Department of Paediatric Endocrinology with Prof. Dr. Abdullah Bereket . She is chosen for one of the most important Fellowship programs in European Union; Marie Curie Post-doctoral Research Fellowship. Within the program she made scientific researches for 2 years at Birmingham University in England. She is particularly focused on scientific researches about congenital adrenal gland diseases which is very com44

mon in turkey due to frequent cross cousin marriages. Assoc. Prof. Dr. Tülay Güran ‘s scientific researches are printed in prestigious medical journals like; “Journal of Clinical En-

docrinology and Metabolism” and “New England Journal of Medicine”. Assoc. Prof. Dr. Tülay Güran is married with 3 kids and currently working at Marmara University.

Healthcare &

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omestic and international investors are ramping up their investments in the pharmaceutical sector to take advantage of Turkey’s attractive market, where the healthcare and the pharmaceutical sector grew by 5.8 percent and 8.9 percent respectively from 2012 to 2013. Expenditures on pharmaceu-

ticals are expected to reach to TRY 20.66 billion in 2015, a 10.3 percent increase on the TRY 18.72 billion figure of 2014. Expenditures on healthcare, meanwhile, are expected to increase by 10.4 percent from TRY 96.01 billion in 2014 to TRY 105.98 billion in 2015, while the growth in real GDP is projected to be 3.5 percent for the same period. Turkey has one of the largest and youngest labor pools in Europe, with more than 42 percent of the population aged between 24 and 54, and the strength of Turkey’s labor force is reflected in the pharmaceutical sector. In the 2011-2012 academic year, more than 41,000 students graduated from vocational training schools and universities in fields related to the pharmaceutical sector. The Turkish healthcare system has undergone the largest transition in its history over the last decade. The successes of health reforms, specifically the Health Transformation Program (HTP), have brought about a

marked improvement in the healthcare system and have enhanced access to healthcare facilities. The Universal Health Insurance (UHI) program was put in place to provide healthcare to every Turkish citizen; and as a result, the Social Security Institution (SGK) has become the number one buyer on the purchasing side of healthcare services. A rapidly growing young population is one of the key factors driving demand for healthcare. Over the next two decades, as the current young population of Turkey ages, there is likely to be a sharp rise in healthcare demand as almost 80 percent of a person’s healthcare requirements typically occur after the age of 40-50. Turkey will experience continued economic expansion and rising incomes which, in turn, will create more demand for health services and products, and these increases are reflected in the healthcare spending projections. According to Economist Intelligence Unit (EIU) forecasts, the

Turkey’s pharmaceutical market became the 6th largest in Europe and the 16th largest in the world in terms of sales in 2012. In 2014, pharmaceutical sales saw a 37 percent increase compared to USD 6.2 billion in 2004, reaching a stunning USD 8.6 billion. healthcare sector in Turkey is set to boom by a CAGR of 5.6 percent between 2013 and 2017, while most developed countries will be experiencing relatively lower growth rates. Turkey is also expected to surpass the forecasted world average with this growth rate. The social security system now covers approximately 82 percent of the total population, with 62.8 million people now covered. Investments in the healthcare sector are expected to continue as the government strives to increase the number of hospital beds per 10,000 population to 32 in 2023, up from the current figure of 27.2. The Turkish government has also taken on an ambitious healthcare PPP program. The Ministry of Health is planning to open health “free zones”, which will include hospitals, rehabilitation centers, thermal tourism facilities, nursing houses, health techno-cities and R&D centers, to be built in big cities where transportation will be relatively easy.

According to PPP professionals, Turkey is the second most attractive market globally for PPP projects in the medium to long term, and official targets related to the adoption and development of e-health systems present significant investment opportunities for ICT infrastructure companies. Turkey’s healthcare expenditure will continue to grow over the long term due to underlying fundamentals driving demand for healthcare

services, its population dynamics, increasing urban migration and the burden of disease in the country. Furthermore, significant private sector investments in healthcare facilities will see the country rise in importance as a medical tourism hub. There are plans to increase health tourism revenues to USD 20 billion by 2023, and as a result, healthcare spending per capita has been targeted to almost triple by 2023, reaching USD 2,000.

$28 billion spent on irreproducible medical research last year

new study published in Open Access journal PLOS Biology by the Global Biological Standards Institute (GBSI). In this report two leading economists estimates that, in the U.S. alone, approximately $28 billion per year is spent on preclinical research that is not reproducible. Analysis of past life science research studies indicates that the cumulative prevalence of irreproducible preclinical research exceeds 50 percent. Be-

cause such low reproducibility rates can contribute to both delays and costs of therapeutic drug development, The Economics of Reproducibility in Preclinical Research by Drs. Leonard P. Freedman, Iain M. Cockburn and Timothy S. Simcoe, also outlines a framework for solutions and a plan for long-term improvements in life science research reproducibility rates. “Our primary goal here is not to pinpoint the exact reproducibility rate

but rather to identify root causes of the problem and develop a framework to address the highest priorities,” says Freedman who is president of GBSI. “Based on examples from within the life sciences, application of economic theory, and review of lessons learned from other industries, we conclude that community-developed best practices and standards must play a central role in improving reproducibility going forward.”

New study on research reproducibility proposes fixes for $28 billion problem applying industry on public and private investments in research and development.”

Analysis and recommendations “The problem of reproducibility has been widely discussed,” says Cockburn. “To develop our estimate of the current reproducibility rate for preclinical research, we reviewed publicly available data from government sources, industry and analyst reports and scientific articles.” The study included an in-depth analysis of the key components of irreproducibility, and used secondary research to benchmark the potential impacts of improved standards. The authors determined that the causes of irreproducible research could be grouped into four categories that align with the typical stages of study development: (1) biological reagents and reference materials, (2) study design, (3) data analysis and reporting and (4) laboratory protocols. Of

these, errors in biological reagents and materials (36% of total) and study design (28% of total) are the two largest contributors to irreproducible spend. “Improving reproducibility levels will require a measured investment in time and resources,” says Cockburn. “We recommend investing in practical solutions and taking immediate steps in the areas where there will be the greatest return on investment.” “While false positives are an inevitable part of scientific research, our study shows that the current level of irreproducibility in preclinical research is very costly.” says Simcoe. “By categorizing the root causes of irreproducibility and estimating their relative importance, we can prioritize potential solutions, and ultimately, increase the overall return

Call to action Numerous recent articles and papers highlight the challenges of reproducibility in life science research. The Economics of Reproducibility in Preclinical Research calls for a paradigm shift from acceptance of an avoidable problem to the adoption of compelling best practices that support better research and better outcomes. By encouraging an investment in standards and best practices, the study promotes better scientific research that quickly translates to therapeutics and cures. This aligns with 21st Century Cures, the U.S. Congressional initiative underway to update laws to support finding new and improved medicines and diagnostics, and keeping America competitive in healthcare and biotech in the 21st century. “Success requires communicating to build awareness, sharing best practices and identifying practical steps with funding behind them to support scientists in their life-saving mission. It requires that researchers own it, funders fund it, media publicize it and consumers care about it,” says Freedman.Additional resources are available on the GBSI website: http://www.gbsi.org/publications/ the-economics-of-reproducibility/ About Global Biological Standards Institute GBSI, a non-profit organization, is dedicated to enhancing the quality of biomedical research by advocating best practices and standards to accelerate the translation of research breakthroughs into life-saving therapies. For more information, visit www.gbsi.org.

Making Turkey a Global Center for Pharmaceutical R&D and Production

urkey, a rising star in the region and the world, has ambitious social and economic goals for 2023 - the 100th anniversary of the Republic. The pharmaceutical industry creates value through innovation. By tapping its potential, the innovative pharmaceutical industry can lead the way in helping Turkey achieve its 2023 goals. AIFD’s vision is to help create a pharmaceutical industry in Turkey that can manufacture higher value-added products, attract globally significant R&D investment, and use advanced technologies to export products on a exponentially greater scale, which will in turn help tip the foreign trade balance in Turkey’s favor. As a result of aging populations, extended life spans, and socioeconomic changes around the world, health services are one of the most

important topics of the 21st century. As the average life expectancy increases, the risk of falling ill to chronic diseases and experiencing health concerns in the later stages of life also increases. When we consider these factors, innovative drugs and new treatments, which can help prevent diseases and reduce treatment costs, become increasing important over time. Thus both developed and developing countries consider pharmaceutical research and development (R&D) aimed at the discovery of new treatments and the production of new drugs a priority area for investment and a strategic growth sector. The Turkish Government aims to make Turkey one of the world’s top ten economies in health services by 2023 by increasing R&D expenditures to 3% of GDP and by increasing exports to USD 500 billion.

Moreover, according to the Turkish Ministry of Science, Industry, and Technology (AIFD)’s Strategy Report, Turkey should become the Eurasian production base for mediumand high-level technology products. Taking into account Turkey’s current macroeconomic conditions, political stability and increasing economic efficiency, AIFD considers these R&D targets to be realistic. As production of innovative drugs increases, the added value of the drugs produced will also increase accordingly. Turkey, which now boasts the strongest and most dynamic economy in the region, can become a formidable player in the pharmaceutical sector. Turkey has the necessary knowledge base, infrastructure, and geostrategic location to attract global pharmaceutical R&D and could become a global player in the pharmaceutical industry.

Association of Research-Based Pharmaceutical Companies(AIFD); Turkish Pharmaceutical Industry Report

The report suggests an exports-focused plan of action to develop Turkey’s pharmaceutical industry into a global R&D and production center and regional shared service center location.

The main targets of the plan are: • Developing Basic and Clinical Research Competency and Services Exports: • Improving Turkey’s R&D competency and increasing national and foreign direct investment; thereby making Turkey’s pharmaceutical sector a leader in R&D Developing Production Competency and Product Exports: • Increasing the production capacity of specific high value-added product groups; thereby allowing Turkey to become a regional/global pharmaceutical powerhouse and net exporter• Making Turkey a Regional

Management and Service Center location for the pharmaceutical industry Prerequisites for this action plan are: • The formulation and implementation of a long-term policy to support innovation in the field of health sciences that makes R&D and valueadded drug production the highest priority. • Additionally, the government will provide grants that support innovation and implement regulations that protect international property rights (IPR). Aging population, extended lifespan, and socioeconomic changes around the world will increase the need for health services in the coming years. • While the world population in 2005 was 6.5 billion, it will reach 7.6 billion in 2020, and the share of people aged 65 years and above in the total population will reach 9.4% with an increase of 242 million. 80%

of people over 75 years of age use at least 1 prescription drug, while 36% of those receive at least 4 prescription drugs. • Exposure time of people to chronic diseases will increase with effects of changing nutritional habits, more inactive lifestyle, and extended human life expectancy. • A 17% increase is expected in deaths caused by chronic diseases in the next 10 years. While hypertension is noted in 639 million people in developing countries as of 2004, this number is anticipated to reach 1 billion in 2025. Similarly, the number of patients with diabetes, 366 million people as of 2011, is expected to reach 552 million in 2030. • As in the SARS and bird flu cases, diseases that can be treated are expected to evolve and spread more rapidly due to the increase in urbanization and mobility. With the increase of need for health services, innovative drugs & treatments will gain importance in the pharmaceutical industry. Contribution of new treatment methods and innovative drugs to public health will increase. • The awareness of patients about the contribution of innovative drugs to public health is increasing, which increases the demand for new treatment methods. • Effects of many chronic diseases have been brought under control by new drugs and treatment methods developed. Turkey has a major opportunity to become a key services and pharma products supplier for neighboring regions with its location, with total export potential of USD 8 billion.

Turkey’s pharma industry can contribute to closing the country’s trade deficit with exports of pharma products & services: Basic & Clinical Research: service exports with USD1 bn potential Value-added manufacturing: Pharma products and active pharmaceutical ingredients with USD 7.3 bn potential Management & shared services center: service exports through Liaison Offices, regional HQs or shared service centers USD 8 billion of export value equal to 2.7% of total import in Europe, Russia, Middle East and Caucasia A numeric look at the neighboring regions EUROPE GDP USD 19.9 trillion Population 668 million Pharma import USD 264 billion RUSSIAN FEDERATION GDP USD 1.8 trillion Population 142 million Pharma import USD 11 billion 56

CENTRAL ASIA AND CAUCASUS GDP USD 0.4 trillion Population 82 million

Pharma import USD 2 billion MIDDLE EAST AND NORTH AFRICA GDP USD 3.3 trillion Population 647 million Pharma import USD 14 billion Source: Investment Support and Promotion Agency, UNCOMTRADE Turkey’s pharmaceutical industry has enough infrastructure and potential to realize this vision and become a global player Strong features of Turkey’s pharmaceutical industry that will support the targets; • The scope of social security services increased with successful healthcare reform, as did patient satisfaction, access to services, and industrial indicators. • Steady macroeconomic structure and rapid growth rates • Modern law system supported by economic and political stability • Turkish pharmaceutical industry ranks 7th in Europe, 16th in the world • Strong production facility infrastructure; 76% of drugs consumed in Turkey on a box basis and 49% on a

value basis are locally produced • Industrial employment includes approximately 25.000 people. • Over 300 industrially sponsored or academic clinical trials are conducted in 2011 • Strong education capacity in fundamental sciences, medicine and pharmaceutical departments • Number of specialist physicians increased from 18.000 to 31.000 since 2002 • Competency in diagnosis and treatment, and strong development of healthcare tourism • Being regional center due to strategic geographical location and high possibility and advantage of export to markets such as the Middle East, Eastern Europe Investments in health and pharmaceutical industries will improve public health and provide an economic benefit by increasing research, production, exports and employment. Public Health Goals: The main objective of the Ministry of Health in the 2010-2014 Strategy Document was defined as “Improving the health care level of our people”.

Supporting R&D studies within the scope of improving health services Increasing the quality, effectiveness, and productivity of diagnostic and treatment services Improving pharmaceutical and medical device services, and sustaining safe market access Making regulations that will encourage the development of new drugs to make progress in the field of pharmaceutical technology, and to carry out scientific studies in collaboration

with the public, universities and private sector Economic and Development Goals: The long-term vision of the Turkish Industrial Strategy was specified as “To be the production base in Eurasia by producing medium - and highlevel technology products”. Strategic Targets: • Promote and strengthen the position of companies that can develop

their competencies and skills in a sustainable manner • Promote medium- and high-level technology industries in production and exports. • Switch from low technology industries to high value-added products Industrial policies include: • Increasing the share of mediumand high-level technology industries in production and exports and developing a policy for industry clusters

Age of wearable health technology

erox Groupâ&#x20AC;&#x2122;s PARC and Smart Design recently discussed their vision of the future with printable tech and their intention to lead the way by creating small smart patches. These miniature wearable devices will either monitor health parameters or deliver medication in controlled doses to the user. Two companies are both working on this project. The patch will be able to help in the diagnostics, monitoring and treatment for a patient. For example, if the doctor suspects a patient has arrhythmia (irregular heartbeat), the patientâ&#x20AC;&#x2122;s heart rate and ECG will be measured on-site

in the hospital or clinic. When the patients leaves, the doctor will have no way to know how his condition reacts to his daily activities or how the patientâ&#x20AC;&#x2122;s heart functions during sleep. With the patch however, the heart rate and ECG of the patient is recorded in set intervals and will present a more accurate representation of the heart activity of the patient. For treatment, a different patch will be designed to deliver the required doses at specific periods of the day or according the bodily needs of the patient. The concept for distribution is simple. Pharmacies will have

printers capable of creating the patches and patients will be able to install the patches themselves with minimal assistance from a pharmacist. In cases such as antibiotics, which are meant to be never neglected, the drug will enter the bloodstream with no risk for human error (such as forgetting). The medication patches could also come with diagnostic parts that will particularly be beneficial for medication taken as needed. At present, people with impaired insulin production often rely on cumbersome technology to deliver doses of insulin at set intervals.

PARCâ&#x20AC;&#x2122;s printable tech department plans to manufacture a patch that measures health or delivers medication; that can be applied to the skin like a BandAid

The problem with these pumps are they are programmed to pump insulin but do not take into account blood sugar levels. This means a wearer would have to do a blood sugar test, which involves pricking a finger and using a digital meter, usually four times a day. With the printed chip, delivery of medication could be closely linked to the bodyâ&#x20AC;&#x2122;s needs. This creates a better way to take medicine and allows a doctor to be more precise with treatments. The chips will also be able to send information to the doctors to monitor the improvement of a medical condition over time. PARC envi-

sions these small patches to be disposable and cheap to produce. PARC and Smart are dedicated to the future of printed technology. According to them, the potential of the manufacturing process and capabilities of a printed device is a disruptive technology that affects all aspects of modern living, from smart packaging to entertainment. The printable monitoring and medicating patches is part of PARCâ&#x20AC;&#x2122;s Printed and Flexible Electronics focus group. According to them, the current market for the technology is valued at $1B and is expected to grow to $45B by 2016.

Turkish Ministry of Health

n ideal health system must be accessible, of high-quality, efficient and sustainable. The system must have a human-centred approach and ensure financial equity. Individuals must have Access to healthcare services in a timely and equitable manner. The state of the Turkish health system at the end of

2002 was in need of radical changes in many significant areas of health, from service delivery to financing to human resources to information systems. Within this framework, we have developed the Health Transformation Programme which is a structural, methodical and sustainable Turkish model based on the so-

cio-economic realities of our country and global developments. The programme we have been implementing since 2003 is one of the best examples of the â&#x20AC;&#x153;Strategic Managementâ&#x20AC;? model. In this context, we prepared the 20102014 Strategic Plan, the first in the history of the Republic.

STRATEGIC PLAN 2013 – 2017 which also revised the 2010-2014 Strategic Plan. We worked with the World Health Organization during the preparation of this plan and we took the Tallinn Charter, the European Action Plan for Strengthening the Public Health Capacities and Services, and Health 2020 into consideration. The European Office of WHO cites it as an exemplary health sector strategic plan for other countries. Our ultimate purpose with this plan is “to maintain and improve the health status of our people in an equitable manner”. We have identified four strategic goals and 32 objectives for this purpose. Ultimate Goal- To protect and improve the health of our people in an equitable manner

Strategic management means renewal of the goals and objectives of the organisation in line with the changing world rather than planning for the future only once. The 2013-2017 Strategic Plan has been prepared in line with national and international health strategies and the new organisational structure in the Ministry,

Strategic Goal 1- To protect the individual and the community from health risks and foster healthy life styles 1. To develop healthy dietary habits, increase the level of physical activity, and reduce obesity 2. To sustain the fight against tobacco and to reduce the exposure to tobacco and the use of addictive substances 3. To develop health literacy to increase individuals’ responsibility for their health 4. To raise awareness of reproductive health and encourage healthy behaviours. 5. To reduce the negative impact on health of public health emergencies and disasters 6. To protect and promote the health and well-being of employees by improving occupational health 7. To mitigate the negative impact on health of environmental hazards 8. To carry out effective actions on so-

cial determinants of health by mainstreaming health in all policies 9. To combat and monitor communicable diseases and risk factors 10. To reduce and monitor the incidence of non-communicable diseases and risk factors Startegic Goal 2- To provide accessible, appropriate, effective, and efficient health services to individuals and the community 1. To improve the quality and safety of health services 2. To protect and improve maternal, child, and adolescent health 3. To ensure the effective utilisation of preventive and essential health services 4. To sustain appropriate and timely access to emergency care services 5. To improve the integration and continuity of care by strengthening the role of primary healthcare 6. To control and reduce the complications of non-communicable diseases 7. To strengthen the regulations of traditional, complementary and alternative medical practices to ensure the effectiveness and safety 8. To continue to improve the distribution, competences and motivation of human resources for health, and to ensure the sustainability of human resources for health 9. To improve the capacity, quality and distribution of the health infrastructure and technologies and to ensure their sustainability 10. To ensure accessibility, safety, efficacy and rational use of drugs, biological products and medical devices, and the safety of cosmetic products 11. To enhance the health information systems for monitoring and evaluation of, and evidence-based decision-making for, the health service delivery system

Strategic Goal 3- To respond to the health needs and expectations of individuals based on a human-centred and holistic approach 1. To strengthen the role of individuals in order to ensure their active participation in decisions regarding their healthcare 2. To better meet the needs of individuals with special needs due to their physical, mental, social or economic conditions by ensuring easier access to appropriate health services 3. To contribute to ensuring equity in the financing of health services and protection of individuals from financial risks 4. To increase the satisfaction of individuals with their health services and that of health workers with their working conditions

Strategic Goal 4- To continue to develop the health system as a means to contributing to the economic and social development of Turkey and to global health 1. To maintain the financial sustainability of health care system without compromising service quality through implementation of evidence-based policies 2. To monitor health system performance and to document its contribution to health and the national economy 3. To promote research, development, and innovation in priority fields of the health sector 4. To promote the contribution of the health sector to the economy 5. To strengthen health tourism in Turkey 6. To be among the leaders in the development and implementation of global and regional health policies 7. To contribute to global health through cooperation and development aid

A BRIEF HISTORY OF THE MINISTRY OF HEALTH OF TURKEY STRATEGIC ANALYSIS When we review the health policies of Turkey from the past to the present, cultural unity and continuity of the Seljuk-Ottoman medical tradition in the organisation of the healthcare services are significant. During the early days of the Turkish Republic, a western-oriented path was mostly followed in the organisation of the state and its institutions and establishing service policies. Within this process, health policies were developed in accordance with global trends. Health Policies from 1920-1923 The Ministry of Health (MoH) was established by Law No. 3 dated 3 May 1920 following the opening of the Turkish Grand National Assembly. The first Minister of Health was Dr. Adnan Adıvar. At this time, there was no opportunity for regular documentation on health because the focus of the MoH was primarily on addressing war casualties and drafting legislation. It is noteworthy that the MoH was one of the first ministries to be established in this young state and was organised during the struggle for independence before the Republic was founded. The Government of the Turkish Grand National Assembly continued to work for the institutional organisation of the healthcare services even during the toughest years of warfare. During this period, Law No. 38 on Forensic Medicine (1920) was also enacted. Health Policies from 1923-1946 During his ministerial term beginning from the foundation of the Republic in 1923 until

1937, Dr. Refik Saydam made great contributions to the establishment and development of healthcare services in Turkey. According to the records we have to date, in 1923 healthcare services in Turkey were provided by the government, municipal and quarantine centres, small sanitary offices through 86 inpatient treatment institutions, 6,437 hospital beds, 554 physicians, 69 pharmacists, 4 nurses, 560 health officers and 136 midwives. In addition, during this period, the following laws, which are still in effect, were enacted: − Law No. 992 on Bacteriology and Chemical Laboratories (1927), − Law No. 1219 on the Practice of Medicine and its Branches (1928), − Law No. 1262 on Pharmaceuticals and Medical Preparations (1928), − Law No. 1593 on General Hygiene (1930), − Law No. 3153 on Radiology Radium, Electrotherapy and Other Physiotherapy Facilities (1937). − Healthcare services were conducted using the model of “single-purpose service in a wide area/ vertical organisation”, − The “preventive medicine” concept was developed through legislation. Local administrations were encouraged to open hospitals and offices of government physicians were established in each district. − Diagnosis and treatment centres were established in 150 district centres in 1924 and 20 in 1936 starting with the regions with higher population first; physicians were banned from working independently. − Ankara, Diyarbakır, Erzurum, Sivas Numune Hospitals were opened in 1924, and Haydarpaşa hospital in 1936, Trabzon Numune hospital in 1946, and Adana Numune hospital in 1970 to set an example for the other provinces.

Health Policies from 1946-1960 The “First Ten-Year National Health Plan”, which could be called the first health plan of the Republican Era, was approved by the Higher Council of Health in 1946 and announced by the Minister of Health, Behçet Uz, on 12 December 1946. However, Minister Behçet Uz left his post in the MoH before the plan, which was prepared with intense efforts was enacted. Dr. Behçet Uz became the Minister of Health again in the government of Hasan Saka (10.8.1947 - 10.6.1948) and the same National Health Plan became a draft law approximately 18 months later. The draft law was negotiated and approved by the Council of Ministers and four Commissions of the Turkish Grand National Assembly. However, it was never enacted due to a change of government because the new Minister of Health, Dr. Kemali Bayazit, withdrew the plan. Even though the National Health Plan and the National Health Programme could not be turned into legal documents or implemented in their entirety, the majority of the ideas included in them deeply influenced the healthcare structure in Turkey. Inpatient treatment institutions, which had been under the supervision of the local governments, began to be managed by the central government. The National Health Plan, in an effort to provide healthcare services at the community level, attempted to establish ten-bed health centres for every group of 40 villages and to provide curative medicine and preventive healthcare services together. Furthermore, efforts were made to assign two physicians, one health officer, a midwife and a visiting nurse to those centres along with village midwives and village health officers, who would work for groups of ten villages.

By 1945, there were eight of these new health centres, increasing to 22 in 1950, 181 in 1955 and to 283 in 1960. In 1952, the MoH established a Division of Maternal and Child Health. In 1953, the first Maternal and Child Health Development Centre was established in Ankara in collaboration with and with assistance from international organisations, such as UNICEF and WHO. During this period, the child mortality rate and mortality due to infectious diseases were high. This led to intensive implementation of the policies for increasing the population. In this context, significant progress was

Eskişehir, Istanbul, İzmir, Konya, Sakarya, Samsun, Seyhan, Sivas, Trabzon, Van) and planning was made accordingly. In order to increase the number of healthcare professionals, Ege University School of Medicine was established as the third medical school in Turkey (after those at Istanbul University and Ankara University) and started accepting students in 1955. As a result, the number of physicians increased from 3,020 in 1950 to 8,214 in 1960. Similarly, the number of nurses increased from 721 to 1,658, while the number of midwives grew from 1,285 to 3,219 dur-

made in terms of developing health centres, delivery centres, infectious disease centres and human resources for health. Average life expectancy at birth was 43.6 years in 1950-1955, 52.1 years in 1960-1965 and 57.9 years in 1970-1975. The “National Health Programme and Activities of the Health Fund”, which served as a continuation of the First Ten–Year National Health Plan, was announced by Dr. Behçet Uz on 8 December 1954. The First Ten-Year National Health Plan and the National Health Programme and Activities of the Health Fund are the cornerstones of health planning and organisation of Turkey. The National Health Programme envisioned a structure comprised of 16 health regions (Ankara, Antalya, Bursa, Diyarbakır, Elazığ, Erzurum,

ing this time period, corresponding to a more than 100% increase in the three occupations in 10 years. The number of hospitals and health centres also increased as did the number of beds. In addition, this period saw an increase in the number of pediatric hospitals, delivery centres and tuberculosis hospitals. There were 14,581 beds in 118 MoH-affiliated institutions in 1950, increasing to 32,398 beds in 442 institutions in 1960. Although these increases were in part the result of the centralization of the hospitals under the jurisdiction of the local administrations, when we consider these increases on a population basis, the number of beds increased from 9 beds per 100,000 population in 1950 to 16.6 beds per 100,000 in 1960.

In addition to the positive developments in the expansion of health institutions and the increase in bed numbers, health indicators also improved, tuberculosis mortality declined substantially, as did infant mortality. Tuberculosis mortality decreased from 150 per 100,000 population in 1946 to 52 per 100,000 population in 1960 in provinces and district centres, while infant mortality declined from 233 deaths per 1000 live births in 1950 to 176 per 1000 live births in 1960. Both the National Health Plan and the National Health Programme intended to insure the public in return for a fee, pay for care of uninsured persons and poor people from a special administrative budget and establish a health fund to finance health expenditures. They also intended to control the production of medical supplies, such as medicines, sera and vaccines; and to establish industrial organisations to produce foods, such as milk and infant formula, for children and infants. It was within this framework that the Biological Control Laboratory was established in 1947 under the Refik Saydam Hygiene Centre Presidency and that a vaccination station was put into service. From that year onward, intradermal Bacillus Calmette–Guérin (BCG) vaccine was produced in Turkey, while the production of whooping-cough vaccine in Turkey was initiated in 1948. Within the same framework, a Workers’ Insurance Administration (Social Insurance Agency) was established in 1946. Furthermore, starting in 1952, health institutions and hospitals were opened specifically for insured workers. Efforts were also initiated during this period to establish a Retirement Fund, thereby expanding the cover-

age of the social security net. This period also saw the development of legislation to establish a legal framework for nongovernmental organisations (NGOs) and certain medical occupations: − Law No. 6023 on the Turkish Medical Association (1953) − Law No. 6197 on Pharmacists and Pharmacies (1953) − Law No. 6283 on Nursing (1954) − Law No. 6643 on Turkish Association of Pharmacists (1956) Health Policies from 1960-1980 Law no. 224 on the “Socialization of the Healthcare Services” was adopted in 1961, but implementation did not begin until 1963. A widespread, continuous, graduated and provincially integrated structure was developed. This structure included health posts, health centres, provincial hospitals and district hospitals. Vertical organisations were partially reduced and the structures that provided different healthcare services were integrated under the health centres. Law no. 554 on Population Planning was adopted in 1965. This anti-natalist (limiting population increase) policy reversed an earlier pro-natalist (increasing population) policy. The “multi-dimensional service in a narrow area” approach was adopted instead of the “single purpose service in a wide area”. A draft law on Universal Health Insurance was prepared in 1967, but it could not be sent to the Cabinet at that time. However, in 1969, the second Five-Year Development Plan foresaw the introduction of Universal Health Insurance once again. In 1971, the draft “Law on Universal Health Insurance” was sent to the Parliament, but it was not adopted. In 1974,

the draft was presented to the Parliament again, but it was not discussed. In 1978, a “Law on the Principles of Healthcare Personnel’s Full-Time Practice” was adopted, prohibiting physicians in the public sector from setting up private practices. After the military coup d’état on 12 September 1980, however, it was repealed by the “Law on the Compensations and Working Principles of the Healthcare Personnel” and the freedom to establish private practice was reintroduced. Health Policies from 1980-2002 Turkey’s 1982 Constitution included provisions regarding both citizens’ right to social security and the State’s responsibility to effectuate this right. According to the 60th Article of the Constitution: “Everyone has a right to social security, and the State shall take the necessary measures to establish the necessary organisation to provide this security”. Additionally, according to the 56th Article of the Constitution, “To ensure that everyone leads their lives in conditions of physical and mental health and to secure cooperation in terms of human and material resources through economy and increased efficiency, the State shall regulate the central planning and function of the healthcare services. The State shall fulfill this task by utilizing and supervising the healthcare and social institutions both in the public and private sectors.” This article also included a provision stating that “Universal health insurance may be introduced by law.” The “Fundamental Law No. 3359 on Health Services” was adopted in 1987. However, because the necessary regulation for the execution of this law was not

developed and because the Constitutional Court repealed some of its articles, the law was only partially put into effect. As the financial management in healthcare gained importance, universal health insurance was brought to the agenda once again in 1987. However, the required legal regulations on this matter could not be agreed upon. In addition, in 1986 health benefits were introduced for Bağ-Kur enrollees (self-employed), thus a three-pronged structure emerged in public health insurance. The most significant outcome of this development was that the three institutions had separate approaches and pricing systems for the same healthcare services. While some institutions covered the cost of certain services, the others did not. In 1990, the State Planning Organisation (SPO) prepared a basic plan for the health sector and in line with this plan, the first National Health Congress was held in 1992. The development of a “Master Plan for the Health Sector” was carried out by the MoH and SPO and was in a sense the beginning of healthcare reforms. The First and Second National Conferences on Health were held in 1992 and 1993, and with them theoretical studies on health reform gained momentum. The Green Card Programme was introduced in 1992 with Law no. 3816 for low income citizens without social security coverage. In this way, vulnerable people who did not have the economic means to access healthcare services gained limited health insurance coverage. The “National Health Policy”, prepared by the MoH in 1993, included five main chapters: assistance, environmental health, lifestyle, provision of healthcare services and a healthy Turkey.

In 1998, a Universal Health Insurance plan was presented to the Parliament by the Cabinet under the name of “Draft Law on Personal Health Insurance System and Establishment and Operation of the Health Insurance Institution” but it did not pass. In 2000, a draft law on a “Health Fund” as part of the general health insurance system was presented to the other ministries for their opinion; however, no agreement was reached.

Turkish healthcare system made it necessary to undertake radical changes in many areas ranging from service delivery to financing, human resources and information systems. With this aim, we launched the Health Transformation Programme in 2003. We prepared the programme by getting inspiration from our own past experiences, particularly related to the socialization of healthcare services, as well as from the re-

The main aspects of the health reform studied in the 1990s were: • Establishment of a Universal Health Insurance Programme by merging the existing social security institutions into a single organisation, • Development of a primary care system in the family medicine field, • Transformation of hospitals into autonomous health facilities, • Providing the MoH with a structure that plans and supervises healthcare services and prioritizes preventive healthcare services. This period is best characterized as one in which theoretical studies were conducted but not put into practice.

cent studies on health reform, and from successful examples of health reform around the world. The programme set out not only to seriously affect the present but also the future of health services in Turkey, seeking to become a significant milestone in the achievement of objectives set in the field of health. With it the MoH showed decisive commitment to implement the programme and through its many reforms to achieve the desired improvements in health status. During this period, courageous and determined steps were taken to simplify the lives of the Turkish people. In addition, the hospitals of other public institutions, including those of the Social Security Institution (SSI) were transferred to the jurisdiction of the MoH.

Turkish Health Transformation Programme from 2003 – 2011 At the end of 2002, the state of the

The coverage of Green Card Programme for low-income groups was expanded and outpatient expenditures for healthcare services and pharmaceuticals were covered by the state. Furthermore, the value-added-tax (VAT) on pharmaceuticals was reduced and the pharmaceutical pricing system was changed. A large discount on the price of pharmaceuticals was introduced, thereby reducing the burden of these expenses on individuals and families, and in the process significantly increasing access to medicines. “112 Emergency Healthcare Services”were added in both cities and villages. The number of emergency stations was increased and ambulances were equipped with state-of-the-art technology and equipment. Sea and air transportation vehicles were also added to the system. Primary care services, particularly preventive healthcare and maternal-child healthcare services, were strengthened; and family medicine, which is an important element of modern health philosophy, was introduced across the country. Moreover, comprehensive programmes were implemented to prevent ill-health and premature deaths associated with non-communicable diseases. In this context, national programmes were planned and implemented for certain diseases, such as cardiovascular

diseases, cancer, diabetes, chronic respiratory diseases, stroke and renal failure. As a result, our indicators for communicable diseases declined to the level of the developed countries after the commencement of the Health Transformation Programme. Regions lacking buildings, equipment, or healthcare personnel were designated as priority areas and the imbalances in these areas were largely eliminated. During the last nine years, a total of 2,021 new health facilities, including 554 independent hospitals and new hospital buildings, were put into service. During the same period, the number of personnel working in public health institutions increased by 226,000, reaching 482,000 persons, including those on service contracts. The large-scale transformation programme that was put in place during the past nine years has been admired by the rest of the world. In addition, while the overall (noninterest) public expenditure have increased by 95% from 2003-2011, the increase in the public health expenditure has only been 74%, illustrating that public resources are now being used more efficiently due to the Health Transformation Programme. Moreover, financial sustainability has been guaranteed

with the adoption of a medium-term financial plan for 2010-2012. In 2003, the level of satisfaction with healthcare services was 39.5%; by late 2011 this figure had reached 75.9%. As a result of the changes made under the Health Transformation Programme, our people have started to demand better service. In addition, their trust and expectations have risen as well. In order to meet these expectations it will be necessary to complete the ongoing reforms and undertake new initiatives, but we have the determination, decisiveness, and experience to make it happen. THE STRATEGIC PLANNING PROCESS The current situation World Health Organization believes that the health system of a country must be designed in such a way as to ensure the provision of high quality health services for all. These services must be effective, affordable, reasonable and acceptable to society. Countries are recommended to take these factors into consideration and develop their own unique health systems. By the end of 2002, the state of the Turkish Health System required radical changes in many areas ranging from service provision to finance and from manpower to information systems. WHO Regional Office for Europe (2012), Successful Health System Reforms: The Case of Turkey: “At the beginning of the new millenium, the performance of Turkey’s health sector in terms of health outcomes, financial protection and patient satisfaction put it at the bottom of the OECD countries and the European Region of WHO.”

We therefore initiated the Health Transformation Programme in order to ensure effective, efficient and equitable health service delivery and financial sustainability. With this Programme, we set a global example by improving our indicators at a rare pace and level. OECD – World Bank, (2008), OECD Review of Health Systems-Turkey “The content of the Health Transformation Programme appears to represent a ‘textbook’ set of reforms for a health system of the type found in Turkey prior to 2003, building on the strengths of the system, yet targeting the weaknesses.” So, how did we accomplish this? We designed the Health Transformation Programme as an efficient, good quality and sustainable model aimed at providing equitable access to health services with a humancentred approach. Quality We have implemented a large number of initiatives to improve the quality of Turkish health services. We have established quality criteria as well as “Hospital Service Quality Standards” that cover all health institutions. We have also carried out Performance and Quality Development activities and published books and manuals to guide health institutions. We are also renewing and modernizing health investments and have begun construction of numerous city hospitals. In the past decade we opened a total of 2,114 health institutions: 606 hospitals and outbuildings and 1,508 primary healthcare institutions. In part as a result of these efforts, the average duration of a consultation increased from 4.5 in 2002 to 9.5 minutes in 2011. Furtermore, we introduced a Qual-

ity Room System and increased the rate of “quality beds” from 6% in 2002 to 31% in 2011. Since 2003, all (completed or new) investments have been “quality beds”. We have established a Patient’s Rights Unit to support our patients in all Ministry of Health hospitals. We have also introduced the Right to Choose Your Physician and have implemented this practice initiated in all of our hospitals and ODHCs as of the end of 2010. In addition, we have improved access to and use of high technol-

can send an x-ray image shot taken in Bahçesaray to Ankara in seconds and have it interpreted there. Finally, we have developed a Pharmaceutical Track&Trace System (PTTS) which is the first widespread implementation in the world of a system that uses data matrix and does tracking. These many initiatives are part of the reason that satisfaction with health services has increased from 39.5% in 2003 to 76% in 2011.

ogy in health. In 2002, there was a total of 18 magnetic resonance imaging (MR) devices in all public hospitals, a number we increased to 273 in 2011. At the same time, we increased the number of computerized tomography (CT) devices from 121 to 446, and ultrasonography devices (USG) from 495 to 2,125, while the number of dialysis devices increased from 1,510 to 4,481. We also established a National Health Information System (USBS). With this programme, we developed national standards for health information systems and thus created the basis for an effective information system. Furthermore, we improved the availability of tele-medicine services, connecting 61 sending and 10 receiving hospitals to each other so that we now

birth the most important health indicator. In its 1998 World Health Report the life expectancy at birth for Turkey was predicted to reach 75 years in 2025, however, we reached this figure in 2009. As can be seen in Graph 4, life expectancy at birth in upper-middle income countries was 71 in 2009. In these countries, average life expectancy increased by two years, while in Turkey it grew by five years.

WHO considers life expectancy at

The 1998 World Health Report predicts infant mortality in Turkey in 2025 to be 16 per 1000 live births. Our infant mortality rate, which was 31.5 per 1000 live births in 2002 declined to 7.7 per 1000 live births in 2011.

In contrast, infant mortality in upper-middle income countries was 16 per 1000 live births. In the past decade, the rate of change in infant mortality in upper-middle income countries was 40.7 % while it was 76.7% in Turkey.

SWOT ANALYSIS We used the meetings with, and the survey of, the stakeholders to carry out a SWOT analysis, which is one of the most important steps of strategic analysis. Strengths A deeply-rooted organisational culture and institutionalized structure Determined decision-making and execution A positive image in the public, the public’s trust and support for the administration Having carried out social security reform Continuity of the HTP, which has been a successful health policy Qualified, highlyeducated, experienced, competent and dedicated personnel welcoming innovation with intrinsic ethical values and team spirit Performance-based supplementary payment for employees Openness to the use of modern management techniques and technologies Excellent cooperation with all pub-

lic institutions/private sector facilities and national and international organisations Successful management of overseas healthcare services Availability of “revolving funds” for healthcare services in addition to the general budget funds A larger share of Gross Domestic Product (GDP) spent on health expenditures Weaknesses Undersupply of health service personnel to meet the demand for services and institutional requirements Obsolete, noncompliant, complex and inadequate regulation Dispersed arrangement of central organisation units Occasional resistance to novelty and change Despite gradual decrease in bureaucracy and paperwork, failure to reach the desired speed in processes and procedures Rapid changes in demographic movements and urbanisation Opportunities Atmosphere of stability in our country Young population in our country Increase in the resources to be allocated for healthcare services with increased national

income Restructuring of the MoH in line with contemporary norms Establishment of the public hospital unions Rolling out of services aimed at health promotion and improving life styles Increased quality of employment in the health sector Expanding the use of information and communication technologies in healthcare facilities due to the advancement of technology Rapid transformation into a knowledge society and greater attention given to research and development Increased interest in the concept of strategic management Development of policies in conformity with Health 2020, the WHO European Health Policy Framework Close relations with international organisations and agencies Allowance and facilitation of “offset practices” Enabling the establishment of free health zones Enhanced health tourism Threats Increasing rate of obesity in the population Reduced total fertility rate and society aging Regional wars and political instability Global and/or regional economic crises Probable threats to health from neighboring and nearby countries A risk of an accelerated spread of epidemics due to increased demographic mobility The emergence of newly defined and unpredicted diseases due to unexpected changes in existing diseases Natural disasters and environmental threats

TURKEY TO RANK FIFTH IN ORGAN TRANSPLANTS

rgan transplantation has been defined as the most important treatment modality improving the quality of life of the people who face with organ insufficiency. Transplant recipients hold on to the life, become able to take up their business life and social life from where they left off, following a successful transplant performed by the experts in the field, at state of the art hospital facilities. The Chief of the Organ Transplantation Center of the Memorial AtaĹ&#x;ehir Hospital, Prof. Dr. K. YalĂ§Äąn Polat gave information about the importance of organ transplantation and donation. Patients prefer Turkey for transplant surgery and surgeons prefer Turkey for transplant surgery training

Based on numerical data on organ transplantation, Turkey ranks fifth in the World in terms of success rates of transplant surgery. Now Turkish people do not have to go abroad to get a transplant anymore, but instead international patients come to Turkey to receive a transplant. Today, surgeons who practice transplant surgery in Turkey are very experienced in this field and Turkish surgeons who have many successes, particularly in the field of living donor transplantation, give a comprehensive training to the surgeons who come from a number of developed countries including US in particular and share their experiences with their guests. Big steps have been taken in organ

transplantation during the last 10 years Regardless of whether a public or private transplant center, the cost of transplant surgery is fully reimbursed by the state health insurance providers. There are 55 thousand registered dialysis patients in Turkey. In addition to these patients, 8 to 10 thousand patients are waiting on the liver transplant list. While many of these patients were dying due to their inability to obtain necessary medical care only 15 to 20 years ago, now they are able to bring back their old healthy days. The number of the patients waiting for organ transplant is increasing based on the 2015 data Based on the 2015 data of the Min-

istry of Health, currently 22.00 patients with kidney disease, 2.200 patients with liver disease, 600 patients with heart disease, 260 patients with pancreas disease, 50 patients with lung disease, 4 patients with valvular heart disease and 5 patients with intestinal disease have been placed on the waiting lists for cadeveric transplants. Many patients lose their life waiting for a donor, since organ donations are far from the desired level. The inadequacy of cadaveric organ donations leads many patients to receive organ transplants from their family members and relatives in order to get healthy. A healthy life is waiting for the patients after transplant

One of the issues that transplant recipients are curious about is the time required to be able to resume their normal life. In fact, even some patients become anxious in the belief that they will never be able to bring their life back to normal and will never be as they used to be. However, their concerns about the future are groundless. On the contrary, a healthy life is waiting for these people rather than hard days. People who are brought back to a normal life by an organ transplant, may resume their social and business life in a mean period of 3 months after surgery and become a productive and working individual again. During this process, they may have children and the individual may continue to live as before. Organ transplantation is a multidisciplinary treatment modality for people with end stage diseases. Following a successful transplant, these people have to follow the recommendations of their physicians. Patients have to comply with their treatment should not skip their regular physician visits. The lifestyle after transplant is as important as the transplantation procedure itself. Patient awareness on these issues is crucial. Civic engagement in organ donations shall be promoted When considering annual statistics in Turkey, the number of kidney transplants has been about 3 thousand. Although this is a relatively

high number of transplants, is still inadequate, since these transplants are mostly living donor transplants rather than cadaveric transplants. Due to the very limited number of cadaveric donations, living donor transplants are at the forefront. Cadaveric organ donations are still inadequate in our country. The inadequacy of public awareness about organ donation points out insufficient information, prejudgment or even unsubstantiated beliefs. People who give their organs to their relatives when they are alive, refrain from organ donation after death. The uselessness of an organ after death is ignored. This situation in the most powerful evidence of the paradox in organ donations. There is a misperception about organ donation that needs to be overcome. Tell your family, your organ donation decision while you are alive While the number of cadaveric organ donations in Europe is 25 to 30 per million population per year, the same number is 4.7 in Turkey. Many families refuse to donate the organs of their relatives with brain death. Organs are donated in only about 26% of the cases of brain death. Public awareness should be raised on the cadaveric transplants. Accurate information about organ donation should be given to the public. A positive attitude towards organ donation can be obtained as long as the public awareness is raised.

We are embracing the world with our instruments Strong Foundation Established 45 years ago in 1968, NÜVE is one of the fastest expanding manufacturers of laboratory and sterilization instrumentation in the world today with a steadily increasing product range. Quickly becoming market leader in our home country, the major proportion of our production is today exported to over 100 countries worldwide and the brand is established as a driving force in the development of new products.

Quality & Reliability Quality is a keyword for NÜVE. This is proven by its certification to ISO 9001:2008 and ISO 13485:2003. Combining this with a strong ethic of providing outstanding value, NÜVE incessantly strives to increase efficiency through evolution of its working practices and investment in the latest machine tools. Top class components and high grade raw materials ensure that the final product is something that the user can be proud of. An important factor in the high level of reliability is the commitment of the production team, half of which has been with the company for over 20 years.

DF 490 Ultralow Temperature Deep Freezer

Investment & Expansion Substantial investment in R&D enables NÜVE to offer an ever-widening range of quality products. A team of highly qualified and experienced engineers has been producing instruments with unique characteristics bringing additional benefits to our customers. The offer in the field of biology in particular has significantly expanded and the level of technological innovation is proven by the large number of trade-marked features recently introduced in the range. NÜVE has been growing continuously and strongly, even during the recent worldwide economic crisis. With its dedication to customer service, NÜVE is committed to ensuring the supply to its customers on time. During the last seven years, the size of the production plant was doubled as were the number of machine tools for production.

Wide Ranging Markets NÜVE products are designed and developed for a broad spectrum of markets including clinical laboratories, medical research, biotechnology, agriculture, veterinary labs, food, beverage and dairy, chemicals, automotive, aerospace, ceramics, water and pharmaceutical industries.

A complete range The NÜVE product range is comprehensive, covering the essential core products for most laboratories, whether this is for ovens, incubators,CO2 incubator, centrifuges, climatic and test chambers, dry or steam sterilization devices, -41°C and -86°C freezers, laminar flow and safety cabinets, water baths and distillers, blood bank instruments... you are certain to find a product to please you.