New Cross-Domain Biomedicine Brings Precision Health for All in Taiwan

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Interview with Chen Hong-chen, Director General of the Department of Life Sciences, Ministry of Science and Technology (MOST), and Liu Tsu-​hwie, Director of the Biotechnology, Health, Medicine and Agriculture Division, Board of Science and Technology (BOST), Executive Yuan

 

The biomedical industry is highly anticipated to drive Taiwan's next generation of economic growth. To lay the groundwork, the Executive Yuan enacted the Act for the Development of Biotech and New Pharmaceuticals Industry in 2007. In 2017, it announced that biomedicine would be incorporated into the 5+2 Industry Innovation Plan. This year, precision health was listed as one of the Six Core Strategic Industries, receiving government-backed R&D investments numbering in the tens of billions of NT Dollars. The government’s strategy to actively support and strengthen Taiwan’s biomedical industry has resulted in a revenue of over NT$559.7 billion for the industry in 2019 alone. In light of economic breakthroughs and health challenges in the post-pandemic era, the Executive Yuan has tasked the Office of Science and Technology Commission, the Ministry of Health and Welfare (MOHW), the Ministry of Science and Technology (MOST), and the Ministry of Economic Affairs (MOEA) to collaborate in steering medical, academic, and industrial sectors towards ground-breaking innovative biomedical R&D and manufacturing. The utilization of Taiwan’s excellent biomedical R&D, clinical trials system, and niche products will allow the country to become a major hub for the biomedical R&D industry in the Asia-Pacific region.


Precision Health Drives Biomedical Industry Upgrades in Taiwan

To transform Taiwan into a leading member in the global biomedical industry, government ministries will take stock of existing scientific research and industries and engage in cross-industry integration. This will allow industries to grow rapidly and continuously based on their respective strengths. The Biomedical Industry Innovation Program (also known as BioMed Taiwan) launched in 2017 has upgraded medical industry ecosystems by introducing digital technology and IoT and integrating big data into databases. As a result, biomedical technology has begun to cross over into supply chains. Fortified by domestic ICT and supply chain manufacturing sectors, Taiwan’s highly advanced tech industries are propelling developments as well as software and hardware equipment upgrades in biomedical research. This has strengthened the country’s position in the global precision medicine industry as it strives not only to reach the pinnacle of medical technology, but also to become a global leader in precision health.

Chen Hong-chen, Director General of the MOST Department of Life Sciences, pointed out that Taiwan is making every effort to promote the development of the biomedical industry. One example is the government’s execution of the 5+2 Industry Innovation Plan over the past four years. The Program for Promoting Six Core Strategic Industries was also announced by President Tsai Ing-wen last year in her 2020 inaugural speech. Policy enactment is currently managed by MOST Minister Wu Tsung-tsong. The program, backed by an investment of nearly NT$10 billion, will run from 2021-2025.

Chen explained, "Why have we decided to promote precision health? This is mainly because Taiwan boasts high-quality healthcare and a robust information and communications industry. The government was already promoting AI three, four years back. They've adapted to Taiwan’s strengths to aid medical centers with utilizing AI technology." He emphasized that the three strategies for promoting precision health are "improving the precision health ecosystem," "supporting the precision health industry chain," and "reaching out around the world." These strategies are aimed not only towards patients, but also those with sub-optimal health. The three strategies currently comprise four tasks, namely (1) Build a large genetic and National Health Insurance (NHI) database; (2) Develop precise systems for infectious disease prevention, diagnostics, treatment, and care; (3) Develop precise products for disease prevention; and (4) Explore opportunities for international biomedical business. Chen believes that the development of Taiwan’s biomedical industry is a matter of course, stating, "In short, the government's push for innovation and development in the biomedical industry comes from a thorough consideration of domestic biomedical technology, general global trends, and other related industries. Biomedical developments, talent cultivation, and basic sciences have additionally been identified as three core areas of innovative value. The government is working hard to bridge the gap between industry and academia by optimizing in-demand talent and supporting industrial upgrades and transformations. Biomedical ecosystems are also being strategically refined. Resources and manpower from various ministries are being gathered to promote the Biomedical Industry Innovation Program. All these efforts will help put Taiwan's precision health industry onto the international stage."

Taiwan’s biotechnology and biomedicine have the potential to compete at the international level. In addition to a well-established home base, the sectors also enjoy effective support from high-quality, comprehensive peripheral industries. Furthermore, with an extensive international network, such technology can be widely applied towards the fields of health, medicine, agriculture, food, the environment, and beyond.  This flexibility can further promote the steady development of many industries relating to pharmaceuticals and medical devices, applied biomedicine, preventive medicine, and health and welfare. Liu Tsu-​hwie, Director of the Biotechnology, Health, Medicine and Agriculture Division of the Board of Science and Technology, Executive Yuan stated, "The biotechnology industry has been listed as a key national industry in Taiwan since the 1980s. Since then, many excellent research centers, research institutions, and departments have been established. Biomedicine continues to be an area of great national interest and has been included in major policies. This sector not only affects industrial development, but also directly impacts national health and the overall progress of health and medicine."

Liu additionally pointed out that threats arising from the pandemic have highlighted the importance of developing the biomedical industry. In the past, Taiwan's medical industry developments were aimed towards pharmaceuticals, medical devices, and biotech products before gradually branching out to areas such as medical healthcare, health, and welfare. The popularization of next-generation gene sequencing technology has further stressed the significance of personalized precision medicine and the establishment of a big data health database. Liu stated, "As biological testing, information technology (IT) and regenerative medical technology mature, precision health will officially become one of six core strategic industries in 2021. Research on biological and biochemical detection technology has expanded to cover physical, electronic, and optical mediums. The introduction of technology can foster digital innovation, such as creating the means to handle diagnostics, prescription writing and delivery, fee payment, and formulating regulations both digitally and remotely. Cell therapy has also become a highly valued emerging treatment method worldwide. The development of top-tier cell therapy technology requires multidisciplinary talent from fields such as information communications and biosciences to assist in bioprocessing, industry chain supply configuration, instrument operation, and information analysis."


Biomedicine Connects with ICT and Looks Overseas

In 2015, the United States put forward the Precision Medicine Initiative, bringing the concept of precision medicine into clinical medical diagnostics and creating potential for personalized medicine. The global precision medicine market is expected to grow from US$78.9 billion in 2018 to US$216.8 billion in 2028. The development of precision health is closely linked to the technical R&D of genetic testing, clinical trial services, and bio-information communications. Precision medicine is further expected to revolutionize clinical medicine in areas such as vaccines, cancer, and aging. Industries around the world are crossing over into developing precision medical products, and this will create a market beyond anyone's wildest imagination.

MOST has promoted ICT-integrated biomedicine, with considerable results. Chen stated that the precision health industry is divided into three major areas: precision medicine, digital medicine (or smart medicine), and regenerative and cellular therapy. Precision medicine incorporates data such as each person's genome and lifestyle into references that increase the accuracy of diagnostics or treatment precision. For example, applying DNA sequencing technology in medical research will provide a more nuanced understanding of how the interaction between genetic variation and environmental factors affects the severity or progression of diseases. This information can help doctors better monitor the course of treatment for each individual patient. An example would be using predictive analytics to foresee changes in patient condition or cancer recurrence. In the future, should a baby undergo complete genetic testing at birth, then their information would be readily accessible from an early age.

Digital medicine is similar to digital technology-assisted medical care. It includes digital telemedicine and efficient hospital management using AI technology. Equipment such as large wearable devices can monitor a patient's physiological signals (e.g. heart rate, blood pressure, and blood oxygen levels) and connect with hospitals to provide early warning. In regard to regenerative and cell therapy, the advancement of autologous cell therapy technology has great potential to make breakthroughs in cancer treatment. To this end, the government has revised laws and regulations and guided medical institutions and industries to develop emerging medical technology in this field. It has also encouraged industry-academic institutions to invest in regenerative and cell therapy in hopes of creating new treatment options for cancer, regenerative medicine, and tissue repair.

Chen noted that a thorough precision health roadmap is needed to build a comprehensive national medical system. In this regard, the construction of a large-scale database for both forward-looking and retrospective data has top priority. To Chen, a well-developed database will serve as the foundation for medical treatment and the development of precision medicine in Taiwan. In response to the COVID-19 epidemic, MOST has invested considerable funds in epidemic prevention-related research. The medical centers of five universities—National Defense University, National Taiwan University, National Yang Ming Chiao Tung University, Chang Gung University, and National Cheng Kung University—have all proposed plans to aid in upgrading epidemic-prevention measures. Chen stated, "The two major medical centers in Chang Gung University and National Cheng Kung University have developed technology that can isolate virus strains to confirm the speed and accuracy of PCR and rapid antigen testing. In the development of domestic vaccines, the medical centers of National Taiwan University and National Defense University have aided in setting up animal model research. The National Health Research Institutes and National Defense Medical College have assisted with clinical trials in biosafety level 3 labs (P3 labs). Chang Gung University has assisted in evaluating vaccine effectiveness. The development of potential drugs has been assisted by National Taiwan University." Database building and analyses with AI, vaccine development, and pharmaceutical R&D are all key industries where Taiwan can gain future international attention. With the assistance of MOST, pilot projects have been promoted since 2020 to link medical centers with the domestic ICT businesses (such as Quanta). In turn, these joint initiatives have expanded the development of clinical databases and value-added AI application projects. At present, MOST has given approval to nine medical centers.

Liu pointed out that in these tumultuous times for the global economy and reorganizing supply chains, the concept of health has gradually expanded from treating diseases to preventive, predictive, personalized, and participatory precision medicine, also known as P4 precision medicine. Advanced countries worldwide are actively pushing to establish a human genome database, which has in effect, driven the development of DNA sequencing. Genetic information is being used in trials for clinically diagnosing and treating cancer and genetic diseases through early screening, treatment, and post-operative surveillance. Academia Sinica is currently working with major domestic medical centers to create a biobank. In 2019, resources compiled through project planning were allocated to create a national biobank platform featuring data from 31 domestic biobanks, approximately 4.5 million sample groups, and 460,000 participants. In the future, the platform can be combined with other databases to advance the development and application of domestic biomedical research and new drugs in precision medicine.

Taiwan's strategy for precision health is to build up an industry in line with international standards. Genetic sequencing, detection, and analysis have become core global trends. Advancements in IT and diagnostic technology, the creation of a massive database, and AI-integrated electronic medical record systems will help doctors formulate rapid, precise treatment plans and provide better patient care. Taiwan's edge in information and communications places its medical field in an ideal position to break new ground in the international market.


Taiwan Becomes Asia-Pacific's Hub for Precision Medicine Development

The Economist organized an international seminar held on January 28, 2021 in Singapore on the theme “Building long-term sustainable and personalized healthcare systems.” It also published Asia-Pacific’s first “Personalised Health Index (PHC Index),” ranking Taiwan as second in the Asia-Pacific region. This international-level recognition attests to the solid foundation, clear legal framework, and developmental achievements of precision medicine in Taiwan.

According to MOHW statistics, Taiwan spent only 6.1% of its GDP on healthcare in 2017, far lower than advanced countries including Japan and South Korea. Liu pointed out that in the face of product competition from foreign industries, expanding the market will require looking overseas. The government has connected domestic biomedical innovation clusters in order to provide two-way guidance for the biomedical industry and academic research. This includes the iBiomed Flagship Hall in Southern Taiwan Science Park. The building features software and hardware centered on smart biomedicine, and displays products created by clusters and businesses. There is also space set aside for business negotiations, training, and educational activities. Taiwan's competitiveness continues to be honed by the growth and funding of domestic medical startups guided by the TransMedx Accelerator program.

The country's medical strengths are supported by big data analytics created with health insurance and healthcare data accumulated in the 25 years since the inception of the National Health Insurance program in 1995. This is reinforced with nearly 20 world-class medical centers plus hundreds of biomedical innovation teams specializing in integrating soft infrastructure and services. For the biomedical industry's next stage of development, Liu stated that key technologies such as AI, IoT/5G, information security, and blockchains will be introduced by the government. Taiwan’s unique global hardware manufacturing ecosystem will also be combined with its complete domestic ICT industry chain to drive industrial growth and cross-domain innovation.

Chen believes that Taiwan's excellent IT and tech industries will benefit drug development, medical diagnostics and comprehensive genetic testing. Worldwide, the limits of biomedical technology are being put to the test by the COVID-19 pandemic. In response, the Taiwanese government has worked with domestic academic communities and major medical centers and promoted industry-university research and collaboration by mobilizing inter-ministerial aid.  Areas of research include developing detection kits and vaccines for severe and novel coronavirus pneumonia, conducting clinical trials, authorizing technology transfers, epidemiology, and constructing databases to analyze virus screenings.


Digital Health Industry Quickens Pace in Post-Pandemic Era

The pandemic has sped up the pace of digital progress in Taiwan as the general public’s need for smart hospitals and telehealth becomes increasingly urgent. In the post-pandemic era, a strong focus on introducing digital technology will spur both the development and normalization of digital health and smart hospitals. This will subsequently decrease the country’s healthcare expenses and lighten the load on medical personnel. The government will also promote collaborations between domestic biomedical and ICT industries to foster digital transformations such as smart hospitals, tele-healthcare, and the digital health industry. These infrastructures will be able to provide even more personalized and precise health services.

Taiwan’s exemplary healthcare and top-tier ICT industries are a solid foundation for the development of precision medicine. The government aims to ensure healthy living and well-being for people of all ages nationwide by 2030. To achieve this, they are formulating strategies for a precision health field and working with both public and private sectors. Plans are also being arranged to build a national health database with big data and to implement projects promoting industrial innovation. Additionally, laws and regulations, talent, investments, and industrial parks will be continuously optimized. The establishment of big data systems will foster integrated, cross-domain industry chains for digital and biomedical technology. This will strengthen and connect Taiwan's precision health at an international level. Other measures will involve developing comprehensive and personalized precision health services for prevention, prediction, treatment, and care. All of these efforts will rapidly transform the biomedical and health industries and bring Taiwan a step closer to realizing the vision of healthy living and providing complete healthcare for all.

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