Asia's Next Frontier: Building Capabilities for Translational Research

Context & Motivation

• Tanisha Carino (Executive Director, Faster Cures/Milken Institute) notes the organization's 15-year mission to bridge the gap between 10,000 diseases and only 500 effective cures.
• Asian life expectancy has increased by 43 years over the last century, driven largely by public health interventions and vaccines.
• The current session focuses on expanding Asian capacity for translational research to reach the next level of treatments and cures.

Key Statistics & Quiz Insights

• Singapore Funding: 33% of total medical research funding in Singapore is dedicated to translational research (compared to ~20-25% by the US NIH).
• China R&D Projection: China is projected to overtake the US in total absolute R&D funding by 2020, a timeline recently expedited by five years.
• Researchers per Capita: South Korea ranks the highest in Asia for the number of researchers per capita.

Defining Translational Research

• Translational research is defined as the phase bridging basic "bench" science and clinical application, specifically making scientific knowledge useful for patients.
• A critical "Valley of Death" exists between preclinical mouse models and human clinical trials, where high risk and distinct skill sets often stall progress.
• Annalisa Jenkins estimates this translational window spans roughly four years (two years pre-clinical, two years post-clinical) to validate patient relevance.
• The Gap: Basic scientists are trained for publication, not industrial processes (chemical libraries, assays), while investors demand early translational work before funding startups.

Regional Dynamics & Strategies

• Market Focus: While China is a massive market, innovative medicine penetration remains low; Auslan Pharmaceuticals targets high-burden Asian diseases (e.g., biliary tract cancer with 200,000 patients in Asia vs. 12,000 in the US) while aiming for US/EU commercial value.
• Singapore's Shift: Singapore is moving from basic research (ASTAR, Biopolis) to translational alignment, with a $19 billion five-year budget explicitly targeting commercial opportunities.
• Incentive Reform: ASTAR is reducing publication expectations and increasing support for scientists who collaborate with for-profit entities, addressing historical industry feedback that researchers lacked incentives to partner.
• Regulatory Reforms in China: A 2017 regulatory overhaul reduced drug approval timelines from 18 months to 2 months and allowed the use of imported data, resulting in a surge from 4-5 innovative drug approvals in 2016 to 40 in 2017.
• Access vs. Economics: A divergence exists where biomedical research is often viewed as an economic driver (jobs/GDP) rather than a direct solution to public health needs, potentially limiting patient access to high-cost precision medicines in markets like China.
• Reimbursement Changes: China recently accelerated its National Reimbursement List updates, approving drugs like Imbruvica (Updivo) for reimbursement almost immediately upon approval, potentially reducing pricing barriers.

The Harrington Project

• A unique initiative designed to bridge the "Valley of Death" by combining a front-end non-profit funded by philanthropists with a back-end for-profit funded by impact investors and pharma partners.
• It aims to provide not just capital, but the specific industry experience and capabilities (e.g., compound libraries, antibody tech) that academic scientists lack.

Data Infrastructure & Precision Medicine

• Singapore Advantage: Singapore's centralized, command-and-control healthcare system allows access to universal electronic medical records, facilitating the identification of specific patient cohorts for clinical trials (e.g., finding 12 patients with a specific leukemia type).
• Genomic Ambitions: Singapore, the US (Project GENOMIC), and China (Project Million) are launching massive population genome sequencing initiatives; Singapore aims to sequence its entire 5-6 million population.
• Data Quality Concerns: Panelists noted a "garbage in, garbage out" risk; medical records are often not curated for research, and real-world data quality is inconsistent across the region.
• Workforce Trends: A cultural gap exists between traditional biology/chemistry researchers and data science/AI experts, with skepticism toward AI-driven drug design persisting despite investment interest.

Patient Advocacy

• Patient advocacy in Asia remains nascent compared to the US, where organized groups drive urgency, fund infrastructure (registries), and influence regulatory science.
• Cultural deference to physicians in Asia limits patient questioning and organization, slowing the adoption of patient-centric drug development.
• Patient groups are critical for rare diseases (e.g., biliary tract cancer) to connect patients with specialists and clinical trials where standard care is unavailable.