 This is so convenient. Thank you all so much for being here today. My name is Dolbana Sinha, and I will be your moderator for this session. I'm the founder of Brava Health, which is a technology pioneer here at the forum. As we all know, I think health care is top of mind for many of us in recent years as the greatest global health crisis of our lifetimes affected all of our lives very directly. And we observed how health systems all over the world faced challenges in serving our communities. So we have an extremely esteemed panel here with us today to discuss some of these challenges, some of these lessons, and what the health care systems of tomorrow will look like. I will like to announce, if you will be posting on social media, please remember to use the hashtag AMNC23. Would also just, before I introduce the panel, I'd like to announce that this week at the annual meeting of the new champions, the World Economic Forum is publishing the Global Health and Health Care Strategic Outlook China edition. The other, the Strategic Outlook is a world economic forum publication that comes out during the annual meeting in January. And then the China edition comes out during the annual meeting of the new champions. So if you go to the WEF's website and look it up, you'll see it has some really wonderful insights and lessons that I think we can take globally for myself sitting in Bangladesh looking at the way China has addressed the challenges of health equity and access are very inspiring. So with that, I will shift gears to introduce our various theme panel here. Sitting to my left, we have Ina Kratzenberg. Ina is based in the United States and is the Chief Business Officer of Ginkgo Bioworks. Sitting next to her, we have Dr. Ren Mingui, who is a professor at the School of Public Health at Peking University and has also held senior roles in the Ministry of Health in China and was the former assistant general of the World Health Organization, the WHO. We also have Christine Zhu here, who's also based here in China in Beijing. She's the Global Senior Vice President and President Greater China for Novo Nordisk. And last but certainly not least, we have Mr. Lu Yemin, the President of China General Technology Group Holding, which is one of the largest health care conglomerates in this country. So just a round of applause for our panelists today. Thank you so much for being here. I think that I'll start with Ina actually, if that's all right. I have a leader for the world's largest global biotech platform. What do you really see as the big moonshots for the future, the big things that we should all be looking forward to through innovators like yourselves? I think the biggest moonshot is really understanding biology and how biology can be used in a variety of different contexts. Specifically, in the context of health care, I think there are two major opportunities that biology can help usher in solutions. The first is developing medicines for unmet medical needs. There are lots of medicines today that are just treating symptoms that are probably suboptimal. But the more we understand how biology behaves, the more we have the ability to design drugs that can specifically work within the context that we want it to work in. We can help to find cures for diseases that don't exist today. The second thing that biology can do is to make medicines more affordable. So there are many important medicines being developed today, particularly around the newer modalities, such as gene and cell therapy. But the cost of manufacturing those medicines make it completely non-accessible to most of the population. So in order for some of these efficacious therapeutics to actually reach patients globally, we have to find ways to make them more efficiently. And particularly for newer modalities, such as gene cell therapy, RNA therapeutics, manufacturing those drugs, are biology problems that we can solve. So I think those are a couple of very important moonshots that we can go after with biology. What do you think the opportunity is specifically with respect to AI and large data sets? Yeah, that's actually a very important enabling technology. Now, AI is as good as the data that you have to train the models. Right now with biology, we're just scratching the surface of what biology can do. So for us at Ginkgo, one of the important things that we feel is going to help engineer biology in a way that can bring forth useful products is to really have a way to do a lot of empirical experiments in a very efficient way. So automation, robotics, high throughput instrumentation, those are the things that we need to help us do thousands, 100,000s, millions of experiments that now researchers can only do in the tens of hundreds. So by leveraging the latest advances in these technologies, we can then do a lot of experiments and generate a lot of data. So for any good AI model, you need to have good quality data to train the model. Annotating the data in a way that allows you to really gain the insights for you to design something rationally and understand the cause and results of the changes that you make is incredibly important. So by having a standard way that we can do these experiments, curate the data and be able to analyze the data in a useful way, that's when AI connected with actual empirical experiments and what lab is going to give us the scientific insights that we need to really develop solutions that are useful. Thank you. I think that point of standardization is an excellent segue to the question I have for Dr. Ren. Dr. Ren, you've spent nearly four decades working in large governance bodies, including the Ministry of Health as well as the Assistant Director General of the WHO. What do you see as the role of government? Governmental bodies are not accustomed to taking risks, but we do need their leadership to set standards, as Ina mentioned. How do you see policymakers, both regionally and globally, can promote innovation meaningfully? Thank you very much for your questions. I want to echo what you said. Probably the government is not so well-known in taking the risk because they have to take the balanced approach to the innovation to look at how is that the quality and safety the innovation might bring to the human beings and then to make sure the risk can be met, mitigated and managed well before the government promote and recommend to the innovation for wide use. But that doesn't mean government don't have a role, as I said. Government can play a very important role to promote an incentive in innovation. Actually, three points I think government can do in the regional and global level. First, I think they can encourage sharing the information, the technology expertise cross-broad with countries, with different entities because this is very important. It can reduce unnecessary overlapping and can speed up and maybe can lead new ideas and new innovation, especially in health and medicine development. The second piece I think government also can do, which about the health financing issues. For instance, it can pool the resources across the countries to have a public and private partnership, even with multi-sectors stakeholders, especially on innovation in-house. And they also can direct support with financial resources to some very important issues, like we see in the past three years a lot of investment from government on innovation for COVID, which can be good legacy for the future for other public health interests. And the third issue is maybe if government can do more in terms of taxation policy, can different taxes for the innovation to get more incentive for the company who really invest a lot in research and development on health innovation. And also, I think the government can support a lot of other issues. For instance, can invest in a health delivery system. So when we have innovation, it's big or potential big changes for the health delivery system. You need well-trained workers. They should know how to use innovation. You need good facilities. And you need good infrastructures. That's really need government to invest, even policy, to make sure this innovation can be regulated to use and to reduce the time between innovation to the stage of scaling up and acceleration innovation. So to that point, I think government can do a lot, actually. And for time being, there are a lot of platform in regional and global levels about health innovation. For instance, we have SAPI, which is a well-known for the vaccine innovation. I think government and others think how they can invest in this platform. And also, we have UNITED, which is a set about more than 15 years ago, and now hand-coding Geneva, with clearly a mission to promote innovation for the products in HIV, TB, and malaria and viral hepatitis, sexual transmission, infected diseases, all these areas. I think we should encourage all stakeholders to support this platform, which exists. Of course, we'll be very encouraging if government and other stakeholders can create a new initiative and platform to give a very clear boosting in these very important areas to give the incentive of health innovation. If I could just have a quick follow-up on that. Can you share some examples of innovation that was forced during the pandemic, for example, that you think we can build on in the future? Yeah, of course, probably one of the examples we can learn from the COVID response is a platform, which is created by WHO, to boost the collaboration of vaccine across the countries. At that time, we don't have a vaccine, and then WHO set up very clear global platforms and information sharing for all the producers and researchers. I think it's very useful. And WHO used their unique policy, that's pre-qualification, to give very clear certification, global-recognized certification if any product of vaccine can be safely used and with clear, with a lot of evidence about safety and the effect of safety, WHO can recommend for wide use and the preachers by Gavi and other partners. With probably one example, we can think about further in the future about other issues, other diseases. Thank you. I think we could have a whole other panel discussion on that, but we'll move on. Christine, NOVO has a global reputation as a leader in advancing science and technology. But of course, these types of investments take time, innovation requires investment. How do you balance between funding long-term innovation and increasing affordability and access in the near and medium term? Thank you for your question. I would say it is indeed not an easy task. However, I believe it could be possible when we work together and to make it happen. And specifically, I would say these three areas are really important. First, to address health challenges, innovation is essential. So innovation is really the key to that. Secondly, collaboration. Collaboration is really instrumental for access to healthcare. And thirdly, conducive policy environment is needed and to develop a sustainable healthcare. So I want to elaborate a little bit to each and of the three points. Please, thank you. For innovation, and as we know that innovation is really the core value contribution of pharma industry and same to NOVO Nordisk. And this is where we do best to live our purpose, which is for now we are driving change to defeat serious chronic diseases, such as diabetes we spoke earlier and obesity and other serious chronic diseases. We have been contributing tremendously over the past 100 years. This year as we embark on the next 100 years at the NOVO Nordisk, of course we are committed to continue drive change to defeat this ever increasing serious chronic diseases. We for sure will continue to invest in research and development. We in fact increased investment in research and development last year and by 35% versus 2021. We are also applying new technologies such as artificial intelligence to speed up the innovation processes that we are also fostering a partnership to make sure a tap into external innovation capability. However, I have to emphasize that innovation from pharma industry alone is not enough to adjust ever increasing healthcare challenges. We see that collaboration and partnership among key stakeholders such as government authorities, societies, academia, industry peers as instrumental for us to work together to create an ecosystem really to drive change and also to increase access to the patients in needs. And we have a great example talking about public-private partnership as Mr. Ren mentioned earlier. There is a program called Cities Changing Diabetes which is a global public-private partnership program aimed at addressing systemic issues underlining the rise of obesity and the type 2 diabetes in city populations to address the health inequity. So that's the perfect example on collaboration. But that being said, to develop sustainable healthcare, we need to have conducive policy environment to encourage innovation faster and a wider access. What is very encouraging is we look at China and we are very glad to see Chinese regulators actually continuously encouraging innovation acceleration, including encouraging global simultaneous new drug development. This initiative will truly enable patients in China can have faster access to global innovation. We are benefiting from that public policy. But of course to encourage innovation, IP protection is fundamental. Then it's equally important that we need to holistically to assess the value of innovation. And for a government, in fact, if we could encourage and foster multi-layer payment system that will be very, very helpful because it's going to provide different level of access to patients with different affordability, including public funding, including private insurance, commercial insurance and including other innovative funding models so that it can expand the access to patients. Thank you. Mr. Liu, you're the president of one of China's largest healthcare conglomerates with distribution channels all over the country. How do you think about innovation and some of the collaborations that have been mentioned on the panel today? Thank you. Allow me to speak Chinese. Sure. Maybe I can more exactly express my idea. So, I speak Chinese, okay. Well, thank you very much for the question. Now, China General Technology is a company in the healthcare sector which has just got involved in the sector but we're developing fast and we've become China's biggest healthcare group, in fact, so we have a somewhat different perspective on application of innovation in healthcare. We started off as a user, as a promoter of innovation. We worked in tandem with our customers. So, for example, Biopharmaceuticals, Digital Healthcare Solutions, Big Data, Cloud Computing and other networked technologies. We have been rapidly scaling these up in order to improve our service to customers' health and our own service capacity. Now, when trying to consolidate our healthcare resources, we found that when it comes to consolidation, if you talk about innovators in healthcare equipment like us or the government, there's a high cost of deployment here because there is a lot of regional variation in China, first of all. Secondly, if you want to roll things out, in particular in digital terms, the supportive capacity of the platforms is not enough, particularly in the case of local hospitals where they face high costs in rolling out technology and also reducing the distance to customers. Now, there's some support from the government, of course, but when it comes to that last mile, the challenge is rather great. Now, China General Technology, as I said, is a newcomer to the medical sector. We work on Biopharmaceuticals, the healthcare, health management, old-age care sector, as well as provision, as well as the underlying financial mechanisms. So we have tried to do our bit to integrate, also with some hospitals belonging to Chinese state-owned enterprises, so as to rapidly set up a professional and integrated digital platform. And that platform will be able to provide a certain level of service to customers in China through a harmonized set of interfaces, contact points, and standards. Secondly, when integrating management processes and resources, we've basically been doing that by trying to harmonize things under the umbrella of our group in order to improve the overall level of service. And on that platform, we will now have the ability to rapidly roll out innovative medicines and equipment and other innovative applications. Our objective at the moment is to provide comprehensive, all-format, whole-of-life care platforms to our customers. Platforms that are able to rapidly scale up new applications. Now, I am confident you talk about new experiments in the healthcare sector. You may be aware that in the Chinese healthcare sector, a big player is public hospitals, government hospitals, but you do have hospitals set up by companies which are much faster in that take-up of innovations and they can make a big contribution to the healthcare sector in future. Of course, we've just started on this road, but I'm sure that with innovation and the appropriate use of new technology, we'll be able to rapidly raise the level of health service provision in China. Thank you very much for your attention. Thank you for your thoughtful response. I just wanted to follow up a bit to get a little bit of a better understanding about how your health system works in terms of how does it interact with public hospitals. You mentioned, for example, a challenge with last mile delivery and I think you talked about local hospitals, perhaps government hospitals. Just curious, how does that actually work and what are the real challenges in distribution? Well, China's general technology has become the China's largest health operation. We also have 343 hospitals of our own with over 50,000, 50,000 hospital beds. Now, that is an integrated system for us which means that in management terms, we just apply the principles of corporate management. Now, as I mentioned, we are now setting up an integrated national digital platform and in these hospitals through a digital system, patient records, processes, test results, and so on are accessible across the board. Thirdly, apart from healthcare in our group, we're also involved in health management, for example health checks and other health services and we have a lot of involvement with old age care as well. So we're centered on our healthcare resources but we provide a broader service for the whole of life to the Chinese government. Now, I talked about it being across the board service as well. We provide health services to healthy patients. We provide treatment to sick patients and we provide old age care to elderly patients and also hopefully hospice care when needed. And so across that open platform, we're going to provide companies in health, product provision including health equipment and service provision for them to get involved in providing services to our customers and that is becoming a full service platform. Now, our hospitals cover 27 provinces and municipalities in China. Now, apart from grade two and grade three hospitals, we're also involved at the community level, at the grassroots level in China, the grassroots clinics and other healthcare bodies which we are rolling out at the community level so that people can access a full range of services and that for me is how you solve that question of the interface. Thank you. Maybe I'll just shift gears a bit back to the opportunity that we have with AI and I'll direct this question to Ina and Christine, either or both of you can respond. What happens if AI invents a new drug? What's the role of responsible AI for the industry? I'll start. I think there's some really exciting, interesting AI models out there and while I think it is very possible for these models to design a protein that may serve a certain function and have the characteristics that you want to be a good drug, the fact of understanding why that protein works still doesn't exist. So these AI models I think are one of many different tools we need in our toolbox in order for us to really understand how and why a drug works and we can use that scientific insight and understanding to develop other drugs. So I don't think AI will replace fundamental research. It is a part of the solution set that we have. It is a tool and the more we understand the scientific insights, the better we can train these models and it's just an ongoing loop from there. Christine. I think AI, this is a very exciting topic and also it's a very important question and I follow different topics about AI and there's a lot of debate as well. So from my perspective I see this and to your questions from three different aspects. First, it's very exciting because AI technology is indeed bringing a lot of positive impact to healthcare development and to many other industry development. So the utilization of AI technology has been increasing across different sectors in pharma value chain including drug discovery, repurposing clinical trials, manufacturing, quality control and even safety control in manufacturing sites. But what's very exciting is to either when you answered your first question or I noticed there was really, you know, talk about AI and drug discovery. It is really the convergence between technology, drug development and biology which I hope that it will lead to better drugs being developed faster and even more accurate. And so we at Noble Notice actually we are actively exploring various AI tools and to accelerate drug discovery processes by both internal development and external partnership. We actually are partnering with in silico medicine for novel target identification. And AI technology actually in healthcare can also support the patients to better manage their chronic diseases. We launched an AI chatbot called Xiaonou Laoshi a few years back really providing disease education and support to patients. Up to now, I think Xiaonou Laoshi answered more than 300,000 questions, professional questions about diabetes and the diet and so on and so forth. But the second aspect I want to emphasize is that if unregulated, AI can have negative impact. So this is my personal perspective, not some official. In my view, the biggest difference between AIs and the human minds is that they all know how to do things but the only human minds know why to do things. Therefore, it is difficult for AI to replace human minds in certain fields. And if AI is not regulated, it could potentially, I'm not saying now, it could potentially cross the red lines and it could have negative impact. If you look at their hypothetical examples in healthcare fields, if verified medical information generated by AI could mislead the public. Absolutely. So all those things, right? And so it brings to my third point is that we do need to make sure create a guardrail for AI development and also AI application. And this is really important because we look at this, we look at it for AI companies. Please make sure correct data and positive contents are applied to AI development training for regulators and associations. Please make sure provide guidance to regulate that. I know that Chinese actually regulators have required filing of AI algorithm. Some countries also have clear requirements to declare disclaimer of the contents generated by AI. For pharma companies, we need to make sure that self-regulation behavior to embed ethical guardrails in AI utilization needs to be promoted. So when we do this well, and I think AI is going to help us and advance the healthcare system. So I do want to open it up for questions, but I'd like to ask one last question and if each of you could answer, it would be great. How far are we from this AI moonshot being able to have an actual impact on last mile health? Or do you think it's already happened? Ina, do you want to go first? I think it's starting. I think it's starting. I think what AI allows us to do is to have more ability to see what's happening in a more democratized way. So I think having the ability to access the data and see how it impacts different aspects of the delivery of the medicines, I think it's going to help address and flag problems that needs to be solved, but I think there's still a lot more that we need to do. Dr. Ren. I think to me it's already happening. It's not just potential. It's already happening. To understand, in China we used AI to accelerate diagnosis in a COVID response, which is very cost-effective, and clearly the technologies can be used very widely for other lung cancer and lung diseases. So to me it's already there. And of course the question is how is that competitive use and the regulates to balance risk and benefit for this technology. And also I'd like to echo what is being said AI is not just technology can be used to have new innovation products. It can be used for the service delivery. For instance, we have so many aging populations. Now we have to move our health systems, which in our hospital nurses is just working in the hospital, rather than just go to the home-based services model. And AI can help a lot for these new changes and new trends. So I think the happening is to me is good. Of course we need regulation to make sure how we can benefit, maximum benefit, and to mitigate the potential risks to the human beings. Thank you. Yes, AI is happening and we are actively using and we need to work together to make sure the benefits are maximized and also make sure working together have constant dialogue to ensure we find solutions that mitigate the potential risks. The risks never happen, so that will be great. Thank you. Indeed, AI is already integrated in our system. We are already using it. I believe that with AI we are also making the health system more equal, fairer. So we are also using an AI to do diagnosis. So then we can also help local hospitals to improve their diagnostic capacity. And for this we are already heavily using AI. Also I talked about integration and digital platform. And with this everybody can have their digital twin. And with the digital twin we are able to offer all types of companies, innovation company, pharma companies, help them have more insight so that they can better serve our people. So overall we are very optimistic to the usage of AI in the health care system. This is what we believe in. Thank you. We do have a very optimistic outlook in this group which is wonderful. Would love to open it up for questions. Hello, I'm Sangu Delia, YGL from Ghana. Thank you, this has been an amazing panel. I've loved the conversations on AI and the possibilities from AI but as we know with all the technology in the world health systems are useless without health workers. We currently have a global shortage of about 4.2 million health workers which the WHO estimates will reach 15 million by 2030. That's just around the corner. In addition to that we have a situation where globally with the exception of certain parts of Asia and mostly sub-Saharan Africa birth rates are below replacement level. 1.7 in the US, 1.4 in Europe, 1.1 in China and Japan has a serious crisis. If I think about those projections and if you look at Africa's population it's going from 1.4 billion to 2.5 billion over the next two and a half decades and currently only has 3% of global health care workers. The old way of doing things the way we've traditionally trained medical personnel cannot work. Even if you gave us 100 trillion dollars today, we're several decades late. So given all of this where do we go in terms of how do we we have the technology and the prospects of AI to build the health care systems of tomorrow but we clearly do not have the people. What do we need to do to make sure that we can fix this chronic shortage of medical personnel which is affected in all of us but which disproportionately affects the content of Africa which currently only has 3% of global health care workers. Please Dr. Ren, go ahead. Yes, I think there's absolutely good questions but I think AI can be very helpful in terms of providing new training models for the potential health workers including nurses and doctors which is probably one of the issues to address your concern. Another probably answer from me is I think AI can be sort of doctor as well and nurses to help doctors to speed up the diagnosis and also use the AI to shift the sort of medicines and any health commitment that you might need in five region areas through this AI system. So I think AI can do a lot for questions of course. The question is how exactly we can make sure the AI, the new technology can be actually accessed by all the country even in a low resources setting. That's exactly the point I would like to echo. Thank you. Thank you. I think just quickly because we do have a couple of other questions. Please. I agree with Mr. Ren. Maybe one point to add is that it is also important for the government to authorities to look into the incentive and also mechanisms of developing the healthcare workers because the talent development is also still key, right? AI is a methodology. I also think we need infrastructure investment. We need more training institutes across the board for all of our health workers. Please, we have a question here. Hi, thank you. It's an amazing, amazing conversation. I have one question. I'm Webin Joseph and YGL from India. Where do you see Chinese medicine within the entire larger healthcare system? Because I think you do have a lot of traditional systems across the world. You talk about Africa as well. But where do you have this and how do you integrate artificial intelligence because I think the large population of the world actually use natural modes of medicine and how does this get in the entire picture and where is it positioned within the entire healthcare system for the world largely? Thank you. Christine and then Mr. Liu. I studied medicine and I know that Chinese medicine works. The challenge is I'm going to say the challenge. The challenge is it's really hard to standardize that. That is why it is the bottleneck to scale it up. So I hope that the AI can give us a chance to understand how Chinese medicine works. Yes, and to standardize it and to scale it. Mr. Liu. Yes, I totally agree with what's being said. Chinese medicine, yes. The first problem is standardization. The second problem is training or capacity. If we use the equipment to diagnose, we can solve the problem of trainings and standardization. I believe with new technologies, we will be able to scale the usage of Chinese medicine. We all have something to say about traditional Chinese medicine. I also believe traditional Chinese medicine works as well. We have a spun out a company that is focusing specifically on bioactives that are found in traditional Chinese medicines. I agree with what Christine and Mr. Liu have said about standardization being an important thing. Two other factors. One is making sure that we can validate the clinical efficacy of those traditional Chinese medicine bioactives. I think a lot of us have certain old wives' tales or parents telling us this works, this works. I also have done a lot of boiling of stuff at home. I think understanding what is the clinical efficacy and what is the right dosage? Often times, you have things that vary significantly. Standardizing dosage, understanding efficacy in the third is making it available, making it accessible. Some of these traditional Chinese medicines are found in roots or plants that are subject to various growing conditions that humans cannot control. If there are some interesting and important bioactives that we can actually understand how to make biosynthetically and make it via fermentation, it gives us another opportunity to make sure that the right ingredients, that the right dosage that is proven to be efficacious can be provided. So, yeah, great, great question. Yeah, let's do that. Yes, Dr. Ren? I have to say, but I probably will not say too much about that standardization. Because to me, medicine should be different. Even people with the same diagnosis, people so different. Why we have against people, different people with the same diagnosis, with the same medicine? It's terrible. I think the best medicine is personalized. It's personalized. So I think probably for Chinese medicine, it's a personalized treatment for every individual who have different situations. Maybe EI can also be a very helpful. Thank you. I think we have time for one last question. I know you've been waiting. Please go ahead. I think Dr. Ren, because he's being off, focused on aging in place using sensors, very similar to the initial question regarding the lack of infrastructure and also labor shortage for Africa's health care infrastructure. I think aging is probably even more severe because people treat these more proactively. And then I really love Mr. Liu and also Professor Ren's comment regarding using community of centers as well as using AI and maybe for everyone like using you know Chinese medicine to in terms of combating this lack of like infrastructure because like we don't really think about like getting old a lot of time because that's why we have pension funds that's why we have insurance for 401k and what do you guys think about how do we come back just kind of thinking or how do you think about the last mile aging in place because it's not economic to build like brand new senior housing for everyone one minute who wants to take it actually we already having a division of old-age care we're doing it in two parts combined with the condition in China our traditional culture is for seniors to stay at home we have a series of new technology for seniors to stay at home and so we train the medical personnel to serve old people at their home also we have institutional nursing care this is also supported by the government so we also have we have a lot of institutional nursing home facilities now and in the future seniors are able to move into these nursing homes so as you mentioned I believe people is important new technologies are as important including sensors we are going to use all of them in our old-age care in order to better serve our people thank you thank you I think we need to wrap up Dr. Ren did you want to make one last comment very quick probably I think in China we have lots of a good demonstration project about aging and as some people said we in some cities the house doctor nurses normally call the populations through the AI approach every day and they use a mobile phone and where whatever AI system might be available in the community and to make sure that the population who aged over 60 or 70s first of they are okay and they call them whether you need something for doctors to to go to your room to provide medicine whatever and then of course they have a very clear alarming system at one one in every some apartments you can press the alarming if any if any alert urgency is happening and to to link the health center I think this is actually one for example how exactly house is to have to move to the more people centered and AI the powered primary health care system I think of course we need to do more but clearly there's something and can be leverage for for the broader scaling up and acceleration thank you I think we've all been so privileged to be with such an esteemed and brilliant and diverse group of perspectives today thank you all for your active participation