 Okay, good afternoon, everyone. My name is Campbell Wilson. I'm the Associate Dean International, the Faculty of IT here at Monash University. And I'd like to welcome you to this session entitled Filling the Gaps, Digital Health in South East Asia. In particular, we have a focus on Malaysia, but also the region more broadly. I'd also like to acknowledge the people of the Kulin Nations on whose land we are gathered today. And I pay my respects to their eldest past and present. Today is a session of the Momentum series of knowledge sharing sessions sponsored by the Australian Department of Foreign Affairs and Trade. Momentum brings together academia, the business sector and government to discuss some of the big challenges the world faces and how we can all work together to address them. Importantly, it has a focus not just on future collaboration but on future generations, with a key component of Momentum being engagement and a new Colombo plan via the NCP scholars, mobility students and alumni, and also NCP business champions. We're broadcasting the seminar live via YouTube and encourage you to interact via the YouTube chat facility, which you can also use to ask questions of the panelists. Panelists, we have more than one panelist. We'll address as many of these questions as we can today and take offline those that we can't get to due to limitations of time. Speaking of time, we expect the seminar itself to run for around about one hour. After that, for those of you physically in the room with us today, please do feel free to stay on and network with those in the room. And I am assured there will be some snacks provided. I can see them over there. So we have a very well qualified panel with us today. Sitting beside me is Professor Chris Bain. Joining us in the room here at Monash. Chris is a professor in the Faculty of IT at Monash and is the university's inaugural professor in digital health. Our other panelists are joining us online. Professor Arbid Khan is the Deputy Vice-Chancellor Global Engagement and Vice-President of Monash University. Professor Andrew Walker is also joining us online and is Pro Vice-Chancellor at Monash University and President of Monash University, Malaysia. Dr Jessica Waderson is a senior lecturer and researcher at Monash University, Malaysia and has a strong research focus around improving health equity, including through the use of participatory and human-centered design. Mark Rosario is the former CEO of General Electric in Malaysia and has been heavily involved in the development of Malaysia's national innovation strategy. Last but by no means least, I would like to introduce also the facilitator for today's event, Annie Zhang. Annie is a 2021 New Colombo Plan Singapore scholar and a current honours student at the University of Tasmania. She is researching personalised medicine, in particular drug targets for prostate cancer and has a keen interest in digital health, particularly as personalisation of medicine will be increasingly data driven in the future. So before I do hand over to Annie, it is my honour to introduce his Excellency Andrew Golodzanovsky, Australia's High Commissioner to Malaysia, who will provide us with some opening remarks. Thank you and over to you High Commissioner. Thank you, Campbell. I appreciate that. Before I start, I'd like to pay my respect to the elders of this country where I am and all the countries from which our participants are living in, and in particular, I'd like to acknowledge any Australian Aboriginal and Torres Strait Islander people who may be participating. I'd like to make a very warm welcome also to all of the NCP scholars, the alumni and the mobility students who are joining us from various parts of the world. I'm delighted to be part of this momentum series, shaping a stronger future together, and I'm particularly pleased with the topic that's been chosen for this session, digital help. I suspect that before the great pandemic, if that's what we're going to call it, is over, there'll be millions of words, scholarly research and papers written about the key learnings that we've taken away from this. But for me, there are two things that stand out. First of all, I think we appreciate now as we never have before the importance of public health. And moreover, the importance of cooperation between governments, universities, the private sector, civil society and media. The other important learning, I think, is how vital our digital integration has been in managing this crisis. Without the internet, we would have been left essentially with medieval solutions. We would have been hiding in our houses, locking our villages and shooting arrows at anybody that was approaching. So the fact that this session is going to be looking at the lessons that have been learned in the area of digital health, I think is very appropriate and very interesting. I won't go through all the panelists because you've done that, Campbell, but I do want to say hello again to Professor Abid Khan, who I haven't seen for three and a half years. He was my first interaction with Monash when I was preparing for this posting. And through him, I'd like to thank the entire Monash team for their contribution to Malaysia, to bilateral relations and to this particular session. And also a shout out to Andrew Walker, my old friend who I've had a lot to do over the years. One last thing I want to say by way of editorial. This is particularly interesting for us as Australia in Malaysia, because our bilateral relationship with Malaysia has probably never been stronger in our long history. And that was really underlined by the fact that our two prime ministers concluded a comprehensive strategic partnership earlier this year. It's a very rare thing and it's something we have very few countries. And part of the work plan for that comprehensive strategic partnership has an element to do with health cooperation. So this will contribute, I think, I hope in a very meaningful way to the larger story of Malaysian-Australian cooperation between ourselves on all sorts of issues, and this one in particular. So once again, I welcome you all to this session, which promises to be very interesting, and I'm looking forward to hearing from the panelists. Thank you very much. Thank you very much, High Commissioner. So it's my pleasure now to hand over, I think, to Annie to kick off what I hope and expect to be a very interesting, exciting discussion around digital health. So over to you, Annie. Thank you, Campbell. And thank you, High Commissioner, for your insights. So before we dive into the fascinating world of digital health and talk with our panelists, I'd like to start by setting the scene a bit more broadly and talk about how we can build an environment within which global collaboration between universities industry and government have the greatest chance of success. And so I'd like to first direct my first question towards Professor Khan, the Deputy Vice-Chancellor of Global Engagement at Australia's largest university, Monash. Professor Khan, can you talk us through your views on this environment in particular, the importance of global networks in this space? What do successful networks look like? And how do we best build them? Over to you, Professor. Thank you, Annie. And welcome to everybody. And my respects, Andrew, to you. It is great to see you again online. And thank you for opening the session. Annie's question is quite a broad one. And so I should start by saying international relationships are actually very strong, particularly across the region, and have continued to remain so that through the crisis, there's a lot of sharing going on. And it's a very constructive dialogue with all of our partners. And in fact, the partnership network grows from my national and my colleagues in many other universities, Annie. I thought I'd focus on just four key domains that have probably evolved, therefore. The first is that the innovation landscape around us is changing. The second is more that there's a move towards solutions-based approaches in relationships now. Cross-institutional collaborations are therefore becoming more strategic and require a little bit more focus and shaping. And then finally, I'll touch a little bit on the education that therefore reflects this new world as well. So if I can spend just a minute on each of those, Annie, I'll dive straight in. The landscape around us has actually shifted quite a bit, even though I say relationships are strong, the actual ecosystem is changing. Our stakeholders have started to focus more on the big complex multilateral challenges that we all face. So it's very much become a world of complimentary relationships. Sorry, Lord Sainsbury in the UK said many years ago that in an age of globalization, location actually matters more, not less. And what he meant by that was that local needs and local capabilities and skills become hugely important, but in a wider context. And that's what we're seeing. We're actually seeing that play out in a really strong way. So while there remains this need to act as our colleagues and capabilities around the world, it's become shaped by a bigger agenda, by the agenda of stakeholders that are saying, well, what's the solution to these problems, not just the early stage contribution, but how do we work along that value chain and integrate the pieces so that we have answers and implementable solutions, particularly at community levels. The one example I'll use, which is the DFAT funded project, is the Australian Indonesia Centre, which brings 11 universities together across Indonesia and Australia. This is an example where big challenges are clustered together and it's pushing on those, but there are a number of other examples of that scale. COVID in my mind has actually heightened the need for value add and complementarity. We don't have as much time to have, while we welcome wide friendships, we don't have as much time to focus on all of that diverse collection of relationships. We have to bring some more focus into specific domains. That takes me to the issue of solutions-based approaches. As I say, this is really about complementarity, but also about networks spanning the value chain of delivery. So where universities remain and always will contribute to the knowledge base in the various countries they operate within, the capacity to translate that research and ultimately have community level impact and then beyond that policy level impact within governments, that whole chain has now become the sequence of events that we have to work within and contribute to. And our education paradigms have to change to match that too. The teams, therefore, we're finding need to become quite dynamic, but also have a resilience to the fact that the world is changing, that they have to be able to operate within models of governance that are quite refined now and resourcing models that are more multimodal. So money's coming from more and more different places rather than big block grants. You tend to have to manage multiple facets simultaneously. A good example there is our mosquito program. It's one of the largest in the world, works all around the world, but has very specific connections across this region where mirror laboratories work with the centre. Relying on the local skills in each country to then challenge the problem directly on the ground. And it's that on the ground capacity that's really very exciting. I've talked about cross institutional collaborations growing, but they can be a little bit ad hoc and lack focus in the traditional mindset, you know, universities all work together, it's wonderful. Now there's a little bit more of an objective orientation. And so the partner selection has become a little bit more rigorous, I would say. People are focusing on what does everybody bring to the party as it were and how do they work. So the science of working well together in a networked world where online is also a big component has become really quite apparent. The need for data sharing and data security and the integration of multiple data sources and the validity and probability of those has become hugely important. Universities are very good at this stuff, but we now also have to work with our colleagues in the industry sector in the government sectors. The collation capacities become really very important. I think a lot of people are looking to universities to take on the more systems integration type role. Where we do that we have success. So universities I think have proven themselves through this last few years as engine rooms of integration and as partners of choice with government and industry and others in that collation exercise. That brings me to my final point, which is that our education and training really does have to reflect this. I was really pleased to have the New Colombo Plan mentioned and mobility referred to in those opening remarks. We already knew that students that get a mobile experience doesn't have to be physical, but it's just an intercultural and highly interactive experience and particularly one that's problem based. They do really well. They can contribute problems very quickly. They can get into industry and government role very quickly. If we can inculcate in those processes methodologies that get them across the notion that the world is now a highly integrated place that uses open innovation models and flexible access to resources. Things like time management, cross-border knowledge, that kind of very material sort of learnings in some cases become really important. But what we're going to end up with is a globalised citizenry that actually knows how to navigate and play a role. So it's not globalization for globalization's sake. It's actually call it globalization with a purpose where everyone can work together, leverage the resources they need to solve the problem. It's a flexible resource base. Understand the facets of that. If we can get that into our students, which we do, but if we can continue to expand on the experiences and exposures they have will be in an incredible place. So that's my sort of hope for the future and now couple to changes I've seen in the environment around us, Annie. I hope that's useful. Thank you. Thank you, Professor Khan, for your views on the importance of creating this space for collaboration between industry academia and the government. And critically digital health is being proposed as a mechanism to fill gaps in healthcare in the region. So I'd like to pose my next set of questions to several of our panellists with research expertise in this field. So let's head over to Professor Chris Bain who is joining us from the Clayton campus at Monash, who is the inaugural professor of digital health at Ornash University. So to start us off, can you define digital health for us? What exactly is digital health? Thanks very much, Annie. Look, I've been at the university for about three years now and doing this role and it struck me very early on that it's really important to try and do that for people when I'm talking to them about digital health because it's quite a broad area. There's lots of different definitions floating around. And the reality is depending on where you are in the world, what you might call digital health looks really different. So somewhere like the US or Israel in many ways is a long way ahead of us. We'd be further ahead than some of our southeast Asian neighbors. So the definition I use with people is really simple and it's encompassing. It's easy to understand. Basically digital health is the use of digital tools and interventions in healthcare and wellness. So importantly in that it's including the maintenance of wellness. It's not just when people get sick and those digital tools and interventions can be quite broad. And so I might talk a little later about some of the examples of those things. The other thing I often say to people in conjunction with that really simple definition, if they're looking at, you know, a project or a system or an ecosystem that's saying is that digital health is a couple of hallmarks which I think encapsulate the true essence of digital health. So if we're talking about things that involve a smartphone, that involve apps, that involve sensors that collect digital biomarkers. So things about human physiology or behaviour you can turn into ones and zeros. If they involve what I call augmented intelligence. So not just artificial intelligence but certainly including that also things like virtual reality. And if we're talking about patient and citizen engagement and empowerment then those sort of features really point to something being quite typical digital health. Thank you Professor Bean for that definition. So can you give us some examples of how digital health could potentially help citizens and governments in Southeast Asia? Yeah, thanks Annie. I know a little bit about the health profile and some of the important background like smartphone use from our colleagues in Malaysia from working in collaboration with them. So I'll give you some sort of disease patterns that are pretty true both for Malaysia but also for Indonesia as well. So as exemplars and in fact a lot of the reasons people die in those countries are actually similar to what happens in more Western society. So, you know, stroke is a killer of many people what's called ischemic heart disease. So we often call them in common parlance heart attacks from narrowing and hardening of heart arteries, respiratory conditions, things like what's called COPD, chronic obstruction, pulmonary disease, diabetes. They're all common killers, a little bit of cancer as well in the top sort of five or 10. So they're not dissimilar to Australia in that sense in many Western countries. So, you know, that those things are driven by again similar factors to what we see here. So high smoking rates, so obesity, high blood pressure, high sugar, high lipid values are all underpinning many of those conditions as well. So I'll give you two really neat examples. One that sort of plays into the cardiac space and one that plays into the respiratory disease space. These are really well advanced, pure digital health products that people can find information about on the internet. I've spoken to many audiences including, you know, audiences full of doctors and nurses in Australia. Many of them haven't heard of these things. So the first one's a product called Cardia, K-A-R-D-I-A. And that's basically the combination of an app on a smartphone, some machine learning, so artificial intelligence and a little, you know, almost like a paddle pop stick type device with electric sensors on it, which you basically touch your finger on and in a more advanced version, your knee as well. So one finger, one finger in your knee and you generate a cardiograph, just as some of you may have seen if you go to a hospital where they stick the stickers on you or the suction cups. So that system can now give you basically half of a traditional ECG, six leads, which lets you see lots of things about the heart. There's about a hundred research papers about the impact of that system. You can buy that system. The odd person in Australia comes up to me after I speak and say, actually, I've got that, right? So, you know, this is the other important thing here. These things don't necessarily follow international boundaries anymore because they're products on the internet for better or worse. The other example I'll give you is definitely in the COPD space or infazema as people often know in lay terms, a disease most often by far caused by smoking and certainly prevalent in the two countries I use as an example. So that system's called propeller, as in airplane propeller. And basically that's a system involving a little Bluetooth cap that goes on top of the puffers people use. So people would be familiar with a ventilant puffer that asthmatics use. So I think a ventilant and other puffers. And basically the combination of that little cap with the usual drugs that people use linked again to a really intelligent app delivered on a smartphone is doing really remarkable things for patients with asthma and COPD. So dramatically improving their symptoms and in some cases doing that with less use of drugs. Okay. So again, that's something that can help patients enormously and in a sense, you know, I'm a little cautious Sanis but in a sense takes the doctor out of the loop and they're really good examples of true digital health that could be used in Southeast Asia today. Thank you Professor for those examples. So I'd like to head over now to Professor Andrew Walker who leads the Monash Malaysia campus and you also have an abundance of experiences and anthropologists who has undertaken research in the Southeast Asia region for over 25 years particularly the society and culture of rural Southeast Asia. And one of the core challenges in this region is societal inequality particularly in healthcare. Can you give us your personal reflections on this challenge based on your experience and also how you see digital health providing opportunities to address this? Thanks Annie. That's a big question. Yes, I'm an anthropologist. I'm much more comfortable walking around in rice fields in Northern Thailand that I am sitting here in a suit. Southeast Asia in many respects has been pretty good at economic growth. Countries like Thailand, Malaysia, even Indonesia, Vietnam they've done well in terms of economic growth. What they've done less well in is equitable growth and sustainable growth. And as you say, inequality is a pressing problem and a politically destabilizing problem in Southeast Asia and I think it's one of the reasons why we see democracy being so vulnerable in Southeast Asia. And I think what we're seeing here with new technology with digital technology is one really important tool for starting to address some aspects of that technology. Like in my work in Northern Thailand, working with farmers in Northern Thailand during the course of my career, I have seen villages going from being pretty much completely isolated in terms of telecommunication and literally for me it happened in the space of a few years. All of a sudden farmers had mobile phones. So they jumped from nothing to mobile digital technology. Fixed landlines, they never went through that long phase of transition that we did in Australia. And that is a revolutionary change. That gives people access to information who previously lacked information and one of the core dimensions of inequality is inequality and access to information. If you can ring around and get market prices for your crop, you can sell to the trader at a much better price. So let's jump down to digital health and think what that might mean for people in terms of not just being able to access information in a passive sense, but in being able to monitor, to report on their own health with the assistance and support of local health practitioners in a way that is genuinely empowering. So to me, the story is about empowerment and it can happen in all sorts of ways, but there's nothing more empowering for people in rural South East Asia than this. It's a remarkable tool and the various spin-offs that can come from this in terms of health, I think we're only just starting to discover. Thank you, Professor Walker. The Monash campus in Malaysia opened in 1998 and has now been operating for over 20 years. So having a comprehensive campus in Malaysia presumably bestows on Monash significant advantages in being able to really deliver on regional initiatives. Can you share with us how you see the strategic benefits of the campus and what role it plays in capturing the regional opportunities in digital health, particularly in translating these into practical outcomes? Annie, let me say to you, if you need some excitement when you're down there in Singapore, come up to the Monash campus in Malaysia. I'm not sure that you made the right choice there, but we are strategically situated at the intersection of a whole series of important developments. And in a way, if I can sing the Monash song for a bit, it's a forward-thinking decision 23 years ago to set up a fully comprehensive teaching and research campus in Malaysia. So let me talk about a few of the intersections we're located at right there in Kuala Lumpur. I've talked about economic development. We are in a region of massive economic development facing very key challenges of sustainability and equity. We're also going through the health transition. Chris talked about, and sadly, some of the ways people die in Southeast Asia. In the parts of Southeast Asia where I worked, not so long ago, people died from not having enough food or from not having access to basic health care or from waterborne diseases or from earlier times smallpox and other pandemic diseases. Now we are seeing the health transition where, you know, to put one aspect of it very crudely, we are now dealing with the health problem not of poverty but of affluence. And the other key intersection we're located in at Monash Malaysia is this is a region of extraordinary human mobility. COVID certainly has put a cap on it for a while, but the Malay Peninsula, as we all know, has been one of the crossroads of the world for a very, very long time. So we have a diverse and mobile population with lots of marginal people in it. And when we're talking about filling the gaps, there's certainly lots of gaps in the landscape we're in. But that's a long-winded way of saying that Monash Malaysia campus is operating in a social, political, cultural, demographic environment that is perfect for investigating some of these digital health issues. Thank you, Professor Walker. And I'd like to now hand over to someone who is actually also based on the Malaysia campus in Monash, Dr. Jessica Waddeson, who is a senior lecturer in digital health. Jessica, you research human-centred and participatory design approaches to improving health equity. And in particular, you've undertaken a lot of work advancing digital health in resource constrained communities. Can you tell us a little bit more about your research and how it has been incorporated in projects in Malaysia? Absolutely. Thank you for having me. So throughout my career, I've recognized the importance of involving communities in the design of health interventions. And just as one earlier example, I was working on a mobile app to promote immunization in urban slums in India. And our research team came in and we told them that we had the idea to send text message reminders when their children were due for another immunization. And so we were speaking with mothers and sharing our ideas. And as we started to do that, we heard from them, one, that many of the mothers weren't able to read, and two, that they were often sharing their mobile phones with their partner as their husband might go to work. And during the day, they might not receive that message and be able to bring their child in for an appointment. So that's just one example of a time when we learned directly from the communities that we were hoping to target what we needed to be doing to address their needs. And it's not always the idea that we come in with as outsiders. That's why it's so important to include them. At Monash, Malaysia, I'm working on a project. We're also working very closely with the community. This project is actually led by my colleague, Dr. Umadevi Puanasami. And she's my colleague in the School of Medicine. Our project is focused on developing and evaluating an app that helps the deaf community to access sign language interpretation when they go for a doctor's appointment. So currently many people in the deaf community avoid going to the doctor, avoid going to healthcare appointments because they don't have a good way to communicate often. So in this project, even before I joined, Dr. Umadevi Puanasami did a fantastic job of building a close relationship with the deaf community in Malaysia. And we now have a prototype of the application that we'll be testing together with the deaf community, with doctors and with sign language interpreters to get their feedback. Thank you, Dr. Wadison. And when we talk about digital technology as a tool to bridge health inequity, another fundamental pillar in addition to engaging with stakeholders, which we have already talked about, is engaging with citizens in the region. What do you think the challenges are when it comes to citizen engagement, particularly around digital health in Southeast Asia? Yeah, so as some of the other panelists have said, obviously smartphones and access to data have been growing in the region. I think in Malaysia, a recent study done by the government of Malaysia found that 91% of households have access to a smartphone. So it's a really high proportion of people. But I think that we, a challenge is that we still need to be really intentional about not leaving anyone out. Being sure that as we're recruiting for research or recruiting for projects that we're not assuming that we're reaching everyone using a digital form, making sure that we're including people from rural areas, from low income backgrounds, and being really intentional if equity is a goal. The other challenge that I think we'll come up against with citizen engagement is being sure that what we're designing is truly relevant and helpful. I think there can be a tendency when it comes to technology and digital health to create digital tools because they can be new and exciting and sexy, but they may not actually be the best solution. And so I think by using a human-centered design approach and truly understanding the needs of the community, we can be sure that technology is actually the right solution. And it has so much potential, but we don't want to jump to a technological solution just because we have the technology. We want to be sure it's the right thing to be using. Thank you, Dr. Whatison. And thank you also to the rest of the panel for sharing some of their fascinating insights and research. I think all of us can agree that funding in research and development in digital health is critical for further progress in this domain. However, that in itself is one of the most pressing challenges facing the field today. So to discuss this in a bit more depth, I'd like to turn to Mark Rosario, the former CEO of General Electric in Malaysia. Mark, you've worked at the highest levels of government in Malaysia and you've also been heavily involved in developing the Malaysian National Innovation Strategy. More specifically, you're a proponent of a very interesting social investment funding model for digital health projects. Can you tell us a little bit more about this particular model and its benefits as you see them? Okay, thank you, Annie. And good afternoon, everyone. Thank you for inviting me today. Yeah, I'd like to, first of all, describe a little bit how this new social financing model works. And then after that, how we're trying to look at applying it in a particular startup called Greenheart to spin off from Monash, that I'm involved in as an advisor. So this social financing model is basically looking at how a social purpose organization, so it could be an NGO, it could be a social enterprise, how they could have a more sustainable source of funding for whatever they're trying to achieve. So if you think about any social issue affecting any country, so in Malaysia, for example, the top social issues could be drug abuse, child abuse, unwanted teenage pregnancies, and also the high incidence of NCDs, as was highlighted earlier, the high mortality rate from heart failure, diabetes. So these social issues cost the government a tremendous amount of funding. So if you think about an example of child abuse, for example, there's an impact, a cost impact to different parts of government. There's a cost to the healthcare system, there's a cost to law enforcement, there's a cost to welfare. And so a lot of this cost is actually more remedial in nature as opposed to being preventive. So who are the ones that are actually working on preventing the incidence of these social issues? It's actually these NGOs or social enterprises on the ground. And a lot of time the problem they have is how are they going to get funded? And typically they'd be looking for one of donations or CSR funding from corporates or philanthropists. Now if you think about the kind of social impact that they're delivering, so you think about, let's say they're focused on reducing the incidence of child abuse, which would have a cost impact on the government, basically reducing the costs that the government has to pay out because you've reduced the numbers. So you have an impact investor that comes in and says, okay, I'm going to fund your program because you're going to be able to deliver a measurable social impact to the government. And at the other end of the spectrum, the government agrees that when the impact is delivered and I can see the cost savings that I'm going to derive from this, I'll pay you a portion of that cost savings. And that money then goes back to the impact investor who can then go and fund another program. So in this sense, you have a very sustainable funding model and so it can be applied in just about any kind of environment where you're trying to reduce the incidence of any kind of social issue. So in the case of Greenheart, which is this spin-off from Monash, they have developed some new technology using AI, small data machine learning, looking at how it can derive data from individual patients from whatever device they have. It could be wearable, it could be just a basic smartphone and being able to prescribe the best treatment protocols that would result in reducing the mortality rate from heart failure. So if you think about this technology and this model that they have, what they're focusing on now, although in terms of commercialization, they have various avenues to look at, but if we focus initially on the government healthcare system and we're starting with this project in Malaysia, working with four hospitals around Malaysia, government hospitals, where we're saying, okay, we'll embark on this program where we're going to be able to reduce the mortality rate amongst these heart failure patients in these government hospitals. And when we show the results that you're not only reducing the cost of healthcare because you have a lower incidence of heart failure that you would have had if you did not have these interventions, there's going to be savings to the healthcare system. And so if up front we have an impact investor that will fund this project and then you're able to show the results and the government then agrees, okay, I'm going to reimburse a portion of the projected cost savings that are realized from the social impact that you're delivering. Now this is going to require a total change of the way the government approaches how it deals and funds social issues. And that in itself is where the major challenge is going to be. So we're starting with this in Malaysia and hopefully when this model can be proven, we can look at other markets in Southeast Asia and beyond. So I hope that gives you some idea of this social financing model and how we're trying to develop this. Thank you Mark for elaborating further on that particular financing model and also for highlighting that health issues also have various indirect forms of cost that are often overlooked. So far we've talked quite extensively about issues with funding in R&D as a major obstacle to further progress in this field and Mark in particular has talked quite extensively about this but I'd like to now turn to some of the other barriers to long-term success in this space and I direct this question to all of the panelists who wish to respond. So broadly what do you think the challenges are when it comes to operational uptake and incentivization of digital health in Southeast Asia? This could be incentivizing industry leaders to make further investment in innovation, academic research or incentivizing citizens as Jessica Wettersen talked about to engage in digital health. What does this actually look like? Can I jump in with a preliminary statement, Annie? Now is a challenging time to be engaging with industry on research. Understandably people have gone through a very difficult period of economic downturn so there are certainly real challenges. The key and I'm going to state it very generally and we might get some more examples is to build up long-term partnerships and it relates to what Abid was saying before and that's what we're trying to do. Not just have individual project-based collaborations but build long-term partnerships that involve pure research, applied research but also collaboration on education, student internships, involvement in curriculum development and I think by building that multi-stranded relationship with core industry partners, it might be a bit slower but we're going to reap the longer-term benefits. Maybe I can also follow on with some comments on what Professor Andrew has just highlighted. At a more micro-level, looking specifically at the green-hot spin-off that I mentioned, the issue they are facing now is they're at the R&D stage doing clinical trials so how is that going to get funded? The government is not going to say, I'm going to commit to giving you this money and if you turn to industry, they're going to say, where's the commercial element of this? At this stage, we need to tap on potential, either governments that may be looking at a broader bigger picture or foundations or corporate CSRs to come in as an impact investor to fund this stage of the program. Then when it shows how it actually works and they're able to deliver the results, the commercialization will come later. If you think about this model where you can reduce the mortality rate of heart failure patients, you start with a government healthcare system and later in the private sector healthcare systems, you would be talking to insurance companies because you're going to be able to save them money as well. But the challenge is always at this stage when you're doing your R&D and your clinical trials, how are you going to get funded? I can answer the other piece of your question, Annie, talking a bit more about how we can incentivize citizens to engage. I think there's a lot of potential for digital health to overcome some of the barriers that we see in our societies, like linguistic barriers, for example. We have a project that we're starting at Monash Malaysia focused on Rohingya refugees who are living in Malaysia and their language is mostly spoken, not written, so that can be a big barrier to them accessing good health information. Our project is focused on developing videos that can provide health information and we're doing that again together with the community to make sure that it's the information that they need, whether that's related to COVID or to other health issues that they want to learn about. We can also overcome cultural barriers. I think as we've seen worldwide, technology is incredibly popular and I think it provides the opportunity to meet people where they are. We see that people are already on Instagram and Grab and Gojek and WhatsApp. They're spending a lot of their time on their phones. So how can we find ways to leverage those same tools to promote healthier behavior? How do we help people to order healthy food on HappyFresh or to connect with people, say, from their mosque over WhatsApp and organize a group to go for a walk? We can try and find ways to leverage the places that people are already gathering. Thank you. Annie, I might just add to Jessica's comments and I'm drawing on observations from Australia but I think this is equally true in Southeast Asia. So both the health professional community and general citizens are relatively unaware of really what digital health can do for them. They're not aware of some of what's going on in the Northern Hemisphere. They're not aware of what's going on in Israel. So I think there's a big opportunity, a big need as part of all this to actually continue to educate people in the general population and equally the health professions about what's possible now, what's actually tangible. A lot of people who do similar roles to me tend to approach it from a futurism perspective. Wouldn't it be great if one day we could and they have some snazzy graphics? I tend to just show them what's real. So here's a real product. Here's 100 real scientific papers saying it works. And even at that level, collective knowledge is still fairly low. So I think addressing that's quite important. And if I may, I was just going to make a similar point. And what we've seen with other technologies and other work we've done over many years is governments still welcome evidence-led research, but also the community interactions. As much as we like to think the governments interact with their communities all the time, they still need sometimes a translation vehicle for what the communities are trying to say. So that notion of doing the gap analysis and then, as was just said, bringing them the tangible tools, not the ones that are 20 years away, is extremely helpful. And industry often sees us as a bit of a proxy for the user community as well. So if we act that way, and we've done this in many other spaces. At one level, I don't see this as being different in some ways because it's a well-practiced solution space if we use those tools. We just need to extend them into this space progressively and more actively. But we do know this works, because it's worked with other health interventions and it's worked with other technology interventions. Thank you, Professor Khan. And thank you to all of the panelists for your responses this evening and for the interesting discussion that we have been able to have. Each of you brings a unique set of perspectives and skills to this field, and it has been a real pleasure to have this discussion with all of you this evening. I'd like to now turn to our audience, whether they are attending physically on the Clayton campus in Monash or whether they are streaming this online. If any of you have questions for our speakers or panelists, please feel free to pop them into the live chat and we will pose those questions directly to the panelists themselves. Okay, I'm going to throw to the room for questions. Do we have any questions from the room? Dan, I'm going off camera. I'm sorry. Good day, guys. My name's Dan. Thank you so much for being a part of this event. It's been incredible to hear your thoughts and your ideas on these matters. It's just invigorating to see the work in this space. Mark, you mentioned that the industry and government are hesitant to enable research in this space as commercial viability isn't proven just yet and it's mainly in the R&D phase for a lot of these projects. I've seen firsthand the individuals on a large scale are searching for ways to help others financially and otherwise. The reason for these people, for these good Samaritans was that they're typically lost in trying to find an entry point into aiding ventures as large as funding digital health research projects. Do you see a future with crowdfunding and community-owned platforms specifically designed to enable wider community participation in funding critical projects like these using technologies like blockchain or DeFi? Thanks. Thanks, Dan. Well, crowdfunding is certainly a very useful tool for providing funding. But I think at the R&D stage, it still will be a challenge because unless the funders are coming in with some kind of social objective as well, it's going to be difficult because crowdfunders typically, you know, they would put in money on the basis of the commercial, you know, basically the commercial potential of whatever innovation that's being presented. So that's why, you know, when that social financing model that I described is actually looking more at what we call like investors who are not just looking for a financial return, but at social element as well. Increasingly though now, especially with SDGs and, you know, corporates having this social obligations as well, many are also looking at the broader aspects of social returns, not just for financial returns. And so from that aspect, you know, it may be possible, but you really need to show how you're able to deliver measurable social impact from whatever projects that you're presenting. And it's certainly possible because there are tools now to show how you can actually measure social impact in financial terms as well as what I described in those cases for social issues affecting the country. You actually have data showing how much a particular social issue is directly costing the government, but you've got a lot of other different cost impacts as well. You know, there's indirect costs. If you think about, think about heart failure, for example, there's a direct cost to the healthcare system, but there's the direct, indirect economic cost as well of a person not being able to contribute, you know, from his work perspective. He's not able to work, and so he's not contributing to the economy. So by being able to quantify these things, you know, you may be able to succeed in getting funding from either corporates or crowd funders who may have a broader intention of not just financial returns, but possibly social return as well. I hope that answers your question. I wonder if there are any other questions from the room here. Brilliant. One second. Just staying within the topic of funding, and this is probably for Chris and Andrew, do you think there is a role for the university sector to be supporting the funding of new research projects and collaborations within an industry and researchers, et cetera? Did you want to address that first Andrew? Well, I would have paid if someone asked that question. Chris, it's a lovely question for me. So we at Monash Malaysia, we're committing some significant preliminary funding for some of the research projects Jessica was talking about. So I certainly think there's a very important role, especially in Monash Malaysia, where sometimes access to external funding can be more challenging for the university itself to enable this research to get started. I'm thinking very carefully about Mark's comments. There's a real difficulty, I suppose, in what we might call the mid-phase between the preliminary research and the commercialisation. What role might we need to play in getting things further advanced along the lines that Mark's talking about? That's something that I'm thinking I want to talk more about. But look, the answer is yes. We're putting money in and we will put more, and we want to really get the maximum impact we can for this investment. Not much I can add to that, except to acknowledge what Andrew said and the fact that he has put a substantial investment into this space. Part of that is embodied in Jessica, who on my screen is just to his right. But that also ties into something that we've said a few times before, having somebody actually dedicated to this on the ground in Malaysia is going to make all the difference in terms of having impactful projects that really make a difference and are informed from the ground up as well. Annie, let me throw back to you. Are there any questions from the live stream? Hi, Campbell. We have a couple of questions around legal responsibilities in terms of digital health. So John online has just asked from an ethical perspective, at what point are we obliged to replace the doctor or the human if the AI is proven more effective? Are we obliged to enact this? This is probably best directed at Professor Bain. There's several PhDs in that. That's an unanswered question. I'd be very careful about, especially depending on your audience, about implying we're going to lose doctors. I think those of us who are deep in this space and like myself have actually been in the health professions acknowledge that we're trying to fill gaps. We're trying to augment human performance. It will be an awfully long time, if ever before many health workers are replaced. And it's also, I don't think, a great way to frame digital health for it to proceed well to imply that that's an inevitable consequence. So I'll give you another really good example. So the use of AI in a procedure called a colonoscopy. So there's a number of places around the world doing this. So a colonoscopy basically places a tube under anesthetic. So if you look in the intestinal track from the rear upwards, it's taking videos as you go basically, a skilled person, usually a gastroenterologist is looking at the lining of the bowel for cancers and other things. But that can all be video recorded. Researchers have now analysed that video, trained AI systems. And in some cases, they are doing better than human performers in terms of picking up cancers and various lesions. Now I've simplified an issue. I think the important sort of take away, the logical step from that is not can we get rid of these people, but can we use this sort of a system to let less experienced people do the procedure. Or maybe in places where you don't have access to a specialist gastroenterologist, you know, a nurse endoscopist could do it with support from an artificial intelligence system. So it's boosting people's capabilities. It's not replacing them. I think that's a better way to think about this kind of an issue. I think you're on mute, Annie. How's that? That's better. Better? Awesome. So that concludes the panel discussion for this evening. Thank you to everyone that attended both online and physically also on the Clayton campus. I'll just head over now to Campbell to make the concluding remarks. But I'd like to again thank DFAT and particularly Monash University for organising this event and for bringing everyone together for discussion. And a very warm welcome. Thank you also to our panellists for participating in the discussion this evening. Over to you, Campbell. Thank you, Annie. And thank you to all the panellists. Just before we conclude, I would like to invite another special guest. Andrew Kampsten is the Victorian State Director of DFAT. I'd like to ask you, Andrew, to make the closing remarks. Thank you very much. Thank you, Campbell. Actually, my primary job was to thank the panellists and Monash University and yourself. And Annie, I think the one, my one piece of value add is to thank you too for your excellent co-chairing. So thank you all for a wonderful session. As someone who works for government, I was slightly apprehensive that this would be a very technical discussion with some sort of very deep health technology discussed. And through it was, I also really enjoyed the public policy aspects. And Mark, I particularly enjoyed your ambition and your obvious, as someone who was a former health economist in developing environment, I enjoyed your social ambition to change the way that health care is funded in your society and to a point that Andrew and Jessica made that it is both public health outcome but also an equity outcome, which is incredibly important for societal health. So thank you again, Monash, for your support to the New Colombo Plan and the Momentum Program. I'd also like to thank Brian Bohemia, who is behind, is the mastermind behind all these events and is an absolute treasure of DFAT. And we're very, we're very proud to be working for us. And I'd just like to make two final remarks for those of you online. The next seminar will be on Thursday, the 15th of April. And is that the right date, Brian? Yep. And quite soon, so next week. And I'd also encourage everyone here at Monash to join us for some drinks afterwards. So thank you very much. And thank you again, Campbell. Thank you, everybody. We will close the session now. And please do join us, as Andrew said, for some networking. If you are in the room, thank you to all of you who chose to tune in online. And we look forward to seeing you in the next Momentum webinar. Thank you.