At the Nordic Air Cargo Symposium in Stockholm, Frank Van Gelder (FVG) gave around 140 participants a look through the keyhole at future trends in the life science landscape.*** Frank is Secretary of the association Pharma.Aero, guest lecturer at a Belgian University and at the same time Managing Director of Mediconed, a company that provides complex project management related to enhanced training for pharmaceutical, medical and supply chain industries. His outlook contained both hopeful and worrying trends that will have a major impact on global supply chains. We spoke to the expert.
CFG: Frank, let’s start with a very positive outlook: one of your key messages at the Stockholm-held Nordic Air Cargo Symposium was that cancer, an old scourge of mankind, can be defeated through individualized medicine and treatments. What is this assumption based on and on what time horizon?
FVG: Currently many different new generation cancer treatments are leaving the research pipeline and entering in the wider range of clinical applications. Especially the CAR-T (Chimeric Antigen receptor) treatments have reached a new era of applications with very promising results, realizing that today these treatments are mostly used in patients with stadium IV cancers, categorized as untreatable and uncurable. It is a mechanism where the T-cel leucocytes of the sick patient are treated outside the body to be re-infused and target the cancer cells. Also, within the ATMP (Advanced Therapy Medicinal Products) there are different other products and mechanisms now tested and explored to treat cancer. One of them is based on the mRNA technology, better known form the Covid vaccine technology, in which the body itself creates the vaccine.
The so-called Spike protein identification of the cancer cells helps the body to initially kill the tumor but also to build antibodies against the cancer for the future. It is one of the most groundbreaking technologies and clinical applications of the past century in healthcare. Seeing the different promising results there is a 15-to-20-fold market growth projected in the next 5 years. One should realize these are still low volume settings and very critical lead-times. As every year around, 4.2 million new cancers are discovered, and with the aging population, will only grow, this will be a big market where U.S., Europe and Asia are investing billions of dollars.
3P’s of Sustainability
CFG: In contrast to the positive cancer perspective, it is worrying that 40% of all medical treatments produced never reach patients. What is the reason for this enormous waste of resources and what needs to change in the supply chains so that this scandal can be ended or at least greatly reduced?
FVG: I think the basis of this is caused by the very strict and unique serialization policies within drug production internationally. Let me give you an example: if we ship drugs currently and at the other end of the supply chain there is an issue, we can’t re-allocate these shipments in the current setting. In other words, the shipments need to come back and be destroyed. And that is in a way understandable as we need to always avoid, that such drugs enter in black markets, counterfeit, and thefts, with a potential uncontrollable quality and danger for humanity. Therefore, it is important to internationally collaborate on higher level and wider scale with the regulators, the drug production authorities, the supply chain and logistic stakeholders and life science manufacturers. It is an issue that would hit the 3P’s of Sustainability, 1) Profit (less drug loss of produced and manufactured drugs) 2) Planet (less waste and destruction of produced drugs and chemicals) and 3) People (higher availability of treatments to people not accessible today and in the need of medical treatment). Supply chain flexibility and resilience is needed to assist and secure a better way of tackling this.
Ticking time bomb
CFG: The Covid crisis is just over. Thanks to innovative medical products and the rapid transportation of serums, hygiene materials etc. by air freight, it was possible to prevent worse things from happening. Now you are assuming that the next pandemic is practically just around the corner. So is humanity experiencing an endless chain of successive pandemics? And if so, why?
FVG: It would be very naïve from humans, that the Covid pandemic was unique and only one to happen. We have had many in human history and examples of what we call zoonotic diseases, where viruses and or micro-organisms of an animal host, jump over on human (the plague in the Middle Ages, Ebola, dengue, malaria, HIV, covid, bird flu, and we can on …). The incidence only increases when animal lines and human lines cross each other too frequently, and when the pathogen mutates from an animal-to-human, to a human-to-human situation. At such a moment, and what happened with the plague and now the covid, the frequency with passing on the micro-organism accelerates. The fact that global population is growing, that many humans live in very basic and unhygienic conditions, it is only a ticking time bomb for the next one to happen. The only good news after covid is that we have created new systems, new policies, and new levels of authorities, to handle more accurate and faster even. It is not a secret that the European commission has asked pharma companies to be able to produce a vaccine within a year for any future potential pandemic outbreak.
Grey tsunami
CFG: Japan, China and to some extent Europe are ageing societies, as are parts of America. What are the foreseeable consequences of this biological development for the global life science industry and the supply chains of tomorrow and beyond?
FVG: The aging population phenomenon is a very multi-factorial impacting trend. Due to better hygiene, better healthcare and better treatments, the population keeps on growing older. On the other hand, in Western societies where this is happening, there is less and less inflow of young children. This will drive us to a societal model, with an increasing need for healthcare, and a lower availability of young healthcare workers. Like we would call it the “grey” tsunami, it will challenge the economy from different sides. In relation to Life Science supply chains, and based on new healthcare model innovations, you will notice a shift to higher chronic home care. This implies e-commerce like models for homedelivery, IoT interconnected patients to a virtual patient control tower, and highly-specialized care centers only for acute care. In other words, the hub-and-spoke distribution model will only be more applicable and e-commerce giants will only enter more and more in drug delivery models and digital management platforms.
CFG: Africa’s population, on the other hand, is very young and growing rapidly. Given this demographic trend, wouldn’t it be logical to shift research, development and production of healthcare products from the industrialized countries to Africa?
FVG: For sure this is a very plausible trajectory that is already explored. Africa should less depend on full external import and production, as it weakens their development and population safety. During the pandemic there were again more HIV cases due to lack of anti-HIV drugs available as there was no uplift capacity. The biggest enemy is the quality in production and logistics. Drugs are often produced from out of different ingredients and therefore often a complex upstream logistics. Also, the quality of producing the drugs is a very big challenge. Recently India came in the news negatively because of quality issues of some coughing sirups with child death as a result. One should not forget, although investments can drive decentralized production from a financial perspective, the experience and track record is important to assure quality. It will happen, within the next decade where countries like Senegal, Rwanda, Kenya and South Africa are interesting markets to look at. I see personally a direct starting market for generic drugs which are currently and almost exclusively produced in India. When it comes down to more complex molecules and therapies, you need a strong research-based experience.
***https://cargoforwarder.eu/2024/04/28/nordic-air-cargo-symposium-2024-summary/
CFG: Frank, thank you for your time and this input.
