What's next in India

While we celebrate the conclusion of the Sweden-India Year of Health, we have already initiated the next stage of our close collaboration. The new decade will bring increased activity within both midwifery and elderly care, covering both ends of the spectrum where Swedish solutions are particularly sought after.

The importance of digital health will only increase, especially with regards to the management of chronic conditions, but here we hope to develop applications and medtech products with Indian innovators which can be applied in both markets in order to ease the enormous health care burden we face. The combination of longitudinal data from Sweden with volumes available in India could lead to significantly more efficient solutions. New agreements can also be expected within infectious diseases, in particular with regards to Anti-Microbial Resistance.

All this and much more was discussed during the State Visit to India last week. Swecare organised the Elderly Care tract with special focus on dementia, ripples of our dialogue with key opinion leaders can already be felt in the Indian health care community. Minister Harsh Vardhan and State Secretary Maja Fjaestad reasserted their commitment to the MoU which exists between our two countries. The Minister has already expressed his interest in visiting Sweden early next year.

MAMTA Founder and long-time Swecare partner Dr Mehra receiving the Royal Order of Seraphim & the Royal Order of Polar Star

How to Make the Strategic Innovation Partnerships Work for You

Sweden has signed innovationspartnerskap with three countries - Germany, France, and India - since 2017. As described on their website, the purpose of the partnership is

"to work together and, through innovation, address the challenges of the transition to[wards] a more sustainable welfare society, create new jobs and maintain social cohesion [sic]."

While the dialogue between governments has been ongoing and some research collaborations among institutions have taken place, there has been little engagement with the third pillar in triple helix: the private sector. Aside from a few projects within clean energy financed by the state, few incentives have been created to encourage companies to leverage the partnership. This, however, does not mean that there are no exciting exchanges taking place.

Below are highlights from visits made by all three countries in the month of June.

Germany

Minister Barbara Klepsch, State Minister of Social Affairs and Consumer Protection of the Free State of Saxony, led a 30-person strong delegation under the theme: Digitization in Health Care.

Photo from https://www.ltu.se/

“This trip is [...] particularly important to me, and I very much value thisopportunity of being able to strengthen the relations between Saxony and Sweden and to engender new collaborations."

The delegation - organised by Tysk-Svenska Handelskammaren and consisting of state, agency, insurance, and company representatives -  visited a number of Swedish companies along with Socialdepartementet, eHälsomyndigheten, the Royal Palace, and universities in Stockholm and Luleå. Swecare had the privilege of welcoming the delegation on its first day and presenting an overview of the Swedish health care system - our strengths, challenges, and vision.

One delegate felt both slightly disappointed and genuinely inspired that Sweden was not as digitised as he had feared, making collaborations on equal terms more likely.

France

Little did we know that when we invited CEO Pascal Roché of Ramsay Générale de Santé, current owners of Capio, for a half-day seminar in Stockholm, it would lead to one of the most interactive events of the year, with both presenters and audience engaging with complete frankness and good humour. Swecare and Business Sweden France hosted the event as a continuation of the conversation from the  conference in Paris on "Innovation in health: A French-Swedish dialogue” with more activities planned for the Fall.

Key take-aways:

• From Pascal: Ramsay Générale de Santé reduces queues and costs by operating more efficiently due to successfully implementing small innovations across all their units. He advises President Macron as to how this can be done within France's public hospitals as well.
• From Jan Gustavsson, Vice President Worldwide Sales for ScandiDos: If you are going to do business in France, keep a significant buffer for administrative costs which should be outsourced.

Macron mentioned health care twice during his five-minutes at the joint press conference held with Löfven early June. This is clearly a prioritised sector for France.

India

On the occasion of the India-Sweden Year of Health, the Swedish Ministry of Health and Social Affairs welcomed a high-level delegation from the All India Institute of Medical Sciences (AIIMS) Jodhpur led by its Director, Professor Sanjeev Misra. As part of this visit, Swecare organised an intimate round table for its members.

The aim of our close collaboration with AIIMS Jodhpur is to lay the foundation for scaling Swedish solutions and products to other AIIMS, with the exception of New Delhi, across India: 8 already functioning, 9 in the process of being built, 4 more planned. This also gives us the opportunity to operationalise the Innovation Partnership.

The 5-person delegation met with government agencies and institutions in Stockholm and Uppsala. They also had the opportunity to test VR tools and visit Swedish companies already engaged in projects in Jodhpur.

Next Steps

We are already planning the next activities in all three countries so please email us at Swecare if you want to be involved!

Converting Agreements into Action: Sweden-India Year of Health

Swecare had the privilege of welcoming a delegation from India organised by our longtime partner InnovatioCuris.

Region Uppsala

Highlights included a highly engaging round table discussion with key Swedish innovators at the incomparable H2 Health Hub in Stockholm and a seminar at Vitalis in Gothenburg.

Aula Medica - KI

The delegation visited Karolinska Institute and Hospital in Solna, Uppsala Region and University, Surgical Science, Sahlgrenska, AstraZeneca's BioVentureHub, and GoCo Health Innovation City during their 4-day trip.

The focus of the delegation was to explore concrete collaboration opportunities between innovators in our two countries - taking the Innovation Partnership signed by Modi and Löfven last year to the next level.











Delegates

VR at Surgical Science

• Dr Sandeep Bhalla, Director of Training, Public Health Foundation of India (PHFI): leading the capacity building initiatives for Primary care physicians in chronic disease management and injuries .
• Deepali Jetley, Qwazent: Managing Partner from an all-female executive search firm with health care focus.
• Kingshuk Poddar, AIC-AMTZ Medivalley Incubation Council: a comprehensive entrepreneur incubation hub catering to convergence technologies in the field of Medtech, Nutratech and Biotech.
• Rohini Pimple, Research and Innovation Circle of Hyderabad (RICH): an initiative conceived to unlock the national treasure created by the top scientific research institutions in Telangana State, and to actively facilitate the process of taking their research to market.
• Rajesh R. Singh, Wadhwani Initiative for Sustainable Healthcare (WISH) Foundation: improving the quality of and access to primary healthcare for under-served communities in India by appropriately introducing promising healthcare innovations in the public health system.
• Sachin Gaur, InnovatioCuris: expert in cyber security and frugal innovations in health care.
• Dr VK Singh, InnovatioCuris: veteran doctor with a decades long career in the Indian military and extensive network in India.

If you were unable to join us during last week's activities and are interested in pursuing any of these contacts, please get in touch. Further information: InnoBRIDGE 2019.

Upcoming projects & activities (email Swecare if interested):

Linda Swirtun, Vinnova

• New Initiative - building a much broader and stronger platform in infection control, where as many Swedish institutions and companies as possible are engaged, establishing a Vision Zero for hospital acquired infections, similar to what has been done for road traffic accidents in Sweden and now exported to India.
• Strengthening Collaboration - reducing environmental risks from antibiotic production & sustainable solutions through building alliances. On the issue, Stockholm International Water Institute (SIWI) suggests a multi stakeholder call for action.
• Vinnova Call - company-driven research and innovation projects (Smart Cities & Clean Energy, Digitisation & IoT). Deadline 15 August - more information.
• Incoming visit - Director of AIIMS Jodhpur 12-14 June.

Seminar at Vitalis 2019

2019: Planning for the Year Ahead

Sweden & India - Partners in Health

A commitment has now been made by both the Swedish Socialdepartementet and the Indian Ministry of Health and Family Welfare to make 2019 the Year of Health - #SwedenIndiaHealth2019. As we plan for the year ahead, we welcome your input as your engagement is crucial to this partnership. The focus will be on aligning Swedish Triple Helix life science actors in delivering a structured solution to common challenges in India. Concrete deliverables along the care continuum is the ultimate objective of this collaboration. Once this proof of concept yields results - increased efficiency, decreased costs, healthier community - the Indian government has expressed interest in scaling the concept to other parts of the country. The Indian Ministry suggests Jodhpur, and its new All India Institute of Medical Sciences (AIIMS), as the test bed for this collaboration.

This, of course, does not preclude collaborations in other parts of India and many of our partners and members have ongoing projects throughout the country. We foresee increased activities with AIIMS New Delhi, Apollo Hospitals, Public Health Foundation of India, MaxCure Group, India Institute of Technology in Delhi, Mumbai, Bengaluru, Hyderabad, Kolkata, and Chennai, to name a few. But these will all be conducted with a view to ensure that Swedish stakeholders, despite having distinct objectives, will be moving in the same direction. Partnerships between Swedish actors is encouraged so that the momentum we have generated results in concrete (measurable) outputs.

Proposed timeline for 10-year celebrations in 2019

• January - pre-feasibility study in Jodhpur to determine scope

• 24-28 February - Swedish Ministerial visit to Delhi (and Jodhpur) in conjunction with the Global Digital Health Partnership 

• April/May - heads of Indian hospitals will be invited to Sweden for a study visit and workshop

• 21-23 May - Vitalis 2019 session to focus on AI & Innovation with an incoming health tech delegation which will visit incubators and hubs in Stockholm and Gothenburg

• September - agency and private sector workshop in India

• October/November - Indian Ministerial or Health Secretary visit to Stockholm along with the 11th Joint Working Group meeting

Other dates to keep in mind

• 5 December - 2nd Private Sector Steering Committee Meeting

• 25-27 February - BioAsia 2019 in Hyderabad

• April/May - Indian elections

• 11-12 October - InnoHEALTH 2019 in New Delhi

• The Swedish India Business Council will also be organising tech delegations so please keep an eye on their website

Calls out

• Big data and Artificial Intelligence for monitoring health status and quality of life after the cancer treatment

• 9th Call - JPIAMR Call on Diagnostics and Surveillance 2019

• Affordable & Accessible Health Care through Early Screening and Efficient Management

Focus areas

• Digital Health - non-communicable diseases, elderly care, AI, Health Tech

• Anti-Microbial Resistance - infection control, knowledge transfer, nurse training, medtech

May I please request that if you have upcoming activities, you contact us so that we can provide the necessary support both in Sweden and in India? We will be coordinating closely with the Indian Embassy in Stockholm and the Swedish Embassy in New Delhi and one of the proposed ideas is to create a quarterly newsletter highlighting events within the life science sector between our two countries which could also act as a status report so do write to us!

Central Baltic Health Access - Dissemination Seminars

Central Baltic Health Access is an EU-funded program that aims to help health care companies access distant markets. The program started 2.5 years ago, and has helped more than 50 companies in the partner countries reach markets in India, South Korea, Uganda and the US. 

Swedish companies presenting at InnoHealth in New Delhi, September 2017

The dissemination seminars are part of the finalizing activities, and last week we met with companies who have entered India and Uganda through the program, as well as companies and organizations interested in learning from their experiences. The idea of sharing expericence and lessons learned proved to be just the right thing:

After having completed my post-graduate studies, I realized that I had, in fact, learned more from my classmates than from my coursework. This is similar to my experience when participating in, and sometimes even leading, Swecare seminars. When considering markets like South Korea, Uganda, India, and the US, the companies need us mostly as a platform to connect with each other and to potential local partners. This might seem trivial at the outset, but if you look for opportunities to meet possible competitors or like-minded companies interested in similar markets at a neutral setting, hosted by an organization without its own agenda - you may come up empty-handed. And this has really been the strength of the Central Baltic Health Access program from the outset.

The dissemination seminars are meant for the companies who participated in the trips, but Swedish Medtech and Swecare decided to extend the invitation to all the companies in our networks which may be interested in the chosen markets. The participating companies thus got the chance to share their experiences and also meet new potential allies in their efforts to enter a new market. It also gave us the chance to discuss concrete activities to ensure that the momentum of our relationships, with each other, the target market coaches, and local partners, could result in concrete deals.

Follow-up trips to all four countries are already being planned so make sure not to miss out! So far Swecare has plans for delegation trips to Bangalore, India (February 14-16) and Uganda and Rwanda (March 19-23). Contact us for more details.

CBHA Uganda Business Mission visiting International Hospital Kampala, August 2017

Svettigt när Finland firade 100 år av självständighet

Det var en munter skara på dussinet som samlades i Finlandshusets konferenslokal för att fira jubileumsåret. Efter ett kortare välkomsttal för att högtidlighålla märkesåret, hölls presentationer av verksamheten och de projekt som organisatörerna (Swecare, Ecca Nordic, Jokilaakso & Co) är engagerade i. Deltagarna som representerade personer från näringsliv och akademi åtnjöt bastukorv som tillagats på aggregatet med en välkomst öl.

Sedan var det dags för dopp i den "iskalla" poolen och hårt bastubadande för fortsatta starka relationer mellan Sverige och Finland inom företagande och kultur. Sista gänget att checka ut passade på att gratulera Dr.Johan Seijsing (t.v i bilden) för att ha vunnint Skolar Award på Slush17 och vinsten på 100 000 € för presentationen av sin forskning på använda enzymer funna i naturen för att tackla problemet med antibiotika resistens.

Tillsammans önskar vi ytterligare minst 100 år utav vänskap och handel mellan Sverige och Finland!

9th Session for the Indo-Swedish Joint Working Group on Health

Often referred to as the most successful MoU in our joint arsenal, the healthcare cooperation has done much to bring India and Sweden closer. Though vastly different demographically, our countries share similar challenges due to a very decentralized governance structure and a large percentage of our populations living far from health care centers. As such, many of the common challenges we face can only be overcome through collaboration and cooperation. In the coming year, ahead of the MoU's 10th anniversary, it was decided during the actual Joint Working Group meeting to take stock on what has been accomplished and explore new areas of collaboration.

For the private sector, this means we need more clarity on the recent bevy of policy changes. Although these changes for the large part have improved the business climate, they are quite confusing not only for the Swedes but Indian themselves. The Indian delegation, which included a senior representative from the Central Drugs Standard Control Organization (CDSCO), very generously shared their business cards with the Swedish companies present for the roundtable and assured each and every one of them to personally call in case of any issues.

The delegation also got a chance to see some of the Swedish products in use at Akademiska in Uppsala and was much impressed by the extremely close collaboration between professors, researchers, medical professionals, investors, and industry. While the Indian government representatives understood that these are the ingredients making Sweden such fertile ground for innovation, they had never truly appreciated how tightly, both physically and intellectually, these actors work together. This was further emphasized during their visit to EMPE Diagnostics at the Karolinska Science Park with which they ended the trip.

Going forward, Swecare, at the behest of some of our members, will focus on:

1. the inclusion of quality criteria in public healthcare tenders - looking in not just the lowest, but the total cost, and
2. exemptions based on global health threats (such as AMR which features prominently in the new Indian National Health Policy) for the price caps being introduced for certain Medtech products by the National Pharmaceutical Pricing Authority.

We are also working to ensure more continuity in our activities with India. Part of this will be through regularly planned trips to India and the cultivation of relationships with potential partners on the ground. If you have any suggestions or requests, do get in touch. India is a vast, and often overwhelming, country but the rewards for successful partnership could eventually affect the national and global health threats facing both Sweden and India - not to mention improve the lives of people.

Central Baltic Health Access trip to India - Sept 2017

Key takeaways

1. You have to be excited to be there. If being in India does not make you happy then it will be very hard to motivate yourself and your team to invest time and money necessary to succeed in the Indian market. Two of the participants woke up at 2am to visit the Taj Mahal from Delhi (+3hrs one-way by car) before their 11am meetings with agencies and distributors. This passion speaks for itself, and the Indian counterparts are much more likely to go an extra mile (in this case quite literally) if you show that you are doing so yourself.

2. A physical presence is extremely important. Most people will actually want to meet you first and then take it from there. If, in the Swedish manner, you try to book meeting weeks in advance with a set agenda, the response is unlikely to be overwhelming. One of our Swedish delegates was so concerned with what she saw as a lack of planning that she "almost didn't come, [...] but there were so many good meetings that were unprepared!" She booked her ticket days before this CBHA trip and was not disappointed.

3. When your extremely talented and dedicated local coach tells you to take an Indian SIM card, listen to him. I regretted not having taken an old phone with me as many of my texts did not go through and data connectivity was patchy at best. There was no WiFi at the conference venue which made it difficult to follow-up and set-up meetings with the leads one had just met, an Indian number would have made life much easier.

4. Use Whatsapp - one of the representatives of a government regulatory body said that he is unlikely to ever answer an email as he is constantly running between meetings and stuck in traffic (many official domains are inaccessible on the mobile). Get potential partners' mobile numbers and use them.

About the trip

The third installment of the Central Baltic Health Access project consisted of three days in Delhi and two days in Bengaluru over the third week in September. The sheer variety of meetings we managed to fit into these few days is nothing short of impressive. For this we have Sachin Gaur and his team at InnovatioCuris to thank. I believe I speak for all participants - six from Sweden, five from Estonia, and four from Finland - when I say that it was a productive trip. Company mission reviews have started to come in and we will book in coaching meetings over the next few weeks in order to ensure follow-up, but the general feeling, even after two days in Delhi, was that many promising connections have been made - with distributors, clinics, hospitals, start-ups, research institutes, regulatory agencies.

We were also privileged to have hands-on support from both the Estonian and Swedish Embassies in Delhi. The Ambassadors spent a considerable amount of time with the companies, in order to understand the needs, challenges, and expectations of each representative. This type of local support is key for success in foreign markets. In fact Swecare is already in talks with the Embassy, Business Sweden, InnovatioCuris, Confederation of Indian Industry (CII), and Federation of Indian Chambers of Commerce & Industry (FICCI) to explore the option of making this type of business-focused trips a regular event. If you are interested in this form of deep engagement, do let us know!

Participants:

Representative name	Organization
Dr. Jaanus Pikani	Documental, Estonia
Ms. Piia Vettik-Leemet	Tartu Biotechnology Park, Estonia
Mr. Jan Erik Hedborg	ApiRays, Sweden
Mr. Priit Aigro	Smart Do, Estonia
Ms. Maarika Merirand	Tehnopol, Estonia
Dr. Pieter Spee	Fibrotx, Estonia
Ms. Malin Hollmark	Swedish Medtech, Sweden
Ms. Shampa Bari	Swecare, Sweden
Mr. Hakan Jideus	Predicare, Sweden
Mr. Pavan Asalapuram	Empe diagnostics, Sweden
Ms. Caroline Danielson	RenaPharma, Sweden
Mr. Joonas Ihalainen	iCare, Finland
Mr. Tero Karhi	Turku Science Park, Finland
Dr. Katja Heikkinen	Turku AMK, Finland
Ms. Marjatta Häsänen	Turku AMK, Finland

Food for thought

Before signing off, I leave you with some few points I have pondering over since the trip.

- If the diagnostic test costs more than the 'cure,' often antibiotics, wouldn't you too just take the latter?

- How to tackle the aging challenge, which the Indian healthcare system is only now coming to see as a threat?

- Can our products be price-competitive when there is such heavy tax imposed on imports into India? Is manufacturing there a viable option?

- When it comes to product tests, must the companies fund the research themselves, or are there easily available funds in Sweden? The Indian research agencies have such funds for the work being done on their end but cannot finance the Swedish engagement, making the PPP project less tenable.