Dr. Leen Kawas, an experienced biotechnology innovator, highlights recent breakthroughs in the field.
Dr. Leen Kawas, an experienced biotechnology innovator, highlights recent breakthroughs in the field.

In today's highly interconnected world, global economies of scale drive companies in many industries. In the manufacturing and consumer goods sectors (among others), large-scale demand and production often enable firms to meet customers' needs while also enjoying desirable profits. The same principle applies to businesses engaged in single-country operations.

As the healthcare industry evolves, large-scale trends and economies of scale continue to emerge. Leen Kawas, Ph.D., Propel Bio Partners' Managing General Partner, detailed the scope of these developments. She also discussed the continued increase in chronic diseases and autoimmune diseases. Finally, Dr. Kawas profiled two innovative technologies that offer promise for better healthcare delivery and more effective patient treatments.

Longer Lifespans (but not Necessarily Healthier Ones)

Each country's average life expectancy paints a picture of the population's overall health and ability to stay well. For reference, the term "life expectancy" refers to the average number of years someone is likely to live. This average number is derived from age-specific death rates.

In 2023, the World Health Organization (WHO) noted that the last several decades have demonstrated a marked life expectancy increase. Between 2000 and 2019, the WHO noted that global life expectancy increased by over six years.

For perspective, in 2000, the average life expectancy was 66.8 years. In 2019, this metric rose to 73.4 years. This global increase has resulted from nutrition and medical science advancements along with public health initiatives.

That said, Dr. Leen Kawas noted that healthy life expectancy (or HALE) is also important. The WHO-reported HALE figures showed an increase of 8% from 2000 to 2019. However, this rise resulted from declining mortality rather than fewer years lived with disease. Stated another way, improved nutrition and healthcare enable people with chronic conditions to enjoy longer lives—but those extra years aren't always healthy ones.

Non-Communicable Disease Frequency Continues to Rise

In May 2023, the United Nations published a World Health Organization report on threats to non-communicable disease (NCD). The WHO's World Health Statistics Report covers data up to 2022. The WHO reported that non-communicable diseases currently account for about three-quarters of all lives lost globally every year. These patient deaths impact families along with local, regional, and national economies.

The World Health Organization projects that if this NCD disease (and related death) trend continues, by 2050, chronic diseases will make up 86% of each year's deaths. This represents a 90% rise in absolute figures since 2019. For perspective, the top chronic diseases are cancer, diabetes, respiratory illnesses, and cardiovascular diseases.

To complicate the issue further, Dr. Leen Kawas emphasized that the COVID-19 pandemic discouraged many people from visiting healthcare providers. In addition to routine patient encounters, many visits would have involved serious disease diagnoses and treatments. This lack of treatment often causes disease progression that could potentially reduce patients' lifespans. These negative impacts continue today.

Diseases Can Strike Anyone — Often Without Warning

Lifestyle risk factors can contribute to certain serious (and often chronic) diseases. To illustrate, the Centers for Disease Control and Prevention (CDC) stated that chronic diseases such as heart disease, diabetes, and cancer are the United States' leading causes of death and disability.

The CDC noted that four personal behaviors contribute to these chronic diseases. Subpar nutrition, little physical activity, tobacco use, and excessive alcohol consumption are major factors behind chronic disease development.

That said, Dr. Leen Kawas noted that diseases are very democratic. Stated another way, a company's Chief Executive Officer (CEO), an elementary school teacher, and a warehouse worker can unexpectedly contract the same disease. Dr. Kawas also said diseases can impact even those individuals who practice extremely healthy lifestyles.

Why Some People Become Ill (and Others Stay Healthy)

When referring to illness and recovery dynamics, everyone is different. Multiple people may be exposed to a colleague with the flu, and yet not everyone gets sick. For those that do become ill, they also don't recover in the same way. Some people return to their pre-flu health level, while others carry lingering reminders of their illness for some time.

Focus on Immune System Resilience

In June 2023, Scientific American spoke with Sunil Ahuja, MD, a University of Texas Health Science Center at San Antonio professor of medicine. Dr. Ahuja also serves as the Director of the Department of Veterans Affairs Center for Personalized Medicine.

Finally, Dr. Ahuja is the lead author of a Nature Communications paper on immune system resilience. This study profiles the factors that enable some people to restore their disease-avoiding immune functions and control inflammation.

Dr. Ahuja detailed three factors that explain why certain people are more prone to sickness than others. First, genetic susceptibility plays a key role. Next, infection-loaded environments offer plenty of opportunities for exposure. Finally, people can vary in their inflammatory stress responses. Stated another way, someone may respond in a certain way to one infection. A different infection elicits a different response.

Dr. Ahuja also explained that people can vary in their degree of inflammation. Certain people may become infected but don't get sick because of a strong inflammatory response. Over time, he noted, those with low inflammation and a strong immune response may experience longer lifespans.

Higher Incidence of Autoimmune Disorders

Autoimmune disorders are affecting an ever-larger segment of the global population. In May 2023, the University of Glasgow published a large, population-based study showing that autoimmune disorders currently affect approximately 1 in 10 people. The study, which involved 22 million UK subjects, was published in The Lancet.

For perspective, autoimmune diseases are triggered when the body's immune system mistakenly combats healthy cells rather than warding off infections. Over 80 autoimmune diseases currently exist. Clear causes have not been determined, although researchers continue to consider genetic and modifiable factors.

For the study, a medically diverse team of researchers analyzed 22 million anonymized electronic health records. Researchers wanted to know if 19 common autoimmune disease cases were increasing, and they sought to find out who was most affected. Equally importantly, researchers wanted to determine how more than one autoimmune disease could potentially affect the same subject. The study confirmed that "some autoimmune diseases tend to cluster together." Additional research will likely seek to identify potential common causes of multiple autoimmune diseases.

Autoimmune Disease Implications

Professor Iain McInnes is the Vice-Principal of the University of Glasgow and the Head of the College of Medical, Veterinary & Life Sciences. As the paper's co-author, he summed up the findings' implications.

"These conditions pose a huge burden on individuals and upon wider society and currently represent an enormous unmet clinical need. This pioneering study provides invaluable insights that will inform improved understanding of immune diseases and their treatments going forward," Professor McInnes concluded.

The Global Healthcare Industry's Scope

With the ongoing increase in disease occurrences as a backdrop, the global healthcare industry continues to grow its capabilities to meet these challenges. In 2021, the worldwide healthcare industry collectively held a $104.44 billion valuation.

By late 2027, the industry is expected to reach a valuation of $272.76 billion. In financial terms, this means the healthcare industry will have a compound annual growth rate (or CAGR) of over 20% for the period.

Major healthcare service providers are driving this worldwide growth. Some firms focus on medical discoveries, while others devote resources to meeting patients' needs. Other large companies are leaders in the medical equipment or insurance arenas. Not surprisingly, each of these industry-leading firms has a market capitalization of billions of dollars.

Governments' Healthcare Priorities

While the mega-corporations provide healthcare technology and infrastructure, many countries' healthcare systems are focused on improving patient outcomes. Dr. Leen Kawas emphasized that this can lead to higher average life expectancies in a specific country.

Governments in multiple countries are devoting increased financial and technological resources to the senior population. Because this growing demographic tends to face more healthcare challenges, governments are supporting healthcare providers' efforts to help the senior cohort enjoy improved longevity over time.

The Benefits of AI and Gene Therapies

Two remarkable technologies are positively impacting the global healthcare industry. Artificial intelligence (or AI) enabled healthcare applications continue to increase. Concurrently, gene therapies are being utilized to help treat and potentially prevent certain diseases. Dr. Leen Kawas profiled each of these intriguing breakthroughs.

AI's Expanding Healthcare Applications

Artificial intelligence innovations rely on two key factors: the availability of digital solutions and the existence of very large (and often complex) data sets. Machine learning, a type of artificial intelligence, drives these advancements. Simply put, machine learning algorithms simulate humans' capabilities to evaluate, comprehend, and present sophisticated medical data.

In the healthcare industry, AI can streamline operations in multiple ways. On the patient side, AI can enhance risk and disease determination and drive better-informed clinical decisions. Here are three ways AI can be a game-changer in the healthcare industry.

Increased Diagnostic Accuracy

The healthcare industry collectively has a big misdiagnosis problem. Every year in the United States, several million people are misdiagnosed, and almost half of them are cancer patients.

Fortunately, AI-enabled computer vision delivers accurate medical imaging analysis. The AI tool can extract data from patient reports, MRI and CT scans, X-rays, and other digital test results. That said, AI is not (yet) sophisticated enough to remove skilled radiologists from the picture.

Enhanced Patient Care

The healthcare industry continues to be faced with labor shortages that can affect patient care. Specifically, patients have complained that poor provider and staff communication degrades the quality of the patients' healthcare experience.

AI can improve patient communication through the automation of repetitive tasks such as appointment management and payment logistics. Therefore, providers and staff members have more time for patient care. On a related note, AI tools can rapidly (and efficiently) analyze data, generate reports, and designate the proper doctors for each patient's needs.

Safer, More Efficient Surgical Procedures

In robotic-assisted surgery, a skilled surgeon guides a robot in precision instrument placement and procedure execution. This enables surgeons to achieve better precision, control, and safety in often complex surgeries.

This remarkable innovation has also enabled remote surgeries for patients who cannot access an appropriate hospital. In a remote surgical procedure, a surgeon directs a robot to perform predetermined tasks.

As an added benefit, multiple studies have shown that robot-assisted surgery patients typically have shorter post-surgical hospital stays than conventional surgery patients. Fewer complications and reduced pain scores have also been experienced by the robot-assisted surgery cohort.

Emerging Gene Therapies

A better understanding of human disease processes is occurring simultaneously with the emergence of precision medicine. The Molecular Therapy — The Journal of the American Society of Gene Therapy December 6, 2023 edition published a review of treatment approaches using "diagnostic and therapeutic biomarkers."

Through 2023's first quarter, over 100 gene, cell, and RNA therapies have received approval. More than 3,700 more therapies are currently in preclinical and clinical development. As this trend continues, the collective global gene therapy market is expected to increase by a factor of 10.

Besides offering treatments for rare diseases, gene therapies may offer treatments for more common ailments. Equally importantly, gene therapies can potentially find the cause of serious diseases. Once researchers achieve this milestone, they'll work on halting disease progression and reversing the condition's impacts.

New Technologies Are Key to Better Outcomes and Improved Longevity

Dr. Leen Kawas acknowledged the global healthcare industry's challenges. That said, she remains confident that new technologies, medical advancements, and economies of scale can together make strides in improving human longevity and quality of life. Through Dr. Kawas' work with Propel Bio Partners, a biotechnology-focused venture capital firm, she can support biotech entrepreneurs who want to achieve these goals.