Global Dynamics and Digital Healthcare in Asia

KAWAHARA Norie introduced IKAWA Takahiro, noting that the theme of “Global Dynamics and Digital Healthcare in Asia” is a critical one in that digital advancements will continue to significantly transform the world of healthcare. However, at the core of digital design is the vision of the world we want to create, and it is crucial to consider whether the systems developed are acceptable to the communities that they serve. Mr. Ikawa’s perspective as an expert in this field will therefore be instructive. 

Through the lens of Japanese researchers exploring cancer in Asia, this course has developed a dual structure, reflecting both how Japan has engaged with Asia, together with the broader regional context of cancer studies in Asia through the perspective of Japanese researchers. 

Mr. Ikawa was introduced to the organizers of this lecture series by Mr. YACHI Shotaro, Chairperson of Fujitsu Future Studies Center, who has for many years been a leading figure in Japanese diplomacy, and was a guest speaker in this lecture series in 2011. It was Mr. Yachi who introduced the concept of international public affairs, which has become a fundamental pillar of the lecture series. 

This year marks the 50th anniversary of ASEAN, a time of significant change in Asia, where digital transformation is a key driver of societal change. Simultaneously, healthcare information, closely linked to personal data, represents a challenging area in terms of national security and international collaboration. The insights provided in this lecture will also connect to future lectures focusing on business field integration.

IKAWA Takahiro noted that he has been working for Fujitsu, a Japan-based technology company, for over 25 years. During that time he has been involved in various international businesses, including in Asia. He noted that he is currently tasked with researching international affairs, economies, and digital trends, in order to provide the Fujitsu executive team with insights and strategic recommendations for the medium- to long-term direction.

In terms of the international landscape, the world today is more complex than ever with significant shifts occurring. The influence of the United States in many fields, such as policy-making, diplomacy, and the economy, is seen to be declining, while regions like Asia or the Global South are becoming more prominent.

Economically, we face a period of uncertainty. This could lead to instability, as well as reducing the free flow of goods, services, people and capital, which are crucial for global trade.

In terms of the environment, the effects of climate change are becoming increasingly evident. We are witnessing more frequent natural disasters and experiencing natural resource shortages. Furthermore, we must address a range of pressing social issues, among which, for example, food security and energy sustainability are particularly critical. These areas are deeply interconnected with ongoing global changes, demanding an approach that combines both urgency and vision to navigate these complex challenges. Overall, understanding the international landscape is vital, as it influences many aspects of the current world. In terms of the global economy, it is crucial to understand the trends of the economic landscape as they often have far-reaching effects upon us. The global economic recovery from Covid-19 remains slow and appears to be losing momentum. In actual fact, the pace of recovery varies widely across the world. Furthermore, significant international issues, including the conflict between Russia and Ukraine, are having a profound impact. These events contribute to market instability and lead to rising prices for commodities such as food and energy, which in turn fuel inflation. This, unfortunately, may further slow economic recovery.

It is forecast that the global economy will grow more slowly at a rate of 3.0% in 2023, down from 3.5% in 2022. This is below the average of 3.8% over the past two decades. The slowdown is very clear in advanced economies, with expected growth decreasing from 2.6% in 2022 to just 1.5% in 2023.

Emerging economies have a somewhat different outlook. While their growth is also expected to slow, the rate of decrease is not as steep, with growth forecast to change from 4.1% to 4.0% over the next two years. These figures reflect economies that are facing significant challenges and are in the process of adapting to new global realities.

While the global economy is gradually recovering, the Asia-Pacific region still remains a key driver of global growth. The region's economy is expected to grow by 4.6% in 2023, which is better than the 3.9% recorded in 2022. Even with the impact of the pandemic, Asian economies have recovered quite fast. However, the speed of this growth is not the same across all of Asia. Some countries are moving ahead quickly, but others are still experiencing troubles.

Care must be taken with regard to the problems that can accompany fast growth, such as volatile markets, inflation, and instability. In fact, in 2024, growth might go down to 4.2%, and it may even go down to 3.9% over time. Even so, it is fair to say that the economy of Asia-Pacific region is performing quite well. A big part of this is the large population, a growing middle class, with increased consumer spending, all of which power a significant growth engine. This is also why more money is being invested in Asia from both inside and outside the region. 

However, challenges like declining birthrates, aging populations, and low productivity need addressing to ensure sustainable progress. These trends also relate to healthcare opportunities and challenges that will be discussed later. 

In the Asian region, China and India are major global players due to their large populations. The ASEAN region is also growing. Japan’s growth is slower which is common for nations with smaller, aging populations.

Economic security refers to ensuring that each country can safeguard its economic interests while maintaining stability and national security.

In terms of the background to current economic security, firstly, we are experiencing a shift in the global economy. This marks a change from the globalization of past decades. In some regions open and free trade is declining, coupled with increasing trade tensions between regions. Strategic economic practices are now important for governments and companies, which are focusing on being self-reliant and being strategically important in the world economy.

A prime example of this strategic economic practice is the European Union's “Promote, Protect, and Partner” approach. The European Union is actively strengthening its economic power by advancing in sectors like green technologies and digital technologies. They are also protecting themselves against economic threats. Furthermore, they are aiming to partner with a broad range of partners as far as they can. This is a good example of how to balance national interests with the benefits of global trade.

In other words, strategies such as that of the EU show the intersection of economics and security. Economy and security are now closer than ever before. Historically, companies were mainly responsible for business and economic growth, while governments took care of national security. However, the landscape has been shifting dramatically in recent years. There is an increasing degree of mutual influence between companies’ businesses and governments’ security concerns. Business operations can have implications for national security, and security policies can have an impact on business.

Understanding this dynamic is crucial for Asia which has become an indispensable player in the world economy. 

One recent trend is that exports of advanced technologies are becoming more regulated. Supercomputers, AI, and semiconductors are very good and well-known examples that are subject to controls. These technologies are vital for digital products and services such as smartphones and cloud computing, making this trend noteworthy. 

Furthermore, such trends also extend to pharmaceuticals, drugs, and biotechnology, which are directly affecting healthcare. Also, cross-border M&As involving advanced technologies are being more closely screened by governments. They can sometimes be delayed or rejected due to  national interests and security concerns, making cross-border business integration more complicated. 

Furthermore, countries like the United States have introduced a series of new regulations to specifically govern these areas. The trend indicates that technology is not just a means for innovation but also is a key element of economic security.

In response to these trends, companies and governments are making efforts to reorganize supply chains. 

Firstly, there are efforts to move from offshoring to reshoring, onshoring and near-shoring. The age of offshoring for cost-effectiveness is shifting. Some companies are now moving operations back to their home or closer neighbors, valuing closeness and stability over the lower cost.

Secondly, there is an increasing move from “just in time” to “just in case.” The “just in time” method, which minimized inventory and maximized efficiency, is giving way to “just in case” strategies. This new approach emphasizes the importance of redundancy and inventory security to buffer against supply chain disruptions.

Thirdly, is the move from efficiency to resilience. Whereas previously, the primary goal of companies was efficiency, which meant optimizing for speed and costs. Now, companies are increasingly focusing on resilience, which means the ability to withstand and recover from disruptions.

Finally, is decoupling and de-risking. “Decoupling” is the process of reducing economic dependencies with different regions, often as a strategic response to geopolitical tensions. On the other hand, “de-risking” means not cutting off economic ties but reducing risks associated with economic relations. Although fully decoupling from other economies may not be feasible, there is a growing trend towards de-risking in some regions to safeguard their interests. This suggests a strategic approach to navigating the uncertainties in the global business environment.

In this era, digital technology holds immense importance for the global landscape for several reasons. It is the engine of innovation and driver of economic growth while simultaneously contributing to national security. Additionally, digital technologies facilitate cross-border information exchange of software, data and services, so-called digital trade. Moreover, these empower individuals, companies and governments, ultimately leading to a sustainable society.

In this context, it is worth noting the substantial investments being made now. Governments and companies are investing tens of billions of dollars in this area to grow digital technologies such as AI, high performance computers, and semiconductors. For instance, it is well known that the United States, through the CHIPS and Science Act, actively supports digital investment and economic competitiveness.

Indeed, this race for technology investment is not happening in isolation. Nations are teaming up with each other and with companies to improve their capabilities. It is important to note, however, that even within these partnerships, competitive tendencies remain as each country pursues their own technological leadership.

Asia’s rise in this field has been remarkable. With a number of digital talents and a growing tech industry, Asia is an innovation leader.

As digital technologies intersect with every aspect of our lives, such as politics, economies and security, digital healthcare also holds paramount importance. Well-being, quality of life, and public health are indispensable for all of us for a variety of reasons. 

Firstly, in terms of demographic shifts, Asia, is grappling with a growing population, aging society, and declining birthrates. The healthcare systems of these countries need to be expanded to meet increasing demand for more comprehensive and advanced healthcare through digital technologies.

Next, in terms of rising healthcare costs, as healthcare costs continue to rise in Asia affordability is becoming a concern. We will need to establish digital solutions that balance costs without compromising the quality of healthcare in the future. 

Lastly, in terms of the trend of movement from treatment to prevention, the shift in focus from treatment to prevention is a significant change in healthcare systems. A proactive approach to health, emphasizing early disease prevention and wellness, has become increasingly important in addition to traditional and reactive medical treatments.

Digital healthcare plays a key role here. It provides a pathway to address the challenges posed by these shifts, ensuring the resilience of Asia’s healthcare systems for the future.

With regard to the tremendous potential of digital healthcare, the first example is e-medical records. These are not just digital files, but rather systems that could enhance the usability of patient data, allowing for better coordination among medical professionals and more informed decision-making among healthcare providers. Fujitsu is the biggest e-medical record supplier in Japan.

A second area is telemedicine, which provides patients in remote areas with access to medical services that would normally be out of reach. Telemedicine transcends physical distances by delivering the consultation room directly to the patient's home. It is particularly important for individuals with mobility challenges.

Also, in the area of drug discovery, it is said that high-performance computing (HPC) and artificial intelligence (AI) will be game changers in the future. They are anticipated to dramatically speed up the research and development of new drugs, making the process more efficient and potentially more successful. There are ongoing collaborations regarding research and development among pharmaceutical companies, computer companies, universities, and medical research entities. Fujitsu is a part of these activities using its various technologies.

Digital healthcare is not limited to the abovementioned areas. For example, AI has the potential to transform health checkups, diagnoses, and treatment plans, improving patient care and its outcomes. AI and HPC are driving a paradigm shift in surgical procedures. This integration is not only enhancing precision and efficiency but also optimizing patient outcomes.

The role of health-tracking devices is also becoming more integrated in our daily lives, providing continuous health monitoring and insights. These devices can bridge the gap between patients and medical service providers, enabling proactive healthcare focusing on prevention and timely intervention.

A wide variety of digital products and services are in development to address different healthcare requirements. One example is streamlining the supply chain management of healthcare providers. Another is optimizing drug production, manufacturing processes, and delivery methods such as the use of drones.

One final development is the explosive growth of generative AI, and AI is reshaping healthcare into a more efficient and personalized experience for everyone.

 While digital healthcare offers vast potential, it also brings with it several challenges that require careful consideration.

Firstly, there is a complex web of laws, regulations and standards across jurisdictions regarding healthcare. In the case of cross-border digital healthcare solutions, laws and regulations have become even more complex. These legal systems and regulatory systems in various countries require thorough legal review by professionals.

Liability concerning digital healthcare products, services and decision-making adds further complexity. For example, who is responsible for AI-supported medical decision making?

There are also issues of intellectual property rights and data ownership regarding patients’ medical data generated through digital services, AI or computer systems. 

Personal data protection, privacy, and cybersecurity are also concerns. Effective procedures to obtain agreement about collecting, using, storing, and transferring healthcare data must be established. Privacy concerns will require robust data protection and cybersecurity measures to be set in place. 

Ethical and legal standards for AI usage are also currently pressing issues. For example, “hallucination” in AI is a concern and important challenge. It refers to the incorrect interpretation of data by an AI program,  and it is this AI bias that can lead to erroneous or unfair outcomes. It is critically important to be cautious about the spread of disinformation. Particularly in digital healthcare the misuse of AI could have serious implications.

There are also other technical challenges to be faced, because in order to realize better digital healthcare it is necessary to build better networks, computers, datacenters and software. Furthermore, skilled digital engineers are also required. 

Cost factors are also critical, given that digital healthcare solutions often require substantial funding. For example, investments in supercomputing, broadband, and computer systems demand significant resources before services can be provided. In fact, while HPC is invaluable in digital healthcare, the associated costs of its design, development, manufacturing, and operation are substantial. Only a limited number of organizations have the capacity to afford such investment at the current time.

Developing new business models is also crucial due to the shift from traditional healthcare practices to innovative digital technologies. Since new participants, from startups to traditional service providers, are entering into the market, business models are needed that will ensure the industry is not only accessible but also economically sustainable.

Finally, Asia’s geographic characteristics, such as numerous islands and vast oceans pose unique challenges for the deployment of digital healthcare. Such  geographic and topographic conditions will necessitate robust digital solutions like telemedicine. Digital healthcare in Asia therefore faces complex challenges, which if they could be overcome could open up many opportunities.

As the world becomes increasingly complex, Fujitsu is well placed to play a significant role in the field of digital healthcare. Fujitsu’s purpose is to make the world more sustainable by building trust in society through innovation. In essence, Fujitsu’s ultimate goal is to contribute to the happiness and well-being of people. 

Fujitsu is not just a technology company. Its portfolio spans a broad range of IT products and services, across various sectors including digital healthcare. With more than 120,000 employees worldwide, Fujitsu has a significant presence including over 20,000 employees in the Asia-Pacific region. Fujitsu is the seventh largest IT service provider in the world, and number one in Japan, and supports customers in more than 50 countries and regions. Fujitsu‘s legacy in the Asia-Pacific region spans over 45 years of innovation with a network of more than 45 locations. With regard to Fujitsu Malaysia, since commencing business operations in 1997 and opening a development center in 1998, Fujitsu has been a presence in Malaysia for more than 25 years. The company employs over 600 IT professionals there and the company’s offerings go beyond simple IT services with hundreds of engineers engaged in system development, management, and operations.

Fujitsu is deeply engaged in digital healthcare which is an integral part of its new business strategy. Specifically, in 2021, a strategic decision was made by Fujitsu to reorganize its business, to concentrate its resources, including investments, on seven key focus areas. This led to the creation of Fujitsu Uvance as a new global business model. The name combines “Universal” and “Advanced,” showing that our goal is to make all things move forward, to create a better, sustainable future, and to serve our purpose. 

Within Fujitsu Uvance, "Healthy Living" stands out as one of the seven key focus areas. Fujitsu's commitment to healthy living is unwavering with a mission to enhance the well-being of individuals. Our approach transcends conventional methods of medical practices, pivoting towards prevention, in order to integrate health services seamlessly into the daily life of people.

This shift requires collaboration among patients, healthcare professionals, governments, and companies to foster a comprehensive healthcare ecosystem. The objective goes beyond delivering care to include devising sustainable health solutions.

Digital healthcare relies heavily on advanced technologies, and as a global technology company, Fujitsu is deeply engaged in the healthcare sector, using our proprietary technologies and knowledge to tackle important social issues and enhance the health of people. Research focuses on five critical technological areas, set out below. 

i) Computing: We use HPC for complex tasks like simulating new drugs and analyzing medical data. Fujitsu’s supercomputers bring the speed and power needed for these demanding jobs. Fujitsu has also developed, manufactured and operates one of the world’s fastest supercomputers together with our research partner, RIKEN.

ii) Networks: The new 5G technology Fujitsu is rolling out provides fast, responsive connections. This is crucial for sharing large medical data quickly, supporting telemedicine and digital healthcare devices, which enables remote patient care and professional collaboration.

iii) Artificial Intelligence (AI): As noted above, AI is revolutionizing healthcare by automating various tasks, improving diagnosis, and analyzing medical data to tailor treatments to patients.

iv) Data and Security: Protecting patient data is paramount, and security technologies ensure that this information remains safe and secure.

v) Converging Technologies: Fujitsu is exploring quantum computing and digital annealing, and quantum inspired computers with a view to solving complex optimization problems in healthcare that are beyond the capacity of conventional computers.

The above technology areas are the foundation of Fujitsu’s Healthy Living business. Fujitsu offers the Healthy Living Platform, a comprehensive data utilization system that facilitates the sharing of medical and healthcare information among patients, doctors and related entities, while always complying with applicable rules and standards. In addition, Fujitsu also delivers analytic solutions, including scheduling of medical resources and simulations for drug discovery. Future plans include the introduction of services that offer health and disease predictions along with tailored recommendations.

In conclusion, it is clear that global dynamics, characterized by a complex international landscape and uncertain economic conditions along with economic security issues, are influenced by digital technology. Its impact on the evolving digital healthcare sector in Asia is particularly immense.

While digital technology enhances patient care and efficiency, we also are encountering challenges like undeveloped digital infrastructure, a lack of skilled engineers, and complex legal and ethical landscapes.

It is clear that collaboration is of critical importance. While collaboration itself may present challenges, it is central to innovation and progress. This year marks the 50th anniversary of Japan-ASEAN friendship, and it is hoped that this anniversary year will provide a stepping stone to more collaboration in the years ahead. 

In summary, our collective efforts are crucial for creating a sustainable, progressive digital healthcare landscape in Asia. Fujitsu Uvance represents our commitment to enhancing healthcare solutions through digital technologies. Together, we aim to make a lasting impact through continuous innovation and strategic partnerships. 

Mr. Ikawa asked students to consider examples of ideas for using digital technologies to address healthcare challenges in Asia.

Dr. Kawahara asked about the term “economic security,” and whether countries in Asia, specifically Southeast Asia, are as aware of the term and what it entails as some Western countries. 

Mr. Ikawa responded that the economic situation is very complicated. ASEAN is part of the Global South and positioned between various regions. Even if ASEAN may be politically close to the Western regions, in economic terms it may be closer to other regions. The economic status diverges from country to country in ASEAN. It is important to balance the economic situation with political tensions to get a better solution for all persons. 

A student noted that digital healthcare technologies could be of great help in diagnosis and other areas, as well as a platform for sharing information among different areas. When digital healthcare systems are applied in aging societies, is it likely that there will be any challenges that could be expected given that elderly people may be unfamiliar with using digital devices?

 Mr. Ikawa noted that he had touched upon the challenges relating to data, but in the case of aging societies there is a digital divide with elderly people being generally less able to deal with digital technologies. Digital technologies are gradually becoming easier to use, and it is hoped that these advances will help to reduce the digital divide. Various digital technologies are under development and the development costs are very high, but the user interfaces are sometimes not so easy to utilize. More attention needs to be paid to user interfaces. 

 A student noted that there is an interesting phenomenon in Asia, namely, that it has been the fastest region to recover from the pandemic. However, Asia’s technological strength and economic strength are not necessarily as strong as the United States and Europe. Given the lack of development in some Asian countries, how could advanced technologies be rolled out in Asia? 

 Mr. Ikawa noted that the populations of Asian countries are on the whole younger than Western countries. One of the reasons for the speedy recovery from the pandemic may be the fact that there are high populations and the economies are still in the development phase, leaving tremendous room for growth. Skilled engineers are incredibly important for the future development of the society and economic growth, and Asia is relatively well-positioned in this respect. Mr. Ikawa added that Fujitsu has had business operations in Malaysia for over 25 years, and Fujitsu employs over 500 people in its research and development center there.

Dr. Ishida (University of Melbourne) asked about healthcare-related IT services in Malaysia, noting that IT products and services are likely to be currently different to those provided in advanced economies such as Japan. 

 Mr. Ikawa responded that in Malaysia Fujitsu has designed applications for enterprises and businesses and operating the computer systems including software for such clients. Fujitsu is also providing data center services and IT products in Malaysia. 

 Mr. Isobe (PMCARE) noted that he is engaged in the healthcare business in Malaysia and agreed that there is an increasing shift from treatment to prevention, or wellness and wellbeing. He noted that he is originally from Sumitomo Corporation, which is now running several clinic chains in Malaysia. In terms of pain points, corporate clients describe medical cost inflation of more than 10-15% each year as a significant challenge. Most private companies cover the medical costs of their employees, so medical cost inflation incurs costs for such companies. One thing to consider is therefore how to shift investment resources from treatment to prevention, because that is an area where the return on investment is likely to be better. He asked if Fujitsu’s analytics have come up with any examples in Japan or other countries of investment in preventive healthcare. 

Mr. Ikawa responded that in terms of the medical situation, while Fujitsu is seeking to shift business focus to preventive healthcare and wellbeing and this is still a work in progress. Various services and offerings are under development hopefully to address the pain points of stakeholders. 

Mr. Mori (Asia Cancer Forum) referred to Fujitsu’s active engagement in digital healthcare and asked which countries Fujitsu is focusing on in addition to Malaysia. 

 Mr. Ikawa responded that in terms of the healthcare business, Asia is a market with great potential, but Fujitsu is still in the early stages of its activities in terms of healthcare. Digital healthcare will be challenging in terms of costs and investments, but it has great potential, particularly as an area for action by startups. 

 Dr. Kawahara thanked Mr. Ikawa for his lecture and discussion noting that collaboration is truly at the heart of innovation. She noted that the wisdom shared in this lecture will be passed on to future lectures and add to the seminar series’ body of knowledge.