For Swedes, research and innovation are a way of life
TODAY reports: Public support, political will and academic fervour all play a part in fostering a culture for research and development in the Scandinavian state.
- Posted 09 Jan 2016 08:31
- Updated 09 Jan 2016 08:36
STOCKHOLM: Speaking to a group of journalists from Japan, Malaysia, Singapore, Germany and Poland. Professor Martin Ingvar of Sweden’s Karolinska Institutet declared: “People like research. We make it easy for people to participate in research.”
Prof Ingvar was not referring to his colleagues at Karolinksa, one of the world’s leading medical universities located in Stockholm, which accounts for more than 40 per cent of medical academic research in Sweden. He’s talking about the public.
Professor Martin Ingvar, Karonlinska Institutet's deputy vice-chancellor for the coordination of matters relating to future healthcare. (Photo: Karolinska Institutet)
For instance, the Karolinska Mammography Project for Risk Prediction of Breast Cancer, or Karma, has had more than 70,000 women opting in and is the world’s best-characterised breast cancer cohort.
The women fill up a detailed questionnaire, and Karma collects data and biosamples each time a participant does a mammography screening or clinical mammography at participating hospitals, and again from those diagnosed with breast cancer. These are linked to various registers such as inpatient and cause-of-death registers with the women’s consent, helping researchers to do better risk prediction.
Such willingness – possibly linked to Swedes’ relatively high interest in science and technology and confidence in university researchers – coupled with the Swedish system of personal identification numbers, means people can be tracked for a long time and researchers are able to obtain information on their follow-ups after various diseases.
“Nowhere else would you be able to get that,” said Prof Ingvar, Deputy Vice-Chancellor for the Coordination of Matters Relating to Future Healthcare.
It is a very important part of the Swedish healthcare system, Prof Ingvar told the journalists who were on an innovation-themed media trip organised by the Swedish Ministry for Foreign Affairs. “When we do a follow-up of, say, 50,000 men who used a screening procedure against prostate cancer, 10 years later we can find 90 to 95 per cent of them, to see if they’ve contacted healthcare services. Which means we have the ability to make statistics on large scale populations with a precision no one else can achieve,” he said.
Extensive registers and biobanks, as well as top research institutes, are draws in getting others to collaborate with Sweden in biomedical research, said Ms Jenni Nordborg, director of the health division at Vinnova, a government agency tasked with strengthening the country’s capacity for innovation.
It is important for the Scandinavian country of 9.4 million people – commonly described to journalists as “small” during the trip – to be globally attractive for investors and research and development, officials said.
The sun sets against the skyline, throwing a reflection off ice crystals in the air to produce a sun pillar phenomenon in Stockholm, Sweden. (Photo: Reuters)
The country, already ranked highly in innovation, has got other things in its favour: Swedish schools are “distinctly anti-authoritarian” and encourage creativity, wrote Ms Eva Krutmeijer, a professional science communicator, in Innovation The Swedish Way, published by the Swedish Institute, a public agency. It is a peaceful democracy that is highly dependent on trade, highly connected and one of the world’s largest investors in research and development relative to gross domestic product (GDP).
According to the Swedish Institute, publicly-funded research in 2012 was just over 37 billion Swedish kroners (SEK) (S$6.1 billion), or 1.04 per cent of GDP. Around 75 per cent of Sweden’s research is financed by companies.
There is total political agreement on the importance of investment in medical research, said Mr Anders Lonnberg, the government’s national coordinator for life sciences. One hour of work in life sciences generates about 1,400 SEK in GDP, far higher than the 450 SEK from regular work, he said. “If we want to keep up the welfare state in the future, we have to be in sectors that have very high value.”
As Singapore makes a renewed push in research and development – a crucial engine for growth in the future economy – TODAY looks at the factors behind Sweden’s success in creating a culture of innovation that permeates its society, from research institutions and universities right through to private companies and the man-in-the-street.
HARDWARE AND HEART
Sweden has built facilities to bring researchers, medical practitioners and the public together, and work is underway to ensure the system also incentivises collaboration among academics, hospitals and the private sector. On their part, universities try to ensure good ideas are funded and help their academics and students with start-ups to commercialise their research.
Karolinska Institutet's Aula Medica building, which houses a 1,000-seat auditorium. (Photo: Neo Chai Chin/TODAY)
The journalists’ meeting with Prof Ingvar and several researchers took place in Karolinska’s new Aula Medica building – a futuristic lecture hall complex financed by a donation from the Erling-Persson Family Foundation, whose chairman Stefan Persson is also chairman of clothing behemoth H&M.
Aula Medica opened in 2013 and its 1,000-seat auditorium enables Karolinska to organise major public events such as Nobel lectures. Stockholm also happens to be the birthplace of Nobel Prize founder and dynamite inventor Alfred Nobel, and where laureates gather each year for ceremonies and lectures.
The Science for Life Laboratory, or SciLife Lab, is another facility. A national centre for molecular biosciences that focuses on health and environmental research, it is jointly operated by Karolinska, the KTH Royal Institute of Technology, Stockholm University and Uppsala University. More than 1,000 scientists are linked to the centre, including Dr Valtteri Wirta, head of its clinical genomics unit.
Dr Valtteri Wirta, head of the clinical genomics unit at Sweden's Science for Life Laboratory, shows where DNA sequencing is done. (Photo: Neo Chai Chin/TODAY)
Technical manager Tomas Askerud demonstrates how to use the Sectra visualisation table at Karolinska University Hospital's clinical skills and simulation centre. (Photo: Neo Chai Chin/TODAY)
Diagnosis of children with rare diseases is his unit’s biggest success so far, said Dr Wirta, crediting Professor Anna Wedell of Karolinska University Hospital for pioneering its work. SciLife Lab’s clinical genomics unit receives requests from the hospital to sequence the DNA of children with rare inherited and metabolic diseases.
Previously, such diseases would typically take five years to diagnose and involve much more guesswork, resulting in distress for families and delays in therapy. With next-generation sequencing, the scientists are able to screen the genes in two to three weeks – or as quickly as a day at a higher cost – and report the results to the clinicians. The unit has sequenced 800 patients in the last 21 months and is confident of sequencing 1,000 patients a year, said Dr Wirta.
“Our wish is that at some point, this would become the first line of diagnostics. This is not science fiction, this is reality today,” he said. “We started with rare diseases, we want to expand and the cancer field is one of the great things we want to go into.”
Another key institution is the New Karolinska Solna University Hospital, which will open its doors to patients at the end of this year and replace the present Karolinska University Hospital. Featuring single rooms for inpatients, it will provide highly specialised healthcare and conduct basic research, patient-focused clinical research and education. The aim: To get new research findings translated into new treatment methods more quickly.
The journalists visited the current university hospital’s clinical skills and simulation centre, to have a look at some of the more notable equipment available for staff and students to train on. The Sectra visualisation table, for instance, is “like a big iPad”, said the centre’s director Gunilla Bolinder. 3D renderings of various layers of the human body can be easily viewed from many angles on the table and this helps with teaching of the anatomy and team discussions.
Dr Gunilla Bolinder, director of Karolinska University Hospital's clinical skills and simulation centre. Mannequins are covered up and handled with respect at the centre, just as patients are treated in the hospital. (Photo: Neo Chai Chin/TODAY)
The centre will have more advanced equipment in time to come but its central objective will remain. “The patient always comes first, but never the first time on the patient,” said Dr Bolinder, a straight-talker who was typical of the experts encountered on the trip, for whom job titles and often-impressive credentials were more of a footnote.
These experts readily shared areas in which other countries were ahead of Sweden, and were comfortable speaking about their research in plain English stripped of tricky jargon, with understated humour thrown into the mix. Case in point: Prof Ingvar complimenting Singapore on its efforts to take research from bench to bedside.
“We try to do what Singapore has done. We’re trying to increase the speed of the development process, the innovation process from molecular science to the patient,” he said.
At the simulation centre, students and staff train just as they would in a clinical setting – this means mannequins are treated with respect and covered with sheets instead of being left exposed, for example.
The hospital also has a students’ emergency department situated beside its actual emergency department, where medical, nursing and physiotherapy students guided by tutors take care of willing orthopaedic patients. This gives students a taste of working in a team with others and shortens the waiting time for some patients, said Dr Bolinder. Participating students have been found to be “very happy” and engaged, she said.
FOR A START, DANCING TOGETHER
Over at Uppsala University, a 40-minute train ride 70km north of Stockholm, students and staff are given a leg-up to capitalise on their research breakthroughs. Its innovation office, called UU Innovation, is staffed by 29 professionals able to manage collaborations and advise on intellectual property and business. “Academia and the business sector are not dancing together very well, you need someone who’s helping with that,” said Dr Pirkko Tamsen, director of UU Innovation. “If you are a researcher and you enter the door, we will help you and guide you to the right place to get support.”
Dr Lars Jonsson, chief executive of Uppsala University Holding Company, and Dr Pirkko Tamsen, director of Uppsala University Innovation. Both entities aim to help academics and students who wish to commercialise their research. (Photo: Neo Chai Chin/TODAY)
The office helped develop more than 100 ideas in energy, materials science, drug development and other areas in 2014, and also helped students start their own companies through the student incubation centre. It also brings the business community to the table by inviting them to submit questions they want academics to help solve. Parties are then matched on Academic Industry Meeting Day (AIMDay).
Uppsala University Holding Company, a for-profit organisation controlled by the university and government, provides early seed money in exchange for a minority share in a new venture, said chief executive Lars Jonsson. It has 50 active portfolio companies, about 10 of which are doing very well and about 15 others that are “very promising”, he said. Ranked among the top five business incubators in Europe, its net profit over 20 years (between 1995 and 2014) from an investment of 134.9 million SEK (S$22.3 million) is 56.2 million SEK, with about 50 million SEK yet to be realised, he said.
Unlike some other countries where universities own inventions from publicly funded research, Sweden has a “professor’s privilege” law mandating that all results from research are the private equity of the researcher. This came about between the two World Wars to stimulate technological development in Sweden, said Dr Jonsson. Between increasing the salary of professors and offering them the possibility of earning extra outside of the university, the latter was the cheaper option.
Professor’s privilege has worked “quite well” and UU Holding Company is involved in an average of 30 patent applications each year, with two-thirds of researchers going through it, he said. Companies in its portfolio include one able to produce 3D holographic labels using a cheaper method, and another that has developed a test to monitor tumour growth during cancer treatment.
At the national level, Mr Lonnberg said policymakers are looking at issues such as incentives for the healthcare system to use new products, and for university researchers to be awarded the same “merit” points whether they collaborate with others within the university, or with external partners such as pharmaceutical companies and hospitals.
There is currently less incentive to collaborate with external partners, he said. “All three sectors need to cooperate to produce functioning new treatment. One sector cannot say, we are more important than you, or that companies are dangerous because they buy lunches for doctors and send them to Hawaii,” he said.
Mr Anders Lonnberg, the Swedish government's national coordinator for life sciences. (Photo: Yuichi Morii)
All parts of the whole – coordinating the efforts of different government ministries, having various players agree on an agenda, getting incentives right and giving smaller companies a helping hand – are essential in the innovation push, he said.
In the short run, connecting information systems to be able to harvest big data and real-world data from the medical system is vital, so that healthcare providers get feedback on what they are doing and what happens to patients, said Mr Lonnberg. “For patients, the future has never been so bright and so full of hope.”
Read the original TODAY report here.