Go Lean…Caribbean

Go Lean Commentary

This foregoing article presses the point about innovation in diabetes care and maintenance – qualifying the great need that we have in the Caribbean.

 By: Caroline Copley, Kate Kelland in London and by Katharina Bart and Paul Arnold in Zurich

ZURICH (Reuters) – Swiss drug-maker Novartis has struck an agreement with Google to develop “smart” contact lenses that would help diabetics track their blood glucose levels or restore the eye’s ability to focus.

The device for diabetics would measure glucose in tear fluid and send the data wirelessly to a mobile device, Novartis said. The technology is potentially life-changing for many diabetics, who prick their fingers as many as 10 times daily to check their body’s production of the sugar.

Success would allow Novartis to compete in a global blood-sugar tracking market that is expected to be worth over $12 billion by 2017, according to research firm GlobalData. Diabetes afflicts an estimated 382 million people worldwide.

The second approach is for presbyopia, in which aging eyes have trouble focusing on close objects. Novartis hopes the lens technology will help restore the eye’s ability to focus, almost like the autofocus on a camera.

Non-invasive sensors, microchips and other miniaturized electronics would be embedded into the contact lenses.

Under the deal with Google, Novartis’s Alcon eye-care unit will further develop and commercialize the lens technologies designed by Google[x], the American company’s development team.

Financial details were not disclosed.

The alliance comes as drug-makers explore ways for technology to reshape healthcare, helping patients monitor their own health and lowering the costs of managing chronic diseases.

In turn, technology firms such as Apple Inc, Samsung Electronics Co and Google are trying to find health-related applications for wearable devices.

Novartis Chief Executive Joe Jimenez said he hoped a product could be on the market in about five years’ time.

“This really brings high-technology and combines it with biology and that’s a very exciting combination for us,” Jimenez told Reuters.

“I think you’re going to see more and more areas of unmet medical need where companies like Novartis are going to take a non-traditional approach to addressing those unmet needs.”

Although the licensing deal is just for the eye, Jimenez said the drug-maker was also thinking about how technology could be applied in other areas, such as remote patient monitoring in heart failure.
Reuters News Wire (Retrieved 07-15-2014) –
http://news.yahoo.com/novartis-hopes-commercialise-smart-lens-within-five-years-091941956–finance.html

There is a high rate of occurrence of diabetes in the Caribbean region – it is one of the primary causes of death – one in five people are afflicted. This is a crisis, and a crisis is a terrible thing to waste! This is the declaration of the book Go Lean…Caribbean.

There is also a race to create technological solutions in response to dealing with this crisis. This book’s assertion is that innovations will spurn new economic activity.

While the Go Lean book is not a Medical Journal, (see Medical Journal Article Summary below ^[Appendix]), it does advocate for a culture of innovation and a solution-minded focus. This is described in the book as community ethos. The book then strategizes a roadmap for economic empowerment, it clearly relates that healthcare and disease management are germane to the Caribbean quest for health, wealth and happiness.

This book purports that a new industrial revolution is emerging in which the Caribbean people and society must engage. This is  pronounced at the outset of the Go Lean book in the Declaration of Interdependence (Pages 12 & 14), with these opening statements:

ix.   Whereas the realities of healthcare and an aging population cannot be ignored and cannot be afforded without some advanced mitigation, the Federation must arrange for health plans to consolidate premiums of both healthy and sickly people across the wider base of the entire Caribbean population. The mitigation should extend further to disease management, wellness, obesity and smoking cessation programs.

xxvii.   Whereas the region has endured a spectator status during the Industrial Revolution, we cannot stand on the sidelines of this new economy, the Information Revolution. Rather, the Federation must embrace all the tenets of Internet Communications Technology (ICT) to serve as an equalizing element in competition with the rest of the world. The Federation must bridge the digital divide and promote the community ethos that research/development is valuable and must be promoted and incentivized for adoption.

This book Go Lean… Caribbean, serves as a roadmap for the introduction and implementation of the technocratic Caribbean Union Trade Federation (CU). This effort will marshal the region to avail the opportunities associated with technology and healthcare. There is the need to better care for our citizens and a plan to foster a local disease management industry, so that we may invite the aging Diaspora back to their ancestral homelands. In fact The CU/Go Lean roadmap has these 3 prime directives:

• Optimization of the economic engines in order to grow the regional economy.
• Establishment of a security apparatus to protect the resultant economic engines.
• Improve Caribbean governance to support these engines.

There is a lot at stake for the Caribbean in considering this subject area. According to the foregoing article diabetes afflicts an estimated 382 million people worldwide. Those who live-work-and-play in the Caribbean have crossed paths with many afflicted ones. Many of these are loved ones (young and old) and we would want to do anything/everything to help them. The Go Lean book dictates that an “anything/everything” attitude should be reflected in our Research-and-Development community ethos. In a previous blog entry (http://www.goleancaribbean.com/blog/?p=554  “Cuban cancer/diabetes medication registered in 28 countries”), some great R&D progress from Cuba was highlighted. We are urged to do more than just mourn the passing of our loved ones, but also foster the climate, environment and atmosphere to forge change in healthcare deliveries. Engaging this ethos early can result in many new jobs, and most importantly, many new opportunities to save lives and impact the Greater Good.

The book details other ethos to adopt, plus the executions of the following strategies, tactics, implementations and advocacies to forge research-and-development and industrial growth in Caribbean communities:

Historically, the Caribbean is quick to adapt to technological ubiquity – cable TV, internet and mobile phones proliferate in the region. But this is only true for consumption, not creation. So the management of change in the Caribbean now must include the attitude that we must also “contribute a verse” to the ongoing stage play that is modern life.

Some communities in the Caribbean have started, like Cuba discussed in the previously cited blog.

We now entreat the rest of the Caribbean to join in, to lean-in.

Download the book Go Lean…Caribbean now!

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APPENDIX – Medical Journal Article Summary: Diabetes in a Caribbean population: epidemiological profile and implications

By: Anselm Hennis ^[a][b][c],  Suh-Yuh Wu ^[c], Barbara Nemesure ^[c], Xiaowei Li ^[c], M Cristina Leske ^[c] and for The Barbados Eye Studies Group ^[b][c][d],

Published: International Journal of Epidemiology (2002) Volume 31 – 01

Accepted: July 11, 2001.

Objective: To examine the distribution and impact of diabetes, glycaemic status, and related factors, in a predominantly black adult Caribbean population.

Methods: The study included 4709 people, or 84% of a simple random sample of Barbadian-born citizens aged 40–84 years, examined between 1988 and 1992 and re-assessed 4 years later. Diabetes was evaluated according to physician-diagnosis and glycosylated haemoglobin (GHb). Associations were assessed by logistic regression analyses, cumulative mortality by product-limit methods and death-rate ratios by Cox proportional hazards regression.

Results: Among the 4314 black participants, the prevalence of known diabetes, predominantly type 2, was 9.1% at 40–49 years of age and increased to 24.0% at 70–79 years. The overall prevalence was 17.5%, while it was 12.5% in mixed (black/ white; n = 184) and 6.0% in white/other participants (n = 133), only 0.3% had younger-onset. Additionally, 2% had GHb >10% (>2 SD over the mean) without diabetes history. Sulphonylureas were the most frequent treatment, while insulin use was infrequent. In black participants, diabetes was positively associated with age (OR = 1.03 per year; 95% CI : 1.02–1.04), diabetes family history (OR = 2.85, 95% CI : 2.39–3.40), hypertension (OR = 1.71, 95% CI : 1.42–2.05), obesity (BMI ≥25 kg/m2; OR = 1.74, 95% CI : 1.44–2.10), and high waist-hip ratio (WHR ≥0.92; OR = 1.29, 95% CI : 1.09–1.53). Ocular co-morbidities were increased among people with diabetes, as was 4-year-mortality (death rate ratio = 1.42, 95% CI : 1.10–1.83). There was a 9% increase in mortality for each 1% increase in GHb (death rate ratio = 1.09, 95% CI : 1.04–1.15).

Conclusions: A markedly high prevalence of diabetes existed in the adult black population, affecting almost one in five people and increasing morbidity and mortality. Prevention strategies are urgently needed to reduce the adverse implications of diabetes in this and similar populations.

Download the entire Medical Journal article here: http://ije.oxfordjournals.org/content/31/1/234.full.pdf+html

Citation Sources:

a. School of Clinical Medicine & Research, University of the West Indies.

b. Ministry of Health, Barbados, West Indies.

c. University Medical Center at Stony Brook, Stony Brook, NY, USA.

M Cristina Leske, Department of Preventive Medicine, University Medical Center at Stony Brook, HSC L3 086, Stony Brook, NY 11794–8036, USA. E-mail: cleske@notes.cc.sunysb.edu

d. The Johns Hopkins University School of Medicine, Baltimore, MD, USA.