Technical Insights: Top Medical Technologies 2011
 

Technical Insights: Top Medical Technologies 2011

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Technical Insights: Top Medical Technologies 2011 Technical Insights: Top Medical Technologies 2011 Presentation Transcript

  • Top Medical Technologies: High Impact Medical Devices and Imaging (Technical Insights) D29C-TI March 2011
  • Table of Contents
    • Executive Summary
    • Technology Snapshot
    • Impact Assessment and Trend Analysis
    • Application Scope
    • Technology Roadmap
    • Analyst Insights
    • Industry Players
    • Glossary
    • Decision Support Database
  • Research Scope
    • This research service titled “ Top Medical Technologies ”, is an attempt to showcase high-impact medical device and imaging technologies that have excellent growth potential in the next 3-4 years and are likely to enhance patient care. The technologies profiled include those that are on the verge of undergoing incremental innovations with significant potential to improve patient quality of life. Emerging technologies, which are likely to change the current practice of medicine have also been profiled.
    • The technologies selected for the research service have been based on some of the following criteria.
    • Multiple end user benefits (patients, medical personnel, clinical labs, hospitals, researchers)
    • Unmet market need/potential
    • Safety/non-ionizing
    • Portability/Wearability (Point-of-care health delivery)
    • Minimally invasive/noninvasive
    • Cost and time savings
    • Ease of adoption/market acceptance
    • The content for each technology has been broadly outlined, which will include key features of the respective technology, the ongoing major technological advancements, the stakeholders involved, future roadmap and analyst insights.
    • While its difficult for all to agree unanimously about the top technologies profiled in this research service, most would agree that these technologies are important and are worth the attention.
  • Industry Overview
    • Increasing awareness among the general public is driving the demand for innovative and minimally invasive diagnostic and treatment methods. These would help in reducing the overall cost and trauma of healthcare for the ultimate end users--the patients.
    • Other end-user communities such as physicians and hospital groups are also becoming more receptive to such innovative technologies and are willing to adopt them, as long as they offer optimal clinical outcomes and high ROI.
    • The medical device industry is constantly evolving with the goal of bringing about radical advancements in treatment patterns and patient care. Driven by changing demographics and disease patterns, patient awareness, emphasis on efficiency of care, these innovative technologies are poised to bring out changes such as altered professional roles, increasing consumerism and an empowered patient community.
    • A new tax in the medical device industry in 2013 and the FDA stalling new devices in the US, medical device firms will look for greener pastures else where for gathering clinical data, new-product approvals, and to make initial revenues.
    • Patients have to travel abroad to places such as Mexico, India for treatments developed by US companies. This will lead to US medical companies shifting clinical trials offshore, resulting in jobs and investments in infrastructure and innovative biopharmaceutical and medical technologies following suit.
  • Medical Devices and Medical Imaging Technologies Medical Devices Medical Imaging Renewable and Sustainable Energy Remote Patient Monitoring Combination Devices Medical Robotics Ultrasound Imaging Optical Imaging Hybrid Imaging Whole Slide Imaging Smart Pills
  • Medical Devices
    • Overview
    • Increasing demand in overseas markets and ambitious investors’ drive to grow global profits has intensified growth rates.
    • US, Japan and Germany are the main consumers of medical devices, they also are the leading producers and exporters of high-quality and high-tech medical instruments and equipment's.
    • A strong bullish growth with high interest in the top middle income countries--namely China, Brazil, Mexico, India, and Turkey is expected.
    • Future Outlook
    • The medical device industry is taking baby steps in this rapidly evolving industry to address the healthcare perspective such as shortage of health personnel, difficulties getting spare parts, lack of standardization, limited budgets for maintenance and for purchasing consumables.
    • Research and development (R&D) should be focused on technologies that use alternate power supplies, resist heat, humidity, dust, relieve workload, require little maintenance, and can be operated with no risk to patient safety, by personnel with little specialized training.
    • Smaller and less expensive robotic systems that allow high-precision surgery will continue to be developed; synergy and miniaturization will direct future innovation in medical device design.
    Source: WHO Medical Device Report, 2009
    • Trends
    • Bullish market with overall sales set to increase.
    • Medical device firms plan to expand in China, India, and Brazil; however, these lucrative new markets are also the most difficult to enter. Developing countries are also investing heavily in developing their domestic healthcare market, which will continue to attract interest from companies located abroad.
    • China, Brazil, and India are considered markets with the best growth potential; while the US, Canada, and Germany are seen as moderate growth markets.
    Medical device markets by region (% sales revenue )
  • Renewable and Sustainable Energy Key Strengths
    • Designed for ruggedness, can withstand outdoor wear and tear
    • Minimal utilization of expensive, short life, disposable battery cells
    • Minimal training is required to operate the device
    Sneak Preview Why is it Important?
    • Medical devices powered from renewable energy has seen small, but sure progress
    • Photovoltaic cells have seen phenomenal growth with respect to the price factor and its efficiency, hence developing such medical devices achieve economies of scale
    • Mainly employed in low resource countries where such devices can see very high growth
    • Improves quality of life for patients at affordable price
    • Increases global health care standards without much dependence on existing power infrastructure
    • Utilizes resources that are free, abundant and have no adverse damage on the environment
  • Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 R&D progressing on microelectronics and MEMS technologies – compact, cheap and powerful devices High High High 2 Focus on battery system redesign, smart power management, low power radio (wireless link) – durable devices with less dependence on conventional resources High High High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 High cost of devices given the limited resources available High Medium Medium 2 General lack of trained manpower and limited training of personnel High Medium Low 3 Absence of accurate, easily obtainable, inexpensive devices High Medium Low 4 Limited awareness of the problems associated with conventional measurement techniques Medium Medium Low 5 Marketing of nonvalidated measuring devices High Medium Low
  • Remote Patient Monitoring Sneak Preview Why is it Important? Key Strengths
    • Remote monitoring of a patient employing various technological devices
    • Mainly employed in treating chronic diseases for preventive care
    • Reduces hospital visits and hence results in cost-effective health care solution
    • Improves quality of life for patient
    • Brings around simple and easy-to-understand technology for chronic disease management
    • Elderly patients can be taken care of remotely while enjoying the comforts of their home
    • Saves on healthcare labor costs as it is primarily a home-based platform
    • Increases quality of life while decreasing cost
    • Allows medical providers to see more patients in less time without geographic constraints
    • Minimizes the occurrence of emergency care and expensive hospitalization
  • Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Aging population Medium Medium High 2 Widespread chronic disease High High High 3 Health care consumers pushing for more convenience Medium High High 4 Expensive hospitalization and related high expenses High High High 5 Familiarity with remote patient technology Low Medium High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Lack of reimbursement High High Medium 2 Affordability High Medium Low 3 Regulatory barriers High Low Low 4 Improper network coverage; hostile attacks Medium Low Low 5 Lack of awareness; require training/assistance High Medium Low
  • Combination Devices Key Strengths Sneak Preview Why is it Important?
    • Breakthrough technology of combining drugs and biologics with devices to create new clinical benefits
    • Imaging agents that interact and detect metabolic abnormalities in a highly specific manner resulting in creating new tools for oncologists, cardiologists, and other specialties
    • Combination devices are capable of detecting multiple diseases in the early stages of infection--which could save valuable time, facilitating the containment of an incipient epidemic
    • Future potential for integrating combination device therapy with wireless healthcare can shift chronic disease management from hospital to a home setting
    • Polymers can easily be impregnated with a therapeutic agent, and the drug can be released quickly or slowly based on the indication
    • Lesser redesign requirements have allowed this segment to broaden into a wide array of short-term implantable devices
  • Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Novel formulations and polymer matrices Medium Medium High 2 Improved tumor targeting Medium High High 3 Enhanced permeability and retention achieved through nanocarriers Medium High High 4 Image guidance for monitoring drug uptake by cells Low Low Medium 5 Drug release modulation and therapy assessment Low Medium Medium 6 Demand for sophisticated drug delivery devices Medium High High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Patient compliance issues High High Medium 2 Bioavailability and biodistribution of drugs at targeted site High Medium Low 3 Requirement arising for encapsulating High High High 4 System toxicity and inability to cross epithelial barriers High High Medium 5 Drug payload and drug release characteristics High Medium Medium 6 Clearance issues associated with nanoparticles High High Medium
  • Medical Robotics Key Strengths
    • Allows medical providers to see more patients in less time, and better results
    • Minimally invasive, reduces hospital stay, and there is less chance of post operative risk
    Sneak Preview
    • Robots are seeing an increasingly important role in the health care scenario
    • Investing in equipment is initially difficult, but, considering the returns is beneficial
    Why is it Important?
    • Improves quality of life for patient, less operation time, less bleeding, less chance of infection
    • Physicians prefer robotic assistance as it leads to less fatigue and hand tremor
  • Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Improved efficiency and outcomes High High High 2 Demand from surgeons; reduces tremor and fatigue High High Medium 3 Increasing awareness among patients Medium High High 4 Reduce post operative risk of infection Medium High High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Lack of reimbursement High Medium Low 2 Low adoption due to high learning curve, budget constraints and high cost High Medium Low 3 Absence of established clinical data Medium Medium Low 4 Stringent FDA regulations and requirements results in high R&D expenditure by manufacturers Medium Medium Low
  • Medical Imaging
  • Key Trends in Medical Imaging Industry Shrinking hospital budgets and reimbursement cuts in developed countries have been challenging the sector’s growth. However, booming health economies in emerging countries will offset the slowdown witnessed in the developed world. With improved healthcare spending and the need for better health services, developing nations could witness emergence of new hospitals in public and private sectors and subsequent procurement of advanced imaging equipments over the decade. The developed markets on the contrary are likely to shift their focus on new technologies expected to be highly efficient and cost-effective to address the needs of cash strapped hospitals and healthcare clinics. In addition to the United States and Europe, major industry participants such as GE, Philips and Siemens, are also looking forward to explore Brazil, India, and China as potential markets in terms of investment and revenue generation in the coming years. In order to improve quality of health care, reduce patient treatment costs, and make healthcare available to millions around the globe, GE Healthcare has already launched the $6 billion healthymagination * initiative. Frequent product approval denials and delayed market entry in developed countries such as US are forcing medical device firms to look for greener pastures elsewhere for gathering clinical data, new-product approvals, and to make initial revenues. With this trend expanding, the consumers of developed nations who have long been the initial beneficiaries of the new medical technology innovations may eventually end up being the late users. Europe has already become the prime market of entry for new innovations. By the end of the decade, emerging countries are more likely to witness prior product launches before they enter developed markets. However, factors such as inadequate intellectual property (IP) protection, language barriers, weak distribution channels and lack of proper infrastructure are challenges that need to be overcome by companies wanting to invest in emerging markets. Medical imaging – one of the largest sectors of heathcare industry * - GE’s $6 billion investment initiative aimed at creating better health for more people, lowering heath care costs while improving quality and access.
  • Medical Imaging Future Outlook Source: WHO, World Medical Markets Factbook, 2009 The above figure shows the percentage of revenues by market sectors. Diagnostic imaging covers almost a quarter of the total medical markets. With new innovative technologies being added to this fold, this sector is expected to grow further in revenues globally.
    • Other major trends that are expected to drive the diagnostic imaging sector in the future include portability, miniaturization, digitization, non-ionizing imaging modalities such as optical and ultrasound and mobile health delivery aids such as smart pills.
    • Overall, the medical imaging sector is a growing market. Technological integration is a major driver with the advent of hybrid imaging modalities such as PET-CT and SPECT-CT. Now the combination of MRI and PET seems to be the most ideal hybrid, which would enable true simultaneous image acquisition rather than sequential imaging, which is the case with PET-CT.
    • The future looks promising in terms of low costs, portability, higher throughput and safety of upcoming technologies and a higher role to be played by potential markets such as India, China, and Brazil in the next few years. All these will eventually contribute to a steady growth of the global medical imaging industry.
  • Ultrasound Sneak Preview Why is it Important? Key Strengths
    • Ultrasound has been one of the mainstays of medical imaging and a major tool for primary diagnosis.
    • Having become an established imaging modality for primary diagnosis, ultrasound is now emerging as an important and safe tool for secondary diagnosis, with safety standards being strictly enforced by regulatory bodies.
    • The ultrasound is nonradioactive unlike other modalities such as MRI and CT, and also has a price advantage and even the most advanced ultrasound costs only one-fifth of a basic MRI equipment.
    • Portability, is another key feature not available in other modalities. This makes it a ubiquitous technology.
    • Ultrasound has the potential to be employed in surgery and interventional procedures apart from diagnosis.
    • Technology advances such as three-dimensional (3D) and four-dimensional (4D) imaging capabilities, elastography, and dedicated probe designs are expanding its application scope.
    • Ultrasound is now applicable as a secondary diagnosis following mammography due to an increasing number of breast screening procedures.
    • The technology’s versatility makes it a highly attractive modality not only for obstetrics and gynecology, but also for urology and other upper body applications.
  • Ultrasound - Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan. Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Noninvasive, non-ionizing and cost-effective technology High High High 2 Diversity of applications and ubiquitous nature Medium High High 3 Miniaturization, portability, improvement in image quality, fusion of modalities, 3D capabilities Medium High High 4 ER and ICUs demand PoC imaging systems--ultrasound provides the ultimate solution Medium Medium High 5 Multiple capabilities--diagnosis, therapy, image guidance Low Medium High 6 Potential for reduction of dependency on sonographers--empowers physicians Low Medium High Rank Challenge/Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Inadequate reimbursements of most ultrasound procedures High Medium Med-Low 2 Inability to image air filled organs (for example, lungs) necessitates an alternate scan (for example, CT) High High Medium 3 Poor battery life of portable ultrasound High Medium Low
  • Optical Imaging Sneak Preview Why is it Important? Key Strengths
    • Advances in photonics and fiber optics are giving rise to novel optics-based technologies that hold the potential to revolutionize the field of medical diagnostics.
    • Some of the optical imaging technologies holding short-term and mid-term potential include optical coherence tomography (OCT), hyper spectral imaging (HSI), and near-infrared spectroscopy (NIRS).
    • Optical technologies have the potential to improve the accuracy of medical diagnosis and also enhance drug discovery processes by enabling tissue and cell imaging at the molecular level.
    • Optical imaging is also very amenable for multimodal imaging. It covers a wide range on the imaging resolution scale and is often complimentary and can be easily combined with other imaging techniques.
    • Due to their low-cost, noninvasive nature, safety and breadth of applications, optical imaging techniques may become the most preferred modalities in the future.
    • On a broad level, optical imaging technology is in its infancy and there have been significant technology advancements over the last decade. Techniques such as OCT has developed rapidly in recent years and has been successfully deployed in ophthalmology and dentistry. This is paving the way for further technology developments in this space.
    • Due to rapid technology advances, optical imaging techniques are expected to have a huge impact in three to five years time.
  • Optical Imaging - Adoption Factors and Their Impact Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Technology advantages such as high-resolution, nonionizing, real-time imaging Low Medium High 2 Portable, noninvasive, safe and less expensive for home healthcare Low Medium High 3 High commercial value of optical imaging, coverage of multiple markets High High High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Lack of validated clinical data using optical methods restricts adoption High Medium Med-Low 2 Poor in-depth penetration limits applications High High-Med Med-Low 3 Slow approval process delays innovation and commercialization High High-Med Med 4 Current lack of reimbursements for optical imaging modalities High High-Med Low
  • Hybrid Imaging Sneak Preview Why is it Important? Key Strengths
    • Hybrid imaging refers to combining two different imaging methods in a single comprehensive technical system, to acquire anatomical and biological information in one study.
    • Hybrid imaging systems such as PET-CT and SPECT-CT allow much faster imaging, thereby reducing patient stress and are one of the mega trends in diagnostic imaging.
    • Due to skyrocketing medical imaging costs and poor reimbursement from federal programs, hospitals and practitioners continue to look for imaging modalities that will best serve their needs as well as provide a complete patient data. Hybrid imaging is a solution to this end.
    • Hybrid imaging allows physicians to diagnose and potentially treat disease earlier. This is of critical importance because most of the disease-related biological processes are already present in our systems. Detecting them before they are visible through anatomical changes provides better curative possibilities for the patient.
    • The high-quality information obtained boosts clinician confidence and results in improved treatment and patient outcomes, it terms of better health at much lower costs.
    • For imaging clinics and hospitals, hybrid scanners allow economies of scale to maintain or reduce the unit cost of individual scans.
    • Molecular imaging is going to be the Holy Grail for diseases such as cancer. Hybrid imaging is going to be the future enabling technology for molecular imaging.
  • Hybrid Imaging - Adoption Factors and Their Impact Drivers Restraints Source: Frost & Sullivan Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Overall reduction in patient healthcare expenditures Low Med-High High 2 Technology innovations such as TOF, solid-state detection , 4D imaging, HD-PET, MDCT, optical sensors and therapeutic ultrasound High High High 3 Ultimate enabling technology for molecular imaging Low Med High 4 Capability to meet clinicians’ needs for complementary image data High High High 5 Time savings and increased patient throughput Med Med High Rank Restraint/Challenge 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Inadequate reimbursement levels High Med Med-Low 2 High equipment installation costs increases procedural costs High High Med 3 Developing hybrid technologist skills through certified courses High High Med 4 Developing standardized protocols for various applications High High Med
  • Whole Slide Imaging (WSI) Sneak Preview Why is it Important? Key Strengths
    • Digital pathology is an emerging technology that refers to whole slide imaging (WSI) and digital capture of the tissue section on a glass slide as a single large image.
    • Image digitisation provides a novel platform for managing and interpreting the information and provides significant improvements in all phases of drug discovery (preclinical and clinical) and also for education, research and clinical diagnostics.
    • Digital pathology allows images to be used by a pathologist in ways that are simply not possible with manual microscopy.
    • Addresses pathologists’ unmet needs by enabling the right pathologist to analyze the right slide at the right time with the right tools, thereby providing improved patient care.
    • Delivers value in the form of cost reduction, efficiency, improvements in revenue as well as quality.
    • Provides improved decision support tools, including image analysis.
    • Enables a more efficient workflow, by enabling pathologists access remote slides via Web-based secure portals. This not only enables critical diagnosis, but also serves in education and improving pathologists’ skills.
    • Allows access to new and targeted therapies (personalized medicine).
  • WSI- Adoption Factors and Their Impact Drivers Restraints Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Improvements in efficiency and workflow enhancement of laboratories Medium High High 2 Cost and time savings due to elimination of slide remake and high-throughput processing Low Med-High High 3 Convergence of pathology and digital imaging with pharma Low-Medium High High 4 Improves diagnostic capabilities of pathologists and treatment outcomes for patients Low High High 5 Web access eliminates geographical barriers and enables peer review of global studies Low Medium High Rank Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Image storage/management and transfer High Medium Med-Low 2 Technical challenges, for example, interfacing with other information management systems (HIS, LIMS) High-Med Medium Low 3 Delayed regulatory clearance for digital pathology systems, especially for clinical diagnosis High-Med Med Low 3 Budgetary constraints for transitioning to digital pathology High Medium Med-Low
  • Smart-Pill Sneak Preview Why is it Important? Key Strengths
    • Smart pills are electronic, smart pills or miniaturized microsystems swallowed by human beings for various biomedical and diagnostic applications.
    • An example of smart capsule is capsule endoscopy, which already exists. Next generation intelligent pills capable of drug delivery and biosensing are fast emerging in the market.
    • When smart pills are coupled with wireless networks and mobile phones, they enable the captured information to be beamed to doctors allowing them to take a timely remedial action. This turns the technology into a disruptive innovation.
    • These capsules have multiple potential benefits. Earlier diagnosis of cancers in a noninvasive manner could be life-saving for patients. Other benefits include timely deliverance of drugs and wireless monitoring and delivering critical vital signs.
    • Enabled by MEMS, the smart pill technology will allow hassle-free imaging, biosensing, and drug delivery, thereby providing open the door for new therapy options for life-threatening and debilitating digestive tract disorders.
    • The combination of navigational feedback, electronically controlled drug delivery and monitoring of the intestinal tract makes smart-pill technology a valuable research and diagnostic tool.
  • Smart Pills - Adoption Factors and Their Impact Drivers Restraints Rank Driver 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Noninvasiveness, disposability and safety; requires no sedation; highly suitable for pediatric imaging High High High 2 Increases treatment compliance; effectiveness of clinical trials Low Medium High 3 Targeted drug delivery of biologicals; timely diagnosis and medication; high life-saving potential Low-Medium High High 4 Effective research tool for pharma drug development Low Medium High Rank Challenge/Restraint 1 - 2 Years 3 - 4 Years 5 - 7 Years 1 Lack of biopsy capabilities in current devices High Medium Med-Low 2 Clinical validation regarding the safety and efficacy/efficiency of devices High-Med Medium Low 3 Developing devices with extended battery life for accurate diagnosis. High-Med Med Low 4 Requirement of HD video enabling technologies for high-resolution colon screening High Medium Low
  • Medical Imaging Technology - Life Cycle Analysis Whole Slide Imaging Maturity Development Growth Smart-Pill Optical Imaging Hybrid Imaging Decline Time Market Value Source: Frost & Sullivan. Ultrasound Smart pills is a technology that is in early stages with clinical use products soon to emerge in the market. Although capsule endoscopy has been on the market over the last decade the technology is still in an evolutionary phase so as to make it more robust and reliable for diagnostic imaging as well as for enabling biopsies. Optical imaging holds future potential for molecular imaging at the cellular level. Other than OCT, techniques covered in the research such as HSI and NIRS are in an evolutionary phase. NIRS systems though available are mostly targeted for research uses with only a few systems being applied for clinical imaging. Similarly, HSI systems with promising medical imaging uses are currently under early stages of investigation for cancer detection. Integration of two imaging modalities as a single hardware equipment has been a trend since 2001, with the advent of PET-CT systems that have been clinically proven as the ultimate diagnostic aid for cancer. However, they are yet to be adopted on a global level. Emerging countries such as India, China are poised for adoption of these hybrid systems. Others such as PET-MRI have just been introduced in to the market. Overall, the hybrid imaging market is in a growth phase with a significant commercial potential down the decade. WSI is an emerging technology with promising potential for improved patient diagnosis. This technology is in early stages of adoption with certain challenges to be overcome before an end-to-end digital pathology solution is implemented. There are a couple of firms with products delivering solutions to this end, but are mostly for histopathology studies. FDA approval for applying this technology for primary pathology studies will boost its large-scale adoption. Ultrasound is a mature technology and has been adopted by many at a global level for OB/GYN and echocardiography applications. Ultrasound is currently undergoing incremental innovations, which make it applicable for a wide range of applications such as molecular breast imaging, urology, and also for therapeutic uses that are in the growth phase. The technology is also one of the fastest growing modalities with broader usability by both the developed and the developing economies.
  • Future of Medical Device Industry 2025 2017 2013 2010 2004 2011 2020 2015 2008 2000 NOW Increasing mortalities due to chronic diseases in low and middle income economies. BEFORE Global health research focused on overcoming infectious disease burden in developing countries. FUTURE Huge investments for advancing medical technologies to address global health challenges . Past technology advances contributed significantly in combating global infectious disease burden resulting in overall reductions in morbidity and mortality. Increasing need for common research goals for developing and developed countries. Broad level implementation of safe and effective technologies overcoming logistical, cultural, financial, and other barriers.
    • Urgent need for intensive multidisciplinary research to translate research findings into practice.
    • Develop and strengthen international scientific collaborations to effectively address complex health issues that transcend national boundaries.
    • Deploy and leverage trained, local researchers and institutions to study local populations and collaborate with US and other investigators.
    • Research undertakings must involve local and outside investigators to study diseases onsite and to develop health interventions that address both local and international unmet needs.
    NIH support needed for international collaboration between investigators in the United States and other countries to conduct research, and train researchers. This allows effective networking and information sharing among global scientists. NIH trained researchers from LMICs, on their return to their home countries should in turn train and develop the next generation of local research force. Requirements Source: Frost & Sullivan