Patients Progress: contracts or collaboration?

Last week was a great one for the number of different stories that caught my attention. Most folk would not have failed to see the story of the State visit of the American President. I have no interest in what he said, did or didn’t say or didn’t do. It was the news that the US and UK had signed a deal, said to be worth £150 billion, for investment in new technologies, particularly artificial intelligence (AI) that drew me in. The investment, although not real money in the bank, would, it was said, keep the UK at the forefront of AI development and its utilisation into improving many aspects of our every day lives.

I don’t know if such promises will come to fruition, time will tell. A great deal of the money is to be spent on so called data centres. These are said to be power hungry and require huge amounts of water for their cooling systems. Both appear to be in short supply in the UK. This lack of resource sustainability might eventually prove to be a deal breaker.

A related AI story last week followed the publication in the journal Nature, of a paper detailing the development of a generative AI tool named Delphi-2M. It is a tool that can predict your personal risk of ever experiencing 1,000 diseases. Likewise, it can forecast changes to population health up to 10 years into the future. At the population level, the AI tool was ‘trained’ using anonymised data from nearly 2 million patient records from two very different health care systems.

At the individual level the AI tool looks at the ‘medical events’ in your history. This includes considering your age and gender, and all illnesses and/or accidents you might have had over your lifetime. Additionally, it also looks at lifestyle factors such as smoking, drinking (alcohol) and a person’s weight (BMI). Interesting so far, but maybe worrying also; consider the ethics of accessing such a tool.

Whilst I can see some advantages at a population level, in terms of planning future service provision and where to focus future public health activities, I’m not so enamoured with the advantages at a personal level. I’m not sure if I would consider it to be a good thing (or even helpful) if the AI tool was to forecast that there could be a 40% chance that I might contract a life changing or life shortening disease in the next five years. What would I do with that information, and what if others knew this about me as well?

One of the other life sciences stories of last week made me also wonder if the NHS will have access to the pharmaceuticals it might need to treat future patients. Whilst the UK has hopefully won £150 billion worth of AI-based technology contracts, we are conversely losing much more from a series of withdrawals from international big pharma as they cancel plans to invest in the UK. Over the last year, all the major pharma companies have announced plans to invest overseas -mainly the US, rather than as planned, here in the UK. And this is despite the UK having some the best life science researchers in the world.

Cambridge University alone has won 125 Nobel Prizes. The so-called ‘Oxford vaccine’ saved thousands of lives during the Covid19 pandemic. Inexplicably, the NHS has been slow to adopt new drugs, and we can’t ignore the impact of the delightfully entitled Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG). As the NHS buys drugs in bulk, the VPAG arrangement means that pharma companies are required to send 23% of the revenue earned by their drugs back to the UK Government. Not, I suggest, a great business proposition.

However, away from these billion-pound stories, it was the wonderful story of how Finland prepares its population for the next pandemic, cyber-attack or geopolitical challenge that most intrigued me. I love Finland and have been there many times. It has a tiny population that lives across a vast geography and endures a Nordic climate. Through public/private partnerships, new agricultural technologies (crop development), national secure storage facilities and emergency fuel supplies, Finland can continue to function very effectively for at least nine months in the event of a major international supply chain breakdown (think of the Ukraine/Russia conflict).

It is not just the vital infrastructure that make Finland’s preparedness enviable, but the underlying commitment to collaboration across the political, economic and societal Finish way of life. In Finland, collaboration is not just an abstract concept, or a political policy, it is the way things are done everywhere and by everyone. A lesson for us all here in the UK methinks.