Paul Bruhn, Regional Business Head Asia, Oceania, MEA of Nestlé Health Science in Singapore, elaborates on the intricacies of these diverse regions and the strategic importance of Singapore as a hub for the region.

You manage the AOA region out of Singapore, could you elaborate on what this region encompasses and how you prioritize your agenda with such an expansive role?

The AOA region includes Asia (excluding China, Hong Kong and Taiwan), Oceania, Middle East & Africa. There are more than enough countries involved to keep me busy and well-travelled!

We further breakdown the region by the market’s level of development. We have a range from very mature markets, like Japan, where it is extremely developed and competitive, to Africa where the market is in its infancy stage. A key priority is making (medical) nutrition better understood by the relevant stakeholders so it can be seen as therapy and not just calories or food.

After being officially established in 2011, Nestlé Health Science has established a strong number two position globally with a workforce of over three thousand people scattered across the world. How much of that expansion has been attributed to the AOA region?

The majority of the global market value is still generated from North America and Europe. These regions are experiencing a slowing of growth on the back of reducing levels of reimbursement in major markets. Industry growth is coming from Latin America, China and many of the markets in the AOA region. The population size, health care demographics and low levels of market penetration are some of the reasons behind the growth. A rapidly ageing population will mean increasing chronic diseases. Diseases such as diabetes and renal disease, both of which require nutritional intervention and management to control symptoms. The importance of nutrition for infants/children is increasing as the region continues to have high incidence of infant and childhood malnutrition, stunting and allergy.

The growth will continue to come from these regions and the rates of growth will be the key drivers of all the industry players overall performance. NHSc is no exception and the expectation is that.


Could you elaborate on your overarching strategy in the AOA region? What are your plans in terms of extending your footprint?

For the ASEAN market it is about development through increasing the awareness and understanding of the benefits of nutrition to health care stakeholders, ensuring nutrition is top of mind for health care professionals. When we speak about Japan, the second most developed market in the world after the United States, it is about continual innovation and competitive intensity. For Africa we start from scratch in many countries where access to basic healthcare and medicine is poor.

The biggest competition in the under-developed markets is not always the usual global and local companies – but rather the fact that patients are not being fed. Even when they are fed, it can be inadequate or inappropriate solutions and practices. The work here is about changing the mindset and the understanding of what nutrition can do. This is the truly exciting part because, we know we can make a difference and have a positive impact on patient outcomes and the overall health care system.

From your perspective, what is the potential value from nutrition when it comes to improving patient outcomes and reducing disease in the region?

When it comes to patient outcomes, nutrition can play a pivotal role. Specialized nutritional supplements taken prior to, and after surgery have been clinically proven to reduce post- surgical infection rates and decrease hospital length of stay. Not only of benefit to the patient, but also the health care system, as significant costs are saved.

The incidence of malnutrition in hospitalized patients is at worrying levels and is a serious issue. Ensuring any patient is at optimal nutritional status, will increase the chances of a better response to any treatment, enhance recovery and potentially reduce hospital length of stay.

Certain diseases and conditions (e.g. diabetes, chronic renal disease, celiac disease) all require specific nutrition to ensure management of the disease. This in turn helps to reduce the risk of onset of any complications.

An illness or hospital admission puts further demands on nutrition as nutritional requirements are significantly increased. This combined with a reduced appetite and ability to eat and drink, places greater emphasis on medical nutrition products (nutritional supplements, tube feeds, fortified foods) at this time.

More than ever people are realizing that nutrition plays a major role in maintaining, and managing health.


When does a food turn into a therapy, and is there even a distinction between the two at all?

Nutrition can be viewed as therapy for a number of reasons.

In certain diseases and conditions, nutrition plays a direct role in the management of the disease and can positively affect progression and complications (diabetes, renal disease, hypercholesterolemia, Crohn’s disease for example).

Some inborn errors of metabolism require specialized nutrition for life (PKU).

Nutrition has also shown it can reduce post-surgical infection rates and reduce length of stay in intensive care and hospital overall.

In a healthcare setting nutrition should be considered as far more than just food. It is vital component of disease management and is an important element in ensuring better patient outcomes, before, during and after recovery from illness, surgery, or treatment.


How does Singapore play into your strategic plans moving forward?

Singapore as a country is strategically important for two reasons.

Firstly it is the regional office for the NHSc business and secondly because of the network and opportunities for external partnerships.

Singapore is a prime location to work with other organizations and the government for research & development and to bring forth innovation. Recently there are many companies that are locating to Singapore to set up innovation hubs.

The organizations that can be collaborated with to bring our business forward are all located here: flavor houses, packaging, nutrition research, A*Star and the EDB to name a few. We are looking to develop projects here before we expand them out to the region. It is a great country for collaboration and testing ideas. There is a state of the art healthcare system with highly qualified and well trained doctors and health care professionals, many of whom understand the benefit of nutrition. Recently the Nestlé research center opened offices in Singapore and is partnering with A*Star in (nutrition) clinical research. Nestlé also have a large and well stablished R&D center in Singapore.

There is a lot to be done in Singapore and the government is very favorable to innovation. They have established a very collaborative and favorable working environment for innovation to flourish.

The government is also very active in health promotion and prevention for the population, and has had a recent focus on diabetes with this in mind. The government understands how to work with organizations to the benefit of society at large. We see Singapore continuing to play a strategic role in our company and the industry for the future.

What aspects of Nestlé Health Science excite you the most looking three to five years out?

Over the past 6 years NHSc has invested in over 10 complementary businesses. Some of these companies have research projects in the nutrition space that are coming to completion over the next few years. These projects have the ability to change the way nutrition is used in disease management and I am looking forward to the ongoing work and results.

NHSc has a focus in the GI category and the work on microbiome is an exciting and fascinating area to watch develop.

How will you ultimately measure your success in these areas?

Of course we measure our success in the traditional business sense with indicators such as such as market share and sales growth, but altruistically we look at disease incidents, death rates, even in diminishing healthcare costs.

The industry has been providing reports on the financial benefits of nutritional supplementation on malnutrition and conversely the cost implications of being malnourished to the healthcare system.

Finally, we are trying to make nutrition a part of therapy by integrating nutrition into the treatment protocol of the hospitals.

We want to see nutrition a part of every treatment protocol in every hospital –that should be our goal!

We are continuing to make progress in making nutrition better understood by all healthcare stakeholders.