Dr. Sze-fai YIP, Chairman of the Hong Kong Society of Haematology (HKSH), shares the mission of the society to support healthcare professionals and other stakeholders within the area of haematology in order to drive better health outcomes, the challenges faced by haematology patients in Hong Kong, and the potential of bringing more innovative treatments to Hong Kong and the Greater Bay Area.
Can you begin by giving a brief summary of the Hong Kong Society of Haematology?
The Hong Kong Society of Haematology (HKSH) was established in 1972 by a group of haematology experts in Hong Kong with the mission of enhancing the training, knowledge exchange and research of local health care professionals working in the field of haematology, thus improving the quality of care for haematological patients in Hong Kong. At the time, the function of the society was more a platform for communication and discussion among healthcare professionals.
Since then, the medical field has defined more specializations and we have grown our membership to include trainees and technical workers. We now organize conferences and training sessions to share best practices on clinical management of the disease, new innovations, and other related topics.
How are the needs of haematology patients being met by the government and public healthcare system in Hong Kong?
The government involvement within the haematology field is very minimal. There is currently no dedicated policy to haematology or haemato-oncology disease in Hong Kong, and therefore, no formal communication channels exists between the society and the Hong Kong government. Most of the government resources are diverted to service operations in the healthcare system. The Hong Kong government has procedures for the management of rare diseases but nothing to the extent of a national policy. Haematology typically follows the usual stream of subspecialties of internal medicine like cardiology or gastroenterology, of which 90 percent of the cases are managed in the public sectors. Since the vast majority of the population in Hong Kong is treated in the public healthcare system, it is heavily congested due to the high demand for care. Resources and funding are prioritized to meet the demands of the greater general public and common diseases, while specialties like haematology are merely an afterthought.
Therefore, the HKSH takes on the initiative to meet haematology patients’ needs on our own. The society helps to explore new agents and treatments for the disease. Traditionally, the public health system is more concerned with the implementation and use of technology that are mature, broadly accepted and backed by many large clinical trials and studies. The process has been slow, and therefore, has delayed access to many new and useful therapies.
The system is also not robust enough to support emerging or innovative technology development. In my opinion, we should speed the introduction of not only mature technology; but also support new therapeutic and technology development in Hong Kong. Other Asian countries like Singapore, Korea, and Taiwan are quicker to grant innovative treatments market access so Hong Kong should strive to meet this regional benchmark. Unfortunately, there is not much incentive in the public sector to be a leader in technology development or medical care at the moment.
What can be done to improve the haematology and rare disease treatment environment in Hong Kong?
The HKSH collaborates with the pharmaceutical industry to explore the use and introduction of newly developed drugs and therapeutic to Hong Kong. HKSH works with pharmaceutical companies and hold educational talks and meetings on novel therapeutics. Through various ‘compassionate use’ drug programs, we may have a chance to get earlier access to innovative treatments here in Hong Kong, before their acceptance into the public system.
New drug and novel therapeutic development need to go through various R&D phases and clinical trials before being granted market access. There is hurdle in our health care system because there is competition of resources to support these studies on a large scale. Healthcare professionals in the public system are already overwhelmed with their daily service. They do not always have time for research or participation in new technology development.
Solving this problem from the bottom up will never succeed. The first step is for the government and the policy makers to realize the importance of biomedical investment. Even though motivation for research and development exists among those frontline scientists and professionals, the infrastructure is not very supportive. A few universities are conducting Phase One clinical trials, but no other institutions are structured or equipped to do this type of innovative investigation in Hong Kong.
There is great potential for many innovative biomedical research projects in the Greater Bay Area. In order to keep up with the regional trends, Hong Kong needs to expend more investment and effort in infrastructure and network development in lieu of patient participation, sample or materials testing, hospitals process engineering and development of professional expertise. This is where we must bridge the gap to prioritize the development of these processes.
What achievements in haematology and oncology treatments have been realized in Hong Kong since the establishment of the society in 1972?
Over the years, most of the development has come from the field of oncology. Hong Kong is a pioneer in working towards improving the treatment of acute promyelocytic leukaemia (APL), a subtype of acute myeloid leukemia (AML). All-trans Retinoic Acid (ATRA), and later on, arsenic oxide, which are now broadly used in the treatment of APL, was first developed in China. Specialists here have revolutionized the treatment of this kind of leukaemia in Hong Kong, through therapies like bone marrow transplantation, an initiative that started almost 30 years ago. Now there are many transplant centers in Hong Kong providing stem cell transplantation as treatment for myeloma, lymphoma, and leukaemia.
For the introduction of new drugs, we need the industry’s help in speeding up access, facilitating the use and implementation, and also adoption into the public formulary.
In the coming decade, we will see exciting development and new challenges from cellular therapy and immunotherapeutic. Unlike drugs which come in a bottle, cell therapy uses living cells in the treatment of illness. Therefore, the logistics, budget, and administration of these agents are new territory to be explored. Although pharmaceutical companies are taking the lead on developing and selling these treatments such as Novartis’ CAR-T therapies, the cost is very expensive. There are also regulatory and licensing challenges associating with development and use of cellular products. We need to find solution on how to make this new technology available to the general public. This is all new and exciting territory for us .
What is your vision for the treatment of haematology and rare disease using biomedical innovations in Hong Kong?
If all the stakeholders in Hong Kong are motivated to achieve progress, I believe that we will succeed. The healthcare professionals and scientists here are energetic and hard working. The regulatory, logistical and resource problems can be overcome if the Hong Kong government is committed to solving it and the healthcare system is supportive.
The Greater Bay Area can open new opportunities for the treatment of haematology or other rare diseases if the government, Hospital Authority and the public system also see the importance of this. This is an area with massive potential to change the lives of patients in Hong Kong.
