Indo-Swedish Collaboration

How Swedish companies are contributing to innovate and develop infection-control devices and how is it relevant for India.

In 2005, the Swedish Minister of Communications and Regional Policy, Ulrica Messing, signed a Memorandum of Understanding (MoU) to further strengthen existing Swedish-Indo research and business cooperation. This agreement was followed up few years later by other similar initiatives. For instance, in 2009, Sweden and India signed a MoU on cooperation in the area of health. This last agreement set up the basis for many of the joint collaboration projects we have today in this field.

In 2015, the Swedish County Västra Götaland Region signed a Letter of Intent with Andhra Pradesh, in India. The aim was to create a coordinated effort and facilitate bilateral cooperation between the government, hospitals, businesses and academia from both regions. The agreement covered areas such as maternal care, lifestyle diseases, cancer, elderly care and infection diseases.

Some 1.6 million people live in Västra Götaland Regional council, approximately one-fifth of the population of Sweden. The County is the authority-in-charge of healthcare; which accounts for 90%  of the  County’s expenditure. The region employs nearly 20%  of Sweden’s life science industry in a total of 470 companies. It is the base for several world-leading companies, including AstraZeneca, Cochlear Anchore Solutions, Mölnlycke Health Care, the Getinge Group, SKF, Dentsply, and SCA.

Sahlgrenska University Hospital is the largest healthcare unit and emergency care hospital in the region and in Northern Europe. It was founded in 1782 and, like Chalmers University, owes its existence to a benefactor Nicolaus Sahlgren, one of the founders of the Swedish East India Company. Later, William Chalmers, a younger contemporary of Sahlgren and the same benefactor as that of Chalmers University, also left half of his fortune to the new hospital. Their intention was to make hospital care available to all, regardless of income. Today, the hospital is a system of three hospitals associated with the Sahlgrenska Academy, the faculty of medicine and the Gothenburg University. The original 24 beds have become 2,700 and the staff of 15 has increased to more than 17,000.

Harald Sandberg, the Ambassador of Sweden to India, stated in his introduction to the book Swedish innovations, Indian interpretations: “Sweden and India are very different. However our cooperation for innovations will help us, together, lead the way to a future that is better for all”.

A Global Issue Requires Global Efforts

In the spirit of the 2009 MoU and to state their intention and willingness to cooperate in the field of antibiotic resistance, the directors for the Indian National Centre for Disease Control and the former Swedish Institute for Communicable Disease Control (now Public Health Agency of Sweden) signed a bilateral Memorandum of Intent for cooperation in May 2011.

Approximately 25% of the disease burden in India is due to infectious diseases (tuberculosis, hepatitis, malaria, HIV, dengue), which are also responsible for around 30% of all deaths. Some of the major reasons for the spread of infectious diseases include unhygienic surroundings, lack of personal hygiene, hospital-acquired infection, development of antibiotic resistance, lack of awareness about infection and infectious diseases, etc. The number of disease occurrences across rural areas is much higher as compared to urban areas. Nearly 80% of the physicians reside in urban areas. Consequently, people from rural areas usually have to travel long distances to reach a doctor even for the most basic healthcare services. All this has contributed to an increasing need for products and technologies for telemedicine, infection control, mobile technology, homecare devices, and portable testing kits.

Despite being home to only 10 million people, Sweden ranks as one of the most innovative countries in the world and there are more than 42000-patented Swedish innovations. Swedish technology and innovations can offer solutions for developing cost–effective health care delivery methods, as well as new possibilities for capacity building and training of isolated rural health practitioners. Innovation and creativity are concepts that have long driven Swedish economic and entrepreneurial development. Today there are approximately 160 Swedish companies established in India.

There have been several concrete initiatives in this area during the last years. Few years ago,  Vinnova, Sweden’s Agency for the Innovation of Science and the Department of Biotechnology, the Ministry of Science and Technology in India (DBT) started a strategic research collaboration program with focus on Tuberculosis. Last January, the Swedish Research Council, Formas, Vinnova and the Department of Science and technology, the Ministry of Science and technology in India opened a joint call for networking grants within the two fields – antimicrobial resistance and e-Science for life science.

There is room for more collaboration and partnership between our countries and regions, especially in areas related to prevention and control of infection. Swedish medical technology companies are on the cutting edge of the development of medical equipment to reduce infection risk and bacterial spread in healthcare environments, making sure that common diseases do not become lethal threats any more. Sweden is also  renowned  for storing   medical  data,   something  that  creates  invaluable  research

opportunities, benefitting both scientists and companies interested in conducting clinical research. The country has reported a usage of over 95% of e-prescription, electronic health records and digitalization in medical imaging and radiology. Today, 70 years after the introduction of identification numbers, there are more than 100 Swedish Healthcare Quality Registries; and a bio-bank register containing over 150 million samples collected from patients attending the Swedish medical health care.

Strong partnerships between authorities, care providers, academia and industries have promoted and developed new products, solutions and processes for evidence-based and cost-effective medical and social care. The following are examples of companies developing innovative products and methods in this field.

1928 Diagnostics is developing a fast, complete and universal diagnostic service for bacterial infection. By enabling fast onset of correct antibiotic treatment, their service will save patients’ lives, diminish spread of multi-resistant bacteria and reduce costs for the health care sector and society.  The company provides an automated bio-informatic analysis of the bacteria’s genetic code, unlocking the power of a whole genome sequencing for use in clinical routine. The raw data files, generated in a sequencing machine are easily uploaded to their cloud-based software service. The file is automatically run through a series of specially selected and adapted algorithms and matched to 1928 Diagnostics’ unique database of resistance patterns.  In just 15 minutes, a full resistance profile is delivered to the client’s computer, tablet or smart phone.

ABIGO Medical develops, manufactures and markets an assortment of medical devices for advanced wound care and ENT. The Sorbact^® method is an innovative approach to reduce bio-burden in wounds, without using any chemically active agents. Instead, a physical principle is used to bind bacteria and fungi to the dressing in the presence of moisture. The Sorbact^® method was invented by two Swedish professors, Torkel Wadström and Stellan Hjertén. It is based on the knowledge that two hydrophobic particles bind together in the presence of moisture. Common pathogenic microorganisms, such as Staphylococcus aureus, Streptococcus species, Escherichia coli, Pseudomonas aeruginosa and Candida albicans, are hydrophobic and therefore bind to the unique surface of Sorbact^®. These are removed from the wound each time the dressing is changed. The Sorbact^® method is also effective against MRSA (methicillin-resistant Staph. aureus) and VRE (vancomycin-resistant Enterococcus) as their resistance against antibiotics neither changes their hydrophobic properties nor their ability to bind to Sorbact^®.

CRC medical provides complete solutions for optimizing patient safety in clinical environments. The company supplies hospitals and clinics with clean-air solutions to prevent post-operative infection, for instance, operating theatre ceilings that are ideal for surgical procedures with a high risk of infection through airborne contamination (no more than 5 cfu/m3 in the operating theatre); intake air filters for operating rooms, corridors and storage areas and much more. Their products can reduce the number of microorganisms in an operating theatre to zero.

Torso Innovation has developed Spoldosan^®, a medical device that reduces the occurrence of legionella, bacteria pseudomonas, mycobacterium avium and endotoxins in the shower environment. This tool prevents water spray from forming in the shower environment. In stagnant water in our water management systems and in temperatures between 18⁰C and 45⁰C, different bacteria multiply. Therefore, regular circulation of the water is important.

If the water contains bacteria, this can be inhaled through water aerosol or by micro aspiration. For the elderly and immune-compromised individuals, this means an increased risk. The shower is considered to be a common source of infection. Spoldosan^® simplifies the flushing of stagnant water from pipes, shower hose and shower head and captures and reduces the amount of water spray in the shower room.

Iliod therapeutics is developing an innovative antimicrobial treatment IDX01, a novel biological pharmaceutical, for hard-to-heal local infection (abscesses) caused by bacteria. The solution allows the treatment of abscesses without the need for surgical methods or antibiotics, enabling patients to leave the hospital after just one injection. The therapy builds on boosting the body’s own defense against microbes by increasing the turnover of white blood cells critical for driving and organizing the process of resolving infection. This is accomplished by an injection of the biological pharmaceutical IDX01. The active substance is an endogenous signaling protein that induces a controlled inflammatory state around the infected area in which bacteria are destroyed both by the white blood cells themselves and by antimicrobial substances excreted by the same cells. Excess inflammatory processes may destroy tissue but the technology overcomes these problems by also inducing controlled removal of potentially damaging cells as well as removal of dead bacteria and tissue

Mölnycke Health Care and Getinge Infection Control are two examples of Swedish multinational healthcare companies in the infection control, which have a presence in India.

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