City’s population is longest living in the world, says top doctor Francis Chan
Researchers are now looking at ways of reversing ageing process
Scientists have discovered that “poo” samples are worth storing
Doctors are creating one of the world’s biggest “libraries” of bio samples
Early adoption of 5G technology is giving healthcare system an advantage
CROWDED, OVER-PRICED and worryingly close to one of the world’s biggest factory belts, Hong Kong should score miserably low in ratings of health scores.
Yet the opposite is true. The community is measurably the world’s healthiest, enjoying humanity’s highest longevity rates, with people of both sexes and at all social strata living longer lives than anyone else on the planet.
Further, the city is also number one in the world for hosting clinical trials of newly developed treatments, and has a healthcare system rated number one in the world for efficiency. Importantly, from a consumer point of view, it has a host of world-beating medical facilities at every price range, from ultra-expensive to completely free of charge.
It’s an underappreciated achievement–and the medical miracles look like they are going to keep on coming, says Professor Francis Chan, dean of the faculty of medicine at the Chinese University of Hong Kong. There are some extraordinary developments in the pipeline that will take the city further towards the forefront of medical innovation.
AREAS OF GROWTH
Several areas for growth are worth highlighting, including the building of two extraordinary bio sample “libraries”: one being the development in Hong Kong of one of the planet’s biggest “biobanks”; and the second is the growth of an extraordinary “poo bank” in the city.
There are two more important factors that are liable to be key to the growth of the medical sector, one being the integration with the Greater Bay Area of Guangdong, with its huge population providing a rich source of biological data as well as a commercial market for healthcare. And the second is Hong Kong’s vaunted skill in business and finance, which will enable the commercialization of medical innovations. These include a number of remarkable projects, including a study into the human body’s ability to stop, or even reverse, the ageing process.
LIBRARY OF BIO SAMPLES
First, consider the “biobanks”. This is the term used for a repository that files and stores large amounts of biological samples for use in research. Their existence in several of the rich western countries has transformed many types of contemporary research areas, including genomics and personalized medicine.
But such facilities have not been available in Hong Kong, or even in Asia. The depth of data and samples need have been missing.
“Nowadays if you want to answer very important questions, you can’t really do a simple telephone survey,” said Professor Chan. “You can’t really do a study of several hundred, even several thousand people. It won’t be good enough. You need to have a big bank of clinical data, as well as bio samples like blood specimens, cancer biopsy specimens, and so on. With all these specimens, you’ll be able to tell over time whether there will be any changes, whether your intervention will be effective. So this kind of bio bank, which is currently lacking in Hong Kong, is really a matter of priority.”
Fortunately, the problem was recognized some time ago, and the Professor and his colleagues have been working on it for several years. “I’ve been doing this for quite some years in collaboration with quite a number of big hospitals in the Greater Bay Area,” he told Nick Chan Hiu-fung in an interview on Friday Beyond Spotlights.
The data and samples are coming in fast, and prospects are looking good for it to be a world class operation. “So this is going to be one of the biggest biobanks, not only in Asia, but also in the world,” he said.
YOU SHOULD HAVE SAVED YOUR ‘POO’
The story of Professor Chan’s “poo bank” is an even more extraordinary tale—although a tricky one to explain.
He introduces it with an analogy to “cord blood”, the blood found in the placenta and umbilical cord following the birth of a baby. It has been found to be rich in blood stem cells, and of great medical use, so is preserved—and many people have heard of it.
Similarly functional, but less well known, is a person’s excreta – Professor Chan prefers to use colloquial language and refer to it as “poo”. This also is a medical resource waiting to be exploited.
“Now we know that our poo collects vast amount of information,” Prof Chan said. “The poo contains 99% of the bodily genome.” (A genome is a complete set of the DNA, or genetic information, of an organism.) He adds: “With such information, we will be able to predict your future health.”
Furthermore, in the same way that cord blood is preserved so that it can save your life decades later, the same should be done with poo. “We know that for kids, their poo is much healthier than when we become adults,” he said. “So if we are able to save their healthy stool samples, we may one day be able to use these healthy stool samples to treat the diseases in the future.”
Why does it change? “As time goes on, the diversity of these stool bacteria, the good bacteria, will become less and less, will be replaced by harmful bacteria,” he said. “So we really want to save up this healthy poo so that in the future we can use this poo, to put it back into their guts to restore the balance.”
Prof Chan knows that the concept of a bank of stool samples which can be reinserted into people may sound insane to the average person, but the medical value of this work has now been confirmed beyond question.
Prof Chan, who is a specialist in the field of the gut microbiome – the “good” bacteria that lives inside people—says that people are only beginning to realize its potential, particularly in its reaction to our genetic material. “What actually is ageing? Ageing is not just about having more white hair. Ageing is some kind of, you can say, ‘wear and tear’ of your genetic material.”
Doctors have realized that the genetic material in our bodies is strongly affected by interaction with its environment. “If the environment is a better environment, I’m sure this ageing process can be stopped, and sometimes can even be reversed.”
We think of ourselves as independent creatures, but in fact we are joint ventures between our genetic material and that of our own microbiomes. “I can tell you, our whole body genome is only about one percent of the total genome in our body. Ninety-nine per cent of the genome belongs to the gut bacteria,” he explains. “So, if we can modify our gut bacterial genomes, there’s always hope that we can reverse this ageing process.”
NUMBER ONE IN THE WORLD
“In Hong Kong we’ve got a first class healthcare system over the past two or three decades,” he said. “In fact our clinical research, our clinical trials, are really number one in the world. And therefore we do have the infrastructure to carry out important clinical trials, whether we’re talking about clinical trials initiated by local researchers or those trials sponsored by big pharma,” the medical researcher said.
“And also with the Greater Bay Area, we will have this support and the infrastructure from our neighborhood, so that we will be able to not only carry out clinical trials, but also to transform our innovations into products that can be available in the market.”
You can watch the full interview with Professor Chan by clicking on this video, or scroll down to read more of this feature article.
MOST EFFICIENT IN THE WORLD
Hong Kong’s Healthcare System is really world class, Prof Chan says. “Bloomberg has classified our healthcare system as the most efficient in the world for several years.” This is particularly remarkable, given that news operation’s well-known negativity towards all things related to Hong Kong.
Doctors in the city in general offer a high level of medical care and are quick to adopt the latest state-of-the-art technology. “So that may be one of the reasons why the life expectancy for the Hong Kong people is the longest in the world.”
Things are likely to get better in the technology field, given the city and the country’s position in adaption of 5G, a high speed internet protocol, largely developed in China, which the city has had for years. “Telemedicine” or “telehealth”, the ability of doctors to use technology to deal with more patients more efficiently, will also be a factor. “We are living in a 5G world,” he said.
“I believe telehealth will be a very important tool, especially for those who have difficulty in accessing healthcare, especially those who are disabled, those who have very limited kind of support by the family or other friends,” he said.
But while many places around the world are doing remote consultations between patients and doctors, Hong Kong, and mainland China, can go further. It can use its 5G system to train doctors who are living in remote places—or even get doctors to use surgical equipment from a distance. “Importantly in Hong Kong, our medical robotic system is very rapidly developing,” Prof Chan said.
MAN BEHIND THE TITLE
The international media’s preference for seeing Hong Kong through a rather negative politicized lens means that the city’s extraordinary successes in health care generally go unreported. Still, Professor Francis Chan exudes confidence, and it’s difficult not to feel hopeful about a bright future once you have heard his message about the city’s progress in advanced healthcare.
And this is particularly true when you get to Francis Chan’s own story, which is an extraordinary rags-to-riches tale. He was born to a family so poor that they could not afford $8 a month to pay for a bus to go to the good school that the bright child clearly deserved to attend. So instead he was sent to a humbler school near the family home.
He says he was unaware of the concept that “you lose a race at the starting line” — which means that people who go to the right schools, and get the right advantages early on, are the winners in the long run. He didn’t know about this concept, and disregarded it, getting to the top by himself.
As a child, Chan was smart and hard-working, and eventually ended up with good school results, despite the disadvantages he faced. He chose to go to a new and untested medical school at Hong Kong Chinese University, instead of the already successful medical school at Hong Kong University.
Now he is the dean of the school, with a powerful reputation in his field of research, plus the accolades of playing a key part into turning the college into a world class establishment.
He keeps a framed picture from the movie “Rocky” for inspiration, because that story inspired him to climb from difficult circumstances to his current position.
He even has a favorite quote from the Sylvester Stallone character in the movie: “It ain’t about how hard you’re hit, it’s about how you can get hit and keep moving forward.”
Friday Beyond Spotlights is an informative yet light-hearted talk show airing every Friday at 8:30pm on Hong Kong International Business Channel (76). The English language program features prominent guests who share their insights into current affairs, business, innovation and culture, as well as their ingenuity, passion and grit which forge their Lion Rock Spirit. The show is hosted by businessman and philanthropist Patrick Tsang On-yip, lawyer and lawmaker Nick Chan Hiu-fung, and seasoned business maverick Herman Hu Shao-ming.
Image at the top by Ryoji Iwata/ Unsplash. Other images from Friday Beyond Spotlights.