By Derrick Z. Jackson | May 12, 2007

ANDRE WAN and Sheo Rai smiled simultaneously, with a wry sense of victory. Wan is deputy executive director of the Biomedical Research Council of Singapore. Rai is communications director for biomedical sciences for the Economic Development Board of Singapore. I had just told them how Singapore was highlighted as one of the top “competitor states and foreign nations” at Governor Deval Patrick’s announcement of his $1 billion life sciences initiative at BIO 2007.

The administration says one of the top “challenges” for the initiative is that “the United Kingdom, Ireland, China, and Singapore have developed coordinated strategies to attract researchers and companies.”

“It’s flattering because in reality we’ve been trying to emulate the United States,” Wan said. “We get questions at this conference of how did we do it. People ask us, ‘What’s your business model?’ The thing is, we’re not a business model. We’ve looked to Boston and the Bay Area for the innovation. You have a much longer history in achievement. We can only hope to acquire the knowledge.

“It’s flattering for us to hear the governor of Massachusetts say these things about us. Five years ago, no one heard of us for biotech. We are one tiny dot on the planet.”

The tiny dot is now a model. Singapore, a nation of 4.5 million people and about the square-mile equivalent of the Fitchburg-Leominster area, is a global technology powerhouse. In just seven years, it has exploded from its birth in biotech infrastructure to global influence in the biomedical sciences. Stem-cell researchers, Genentech, Eli Lilly, GlaxoSmithKline, and Novartis all have announced expansions or plant openings in Singapore in recent months.

According to the newsletter FierceBiotech, Singapore has for two years running been one of the world’s top five regions for industry growth, right there with California. Patrick said Massachusetts would invest $1 billion over 10 years into the life sciences. That important step was almost universally welcomed by scientists and business leaders this week. But a year ago, Singapore announced a fresh $8 billion investment over five years.

“A lot of places plan their research and development in five-year blocks,” Wan said. “Singapore plans for 10 to 15 years out.”

With such energy, Singapore is the top-ranked nation in the Foreign Policy Globalization Index and second to the United States in the World Competitiveness Yearbook of the Swiss-based International Institute for Management Development. The CIA World Factbook says Singapore’s investments in the life sciences and medical industry “will continue efforts to establish Singapore as Southeast Asia’s financial and high-tech hub.”

Wan and Rai pointed out that one reason Singapore is so attractive is because of its emphasis on math and science and investments in public education at the earliest ages. In the 2003 Trends in International Math and Science Study of the International Association for the Evaluation of Educational Achievement, Singapore was number one in the world in fourth-grade and eighth-grade math and fourth-grade and eighth-grade science.

While the Bush administration flat lines or slashes budgets for health research in the United States and cuts student loans, the Singapore government is in the middle of a program to fully fund 1,000 scientists to achieve their doctorates in Singapore and around the world by 2010. Rai said the average cost per student is about $660,000 in US dollars. About 700 students have been enrolled since 2001.

“You have to have a comprehensive education system,” said Wan, a physician by training. “Yes, it is true that we were able to play on our strengths we already had in math. We had a good education system. But even with this comprehensive system, we realized that not a lot of students were choosing to do PhDs. They needed a boost. The credit goes to the government for realizing that to be competitive at the next level and to encourage bright minds to stay here, they had to provide the boost.”

In announcing Massachusetts’ $1 billion investment in life sciences, Patrick said he hopes the money will help close the federal funding gap and “bypass” the Bush administration’s limits on stem-cell research. But the state-by-state approach supporting the science and industry that could save millions of lives seems pale in the face of Singapore.

“Singapore is a nation with no mineral resources, no agriculture to speak of,” Rai said. “We realized that our natural resource was our people. To be in the global economy, we had to invest in people.”

Derrick Z. Jackson’s e-mail address is jackson@globe.com.

In New Hampshire, Soft Sell Eases Vaccine Fears

By PAM BELLUCK

CONCORD, N.H. ­ A vaccine for a sexually transmitted virus that causes cervical cancer may be creating controversy across the country, but in New Hampshire physicians say so many people want it that they cannot satisfy the demand.

The New Hampshire experience contrasts sharply with that in many other states, where opponents have cited factors like the drug manufacturer’s profit motive and the fear that inoculating young girls will encourage them to be sexually active.

New Hampshire has critics of the vaccine, too. But its health officials, wanting to encourage use of the vaccine, called Gardasil, say they have hit on an optimal method: making it voluntary and giving it free to girls ages 11 to 18.

In many of the more than 20 states that are considering bills to require girls to be vaccinated, a backlash has developed. In Texas, a lawmakers’ revolt overwhelmingly overturned Gov. Rick Perry’s effort to mandate vaccinations.

Virginia recently became the sole state with a law requiring the vaccine for girls entering the sixth grade but allowing parents to refuse shots for their children.

In New Hampshire, where people wear their independent streaks with pride, “I suspect that we’re not seeing a significant controversy because there was a never a discussion about whether to make this mandatory,” said Greg Moore, a spokesman for the Health and Human Services Department.

“This is a different type of vaccine rollout than we have ever seen,” Mr. Moore said. “We usually have to bust our hump every September to convince people to get their flu shots.”

Sanders Family Medicine in Concord has a four-month waiting list for the vaccine, which guards against four strains of the human papilloma virus. Exeter Pediatric Associates, one of the state’s largest practices, has given out all 380 doses it was supplied by the state since January and has a long waiting list for the next month’s supply, Dr. Wendy Gladstone said.

Penacook Family Physicians has devised an elaborate triage system. Ardell Currier, a nurse practitioner, said Penacook first vaccinated 18-year-olds and then younger girls who have been sexually active, take birth control and “have had an abortion or have had health issues, particularly psychiatric conditions” that may make them more likely to have sex.

“The ethical dilemma is whom do we give that vaccine to,” Ms. Currier said.

New Hampshire is spending $4.9 million on Gardasil this year, said Dr. Jose Montero, the state epidemiologist. That is 28 percent of the state immunization budget, which obtains half its financing from federal money and half from private insurers, Dr. Montero said.

The legislature does not have to vote on the program or appropriate money, he added. Money for other immunization programs was not reduced, he said.

Since January, the state has distributed more than 14,000 doses and is trying to obtain more doses for physicians with waiting lists. Dr. Montero said he would evaluate whether to ask for more money to buy more vaccine.

At least two other states, South Dakota and Washington, are echoing the program here. South Dakota began providing Gardasil free to the same age group in late January with $1.7 million approved by the Legislature and $7.5 million in federal money, Health Secretary Doneen Hollingsworth said.

South Dakota is a relatively conservative state that tried last year to ban most abortions only to have the ban repealed in a referendum. Even so, when it came to the HPV vaccine, Ms. Hollingsworth said, “the naysayers, there weren’t a lot of them, and they weren’t terribly loud.”

Ms. Hollingsworth said the state had provided almost 20,000 doses.

“There’s been a tremendous amount of interest,” she added. “But I haven’t heard anything about anybody running out” of vaccine.

In Washington, the Llegislature just approved $10 million for voluntary vaccination for 94,000 girls over the next two years.

“We basically want to see as many people get this as possible,” said Tim Church, a spokesman for the Health Department who said Washington would primarily focus on 11- and 12-year-olds on the theory that it is best to be vaccinated before being sexually active.

The cost of Gardasil, which is administered in three doses over six months, is normally $360. The federal Centers for Disease Control and Prevention recommend it for ages 9 to 26.

In New Hampshire, girls outside the 11-to-18 range of the free pool have to pay out of pocket or through insurance. Some families of 11- to 18-year-olds have been doing that, rather than wait for the free vaccine.

Physicians say the supply of vaccine for patients who are paying for it themselves or through insurance, produced by Merck, has been adequate. Exeter Pediatric Associates has given 480 doses of privately ordered vaccine since December, Dr. Gladstone said. Even women older than 26 are requesting it.

Starting in July, the biggest insurer in the state, Anthem Blue Cross and Blue Shield, will not cover vaccines for HPV and other illnesses for 11- to 18-year-olds because they are eligible for the free pool, which receives money from Anthem, said a spokesman, Chris Dugan.

Other insurers are expected to do the same, Mr. Dugan said. Doctors said that could increase the backlog for the free vaccine.

Melissa Whitney of Hampstead has put her 13- and 11-year-olds on the waiting list at Exeter. “They said there were many people ahead of me, and, ‘As soon as we get some more vaccine in, we’ll give you a call,’ ” Ms. Whitney said.

On Wednesday, Sophia Wheat, 16, received her second injection at Sanders Family Medicine, a few weeks later than the optimal time because of the limited supply, said Dr. Elizabeth Sanders, who is careful to inform patients that Gardasil is not effective against all strains of HPV or other sexually transmitted diseases.

“It sounded really important, so I thought it would be a good idea,” Sophia said as a medical assistant placed a yellow crayon-shaped bandage on her arm.

To sort through waiting lists, some doctors give priority to older girls, some to younger ones and some to girls who have already received a dose.

Yet, not everyone is rushing for the vaccine. Ms. Currier at Penacook Family Physicians said her practice had called all its 18-year-olds first, especially to recruit “the folks most at risk for HPV, because they are going to be not those most engaged in health care.”

About half the 18-year-olds or their parents refused it, “most because they feel it’s too new,” Ms. Currier said. “Some parents of younger girls feel that they’re not sexually active, so they don’t need it,” she added.

Maggie Theriault, a nurse from Merrimack, declined Gardasil for her 14-year-old, Samantha, because “I haven’t really investigated it all that much.”

“When I did hear about it originally,” Ms. Theriault said, “I wanted her to have it. But I don’t want to be ignorant and I don’t want to rush.

“She’s not sexually active yet . We have an agreement that she’s not going to be until, hopefully, she’s at least 18. I’m not saying that we won’t ever get it. It’s just that we’re going to wait a bit.”

When Kimberly Barlow arranged for three of her daughters, ages 18, 15, and 13, to receive the inoculation, “my mom was actually against me getting it for them,” Ms. Barlow said.

“She was saying it would lead to their promiscuity and stuff,” Ms. Barlow said. “I just thought that it was an option to do something that will likely prevent cervical cancer in my children.”

Pauline Doucette put her daughter Olivia, 13, a volleyball player and karate fan, on her pediatrician’s list in October, three months before it was available.

Olivia’s grandmother had cervical cancer, which is not hereditary, and Ms. Doucette had a precancerous condition, making Olivia aware of the illness. Ms. Doucette said she discussed the sexual transmission of the virus with Olivia, who has received two doses.

“Most everybody in school,” Olivia said, “is getting the shot.”

Insightful and humorous.

Our chaps and scholars are going.

Catching up with George Daley here in Boston this afternoon. He chairs the ISSCR

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Sounds cool… Are u going to go for it?

Poor student here has neither money nor time to go… :p Will stick to reading journals…

Yes, of course: How one reads a paper depends quite largely on what you aim to get from it.

Even if one is unsure of one’s aims, one could speed-read it still: For exploratory purposes, like wanting to traverse unseen/tangential territories.

Abstracts can be useful; it does depend. Because sometimes the language may differ from discipline to discipline and someone lacking formal education in a particular discipline may need to first read the paper, then attempt to find a parallel conceptual system for trying to understand.

Though that’s prolly a major cognitive problem on my part as well.

_________________________

Dr Dee // May 11, 2007 at 2:25 pm

Dear Department for the Care of Mesodontrachia:

Yeah, you can speed-read through the journal. Unless you want specific information on the materials and methods used in the experiment, reading the abstract, a little bit of the introduction and the discussion part will give a good idea on what the journal is about.

Yours sincerely,
Dr Dee