At the Ülemiste City Future Forum in April, Michal Wronka, Head of AstraZeneca Baltics, will discuss innovation in the medical field and the company’s vision for the future in Estonia. According to him, the goal of healthcare innovation is to extend the years lived in good health through early diagnostics, genetic technologies and AI-powered data processing.

How is AstraZeneca doing currently and what are your main focus areas?

AstraZeneca recently published its financial results for 2024. It was a year in which we grew by 20% and introduced eight new medications. This is part of our ambition to bring 20 new medications to patients by 2030. We have a strong pipeline: 210 ongoing clinical trials in breast, lung and prostate cancer, chronic obstructive pulmonary disease, severe asthma and rare diseases, which have the potential to bring innovation to patients around the world.

We focus primarily on four areas: cardiovascular and metabolic diseases, cancer, and respiratory diseases. And last but not least, rare diseases.

We are a global company, operating in 125 countries, but also right here in the Baltics, including Estonia. Over the past two years, the company’s local representation has nearly doubled and we currently have more than 120 employees in the Baltics.

What kind of employees are you looking for in Estonia?

We are shaping the future of healthcare through science and innovation for the benefit of people, society and the planet. We value flexibility, an innovative mindset, strong collaboration skills and open-mindedness. We need specialists who are also willing to think outside the box and seek better solutions to improve healthcare efficiency.

New employees must also be excellent collaborators because our work requires very good collaboration skills both inside and outside the company. We believe that healthcare can be transformed not only by introducing new medications, but also through various partnerships within the healthcare sector. We already have several successful examples of collaboration between the public and private sectors and universities, which positively impact both patients’ lives and society.

What are some examples of public-private collaborations?

One example is the Estonian Lung Cancer Patient Journey Project, involving public and private sectors and academic institutions, including Tartu University Hospital. The overall goal of the project was to improve the lung cancer patient journey in Estonia, identify bottlenecks and find solutions to them.

Various parties were involved in this process: doctors, scientists, public sector representatives, funding organisations and private sector representatives, including AstraZeneca, one of the leaders of this initiative. The results of the lung cancer patient journey mapping are now publicly available and have been partially implemented for the benefit of patients. For example, lung cancer diagnostics have been improved in several hospitals, including Tartu University Hospital.

Based on this collaboration, a new public-private partnership is now in its early stages, aiming to map the patient journey for other critical conditions, such as heart failure, to identify problems and find solutions.

By sharing common goals and prioritising patients, we can work together to achieve better outcomes for both patients and society. When different parties come together to find solutions and move from theoretical and academic discussion to real action, we can optimise the healthcare system and improve patient outcomes.

What is the role and importance of the Baltic region in medical innovation?

What I like about this region and especially Estonia is that the cooperation with different public and private sector partners is flexible and fast. For example, when an algorithm for diagnosing rare diseases was created in Estonia, it was almost immediately implemented in Latvia to help patients with rare diseases. This is a complex area because identifying rare diseases is like finding a needle in a haystack. A fast and flexible approach is key for the well-being of patients.

And that is what I like about our healthcare landscape – the small size of our country gives us an advantage because it is relatively easy for us to come together, find a common solution and implement ideas.

What are the problem areas here that are holding back innovation?

The biggest problem is access to healthcare services. Compared to other sectors, healthcare can be a significant expense in a country’s budget, but it should be viewed as an investment. A well-funded healthcare system allows people to live longer, healthier lives, remain active in the workforce, contribute to society, etc.

There is an objective measure by which healthcare spending is assessed, namely a percentage of GDP. According to the European Commission, the percentage spent on healthcare in the Baltic countries is between 7 and 7.6%. The European average is 10.4% and in leading countries this figure is even around 12%.

This creates a gap, especially in terms of access to medications and services. For example, if we look at all the new medications and treatment methods that were registered in the European Union between 2019 and 2022, there were 167 in total. These medications bring real innovations and better treatment outcomes.

We checked, based on statistics, how many of these new medications were available to patients on European markets by the beginning of 2024. Of these 167, almost 150 were available in Germany in January 2024. In Latvia and Estonia, only 31 of these 167 were reimbursed and available to patients. In Lithuania, this number was even lower – only 14. Unfortunately, patients in our countries often have to wait the longest for new medications compared to other European countries.

Financing healthcare and supporting innovation is an investment in society – it leads to better budget planning, higher incomes and a healthier population. It is therefore important to see healthcare not only as a cost, but also as an investment in innovation.

What global problems could medical innovation solve or what future crises could be prevented?

One of the biggest challenges that medical innovation can address is ageing populations – not just increasing lifespan but improving the number of years lived in good health.

It is like a quality of life parameter that can be improved with innovation, new medications and treatments. This means that we would be able to live a full life until the end, being 80 or 90 years old.

Today, we already have many healthy and active individuals in their 60s and 70s who contribute to society and are not an economic burden. Through innovation and the introduction of new medications and methods (including prevention and screening programmes), we can ensure that people can live not only longer but also healthier lives.

The second dimension here is how we can optimise the entire healthcare system. Healthcare is a major cost and burden on societies in economic terms. With modern diagnostic tools and data management, we can identify patients at an early stage of prevention or at treatable stages of the disease and avoid the additional costs of treating patients in later stages.

How many diseases are actually preventable?

Cancer, cardiovascular diseases, metabolic diseases, respiratory diseases and rare diseases account for 80% of all healthcare costs. Of these, 80% are preventable and these are precisely the diseases that we focus on at AstraZeneca. This does not mean that people will soon be able to live forever, but the average lifespan will increase and, more importantly, we will be able to live healthier lives.

It is also noteworthy that all these diseases were previously treated as independent diseases. In fact, we should not look for solutions that are suitable for treating diabetes, heart failure and chronic kidney disease separately, but they are all interconnected. So, in healthcare in general, we are moving from a disease-based perspective to a patient-centred perspective. Ninety per cent of our portfolio is already personalised medicine.

How can data be better used for the benefit of medical innovation?

The problem is usually that we have a lot of medical data, but it is aggregated in different systems. This makes patient information scattered. The first systemic challenge is integrating all the data that is available in different systems. This is a big challenge for healthcare systems. But if we do this and start using this data in a targeted way, then wonderful things can happen, especially when it comes to early diagnosis or detection of rare diseases,

for example, if the disease is so rare that the doctor may not even consider it for the patient. Having access to large volumes of data, you can focus the doctor’s view and direct their attention to its possibility. We have real examples of patients with rare diseases who have been diagnosed thanks to such an algorithm.

While we used to have to do experiments in the laboratory in the early stages of medication development, now we can replace some of this with a virtual laboratory. We have a collection of potential medications that have virtual images. We can model and test in a virtual environment, that is, we move part of the research into a virtual environment supported by artificial intelligence, which saves time and increases the potential and speed of finding effective medications.

What could be the next big ‘growth area’ or new focus in medicine in the future?

I believe it could be genome repair. Just like taking a car to a repair shop, we might one day have ‘repair shops’ for humans. While today we simply have to live with certain diseases and treat the symptoms, in the future, the disease could potentially be completely cured.

If the disease is simple and caused by a mutation in a single gene, it is already possible today to remove the mutated part of the DNA and insert a whole version of that gene using genetic scissors. This technology is called CRISPR. However, we are still in the learning phase and we are not yet ready to fix multifactorial diseases in this form. However, I believe that we are moving in the right direction and are on the way to finding solutions.

I wish for all of us not just a longer life, but a healthier one. If you are in your 30s or 40s, you think that there is still a lot you could do in your 60s or 80s. But when you talk to people who have lived past 70, sometimes they have dreams and plans that they have not realised yet, but their health condition no longer allows them to fulfil their dreams.

My goal and personal dream is that when I reach my 70s or 80s, I can still do the things I dreamed of in my 40s. With innovative medications and healthcare, I believe these dreams can come true.