Download this PDF file - Folia Medica Facultatis Medicinae

Review article
Turning the Challenge into Opportunity – A Strategic
Framework for the Biomedical Engineering Development in
Bosnia and Herzegovina
Sabrina Mustoo1*, Lejla Gurbeta2
Verlab Ltd Sarajevo, Medical Device Verification Laboratory, Sarajevo, Bosnia and Herzegovina
Faculty of Electrical Engineering, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
1
2
Abstract
Introduction – the mystery around
In respect with growing population, health care systems are becoming main priority in social-economy policies. Within the
modern health care system, overcoming challenges in human
health protection, disease prevention, treatment and rehabilitation of patients require engineering involvement. Investment
in biomedical engineering (BME) creates a base for progress in
many fields, from cutting health care expenses, better quality
and accuracy in diagnosis and patient treatment, increase of
medical therapies reliability and, finally, improved populations’
life quality. Economic growth, improvement and competitiveness of the country through BME require highly educated engineers, appropriate legislative in accordance with World Health
Organization (WHO) and government support. Main goal of
this article is to present the basic strategic framework necessary for BME development in Bosnia and Herzegovina, with
potential to influence economic growth. This cause-a-consequent connection between economic growth and BME is still
unexplored in Bosnia and Herzegovina. Discussing the BME
phenomena in Bosnia and Herzegovina has a great significance
since it can determine the possible reason for increase in its internal and external funding. The future holds so far unexplored
possibilities in the field of BME in Bosnia and Herzegovina,
which can lead to social and economic progress, and the first
step toward it is to create a strategic framework as a foundation.
Keywords: biomedical engineering, strategic framework, education, knowledge society, economic growth & development
biomedical engineering significance
© 2015 Folia Medica Facultatis Medicinae Universitatis Saraeviensis.
All rights reserved.
*Corresponding author:
Sabrina Mustoo
Verification Laboratory “Verlab”,
Ismeta Mujezinovića 30,
71000 Sarajevo,
Bosnia and Herzegovina
Phone: +38761213699
e-mail: [email protected]
18
In industrial society, work force and capital were considered to be key factors of manufacturing. In modern
society (late 1970s), information and communication
technologies played key role in manufacturing. Since
the late years of 20th century human knowledge became
driving force of society change and improvement. That
is the way that informational society became knowledge society [1]. Since 1950s technological innovations
became central growth driving force of economy leaders due to expansion of research focused institutions,
where researchers and engineers played essential role in
human well-being improvement. Importance of BME
research can be overlooked from three main aspects.
First, scientific research aspect, is valued by number of
publications and research output. About half of Europe
scientific publication tackled the BME issue [2]. Second, economic aspect consider return of investment in
BME research activities. This segment is best described
in Health Economics Research Group and Office of Health
Economics (2008) report: What’s it worth?- where is
highlighted that every pound invested in BME brings
39 pennies each year, in long term [3]with no tendency
to interrupt the process of creating investment benefits.
Connection between research investment and economic growth is best shown on United Kingdom (UK) example. Through long term investments in BME, UK
succeeded to make most important and most efficient
sector in economy after financial. They made it possible through commercial use of research results. Similar study was conducted in United States of America
(USA) that showed that every US$1 spent by National
Institutes of Health (NIH) usually generates US$2.21
in 12 months[4]. On the other side, US National
Academies of Science, states their opinion on BME in
article “Rising above the gathering storm”, pointed out
foliamedica.mf.unsa.ba
Folia Med. Fac. Med. Univ. Saraeviensis 2015; 50(1): 18-22
SABRINA MUSTOO, LEJLA GURBETA: STRATEGIC FRAMEWORK FOR THE BIOMEDICAL ENGINEERING DEVELOPMENT IN B&H
the fact that without competitive and highly educated
engineers and entrepreneurship development, American economy would lose position of world leader due
to growing competition [5]. Third aspect refers to
health and social benefits of the population. In that
manner population benefits from BME researches
mostly through new discoveries which improve health
(healthy working population), extend populations’ life
expectance and increased populations’ life standard. At
the same time, this aspect is connected to economic
expenses/ cuts of health care system. BME innovations
can unburden health care systems which are mostly under debts especially in transition countries. It is these
reasons why current state, possibilities, challenges and
future development of BME in Bosnia and Herzegovina should be discussed while awareness of this question
should be spread through politicians, government and
population.
Wealth
of
nations
&
Biomedical
engineering commitement
National point of view
Many countries have benefited from BME commitment. Singapore, for example, a few decades ago, was
emerging biotech cluster with the main aim to position
itself as a world-class research and development center
due to government financial support. As key advantages, Singapore has used an educated and skilled workforce, government funding, favorable business and legal environment, and government supported research
institutes. Ten years ago, Singapore has decided to put
a national focus on BME, taking into account changes
in the world economy, striving for the rapid economic development, especially after gaining statehood in
1965. It should be noted that until 1960s, Singapore’s
economy had an attribute as a labor-intensive economy
due to the low level of educated work force, strikes,
high unemployment rate, and a rapidly growing population. By 1970, Singapore was focused to industrial
and technical education of the work force.
This strategy of economic growth was successful until
the mid-1970s, when developed countries have exceeded the development of high-tech production. Therefore,
the Singaporean government decided to focus on production based on skills, added value, technology, as well
as the production of electronics. After the first major
recession in 1985, Singapore was looking for new areas
for economic growth. Bearing in mind the population
of less than 4 million (same as Bosnia and Herzegovina),
and few natural resources, the government of Singapore
has decided to focus on human capital as the most important resource. In other words, Singaporean economy
was built on knowledge, skills and innovation.
Folia Med. Fac. Med. Univ. Saraeviensis 2015; 50(1): 18-22
It was late 90s of 20th century, when Singapore recognized biomedicine as an area with huge growth
potential. The growth was conducted through two
phases. First, from 2000 to 2005 foundations were set
by pointing out the importance of human and intellectual capital. Once the foundation were set, in the
second phase (2006 to 2010) Singapore has focused
on strengthening capabilities in clinical research to improve populations’ health care, which contributed to
the economy and society in general.
Government investment in BME, in Singapore, by the
end of 2014 was about 3.5% of gross domestic product
(GDP) [4a].
During the recessions governments tend to cut expenses in research and education. On the other hand, the
Swedish Ministry of Finance held the view that investment in research infrastructure is what creates future
economic growth and should not be subject to financial cuts [6], which was recipe for economy recovery.
In the same period Canadian government actually
decided to, among other things, halve investment in
BME research. However, the economic revival was not
caused by these cuts, but only thanks to the fact that
during this period the US increased imports of Canadian products.
In addition to the United States and European Union
countries, the possibilities of BME research has been
recognized by India and Brazil, which are slowly becoming important players in the field of science. Asian
countries have also speeded up its research activities by
combining education, investment and involvement of
local governments. The reason for this are precisely the
benefits mentioned above.
Individual point of view
One of the formal definitions of BME engineer is an
expert who “builds on scientific understandings of disease and to design new healthcare technologies” [7].
Therefore, BME engineers can design and develop
devices, instruments and/or programs to solve specific clinical problem, thanks to broad knowledge in the
field of technology and medicine.
Becoming a BME engineer usually requires a minimum
four years of university education. However, attending
the second and third cycle of university programs offer
much greater opportunities for promotion into the top
BME researcher and expert.
According to CNN research from 2013, BME engineer
took the title of the best job in the United States, as
this work brings high job satisfaction, low stress, high
income and earnings, high contribution to society and
flexible work. Also in 2014, Forbes has rated BME engineer to be the most desirable job within health care
sector. Also, there is a need for BME engineers in Europe, since BME sector is leading competitive Europe-
foliamedica.mf.unsa.ba
19
SABRINA MUSTOO, LEJLA GURBETA: STRATEGIC FRAMEWORK FOR THE BIOMEDICAL ENGINEERING DEVELOPMENT IN B&H
an sector with the market size of 95 billion EUR, which
operates in favorable European legislation framework
since the European Union tends to build the European
Research Area by 2020.
While in most countries, universities compete to bring
world top students, in Bosnia and Herzegovina we are
witnessing a lack of BME study programs which are
the main precondition of any possibility for job systematization in this field. Absence of BME study programs is the main obstacle to “produce” skilled BME
engineers, and in the end to create and develop BME
sector in Bosnia and Herzegovina.
Strategic framework biomedical
Engineering in bosnia and herzegovina
As already mentioned, BME has the potential for rapid
development of countries with low GDP through the
integration of social sciences insights and technological
innovation, from concept to production. This article
presents entirely new idea, a development accelerator
of Bosnia and Herzegovina through the BME commitment supported by medicine, electrical engineering,
mechanical engineering and economics postulates.
Acceptance and implementation of this idea demands
governmental, academic and industrial support. The
following text provides strategic framework for BME
development in Bosnia and Herzegovina through four
key factors that must be developed and balanced in the
coming years in order to provide economic recovery
based on knowledge and innovation, instead of lowcost workforce.
Creating a strategic framework for the BME development in Bosnia and Herzegovina is indicated by the
fact that in comparison with neighboring countries,
the countries of EU28 and EU4 and five countries
which are our largest export partners, Bosnia and Herzegovina has the lowest GDP per capita for 2013 and
2012 [7]. Given that industrial production remains
burdened by debt, tangled in the post-war privatization process, with the necessity of huge investments in
equipment that Bosnia and Herzegovina isn’t currently
financially capable to deliver. Recovery and development should be based, according to the views of the
authors of this article, on investment in knowledge and
competence of human resources. Favorable geopolitical
area, with highly educated, capable and competent professionals, as well as a favorable business environment
can very quickly distinguish Bosnia and Herzegovina as
desirable destination for foreign investment. Therefore,
BME can be a trigger for the economic growth of the
country through the implementation of the strategic
framework presented in this paper. Four key factors are
following:
20
Support body. As a starting point in the strategic
framework implementation body responsible for development of BME in Bosnia and Herzegovina should
be established. That support body can be an existing
body, Society for Medical and Biological Engineering
(DMBIUBIH), which brings together a large number
of university professors, doctors, engineers and technicians in the field of medical, biological, electrical, mechanical engineering, pharmacy and other related science fields and can help the government in determining the strategic direction related to BME. The society
should be invited to make proposals for the creation of
pioneering model for productive international cooperation of biomedical engineers, application of university
programs, cross-cultural learning, foundation of BME
research, etc. Effective functioning DMBUBIH would
solve the problem of inferiority of BME in Bosnia and
Herzegovina. Also, the society could be responsible for
linking education and research with industry.
One of the currently most noticeable indicators of the
inferiority of the scientific research sector in relation to
the environment is little presence of our researches in
international scientific meetings, their minor appearance in scientific literature (indexed journals),inability
to organize the scientific events such as conferences,
little or almost no publishing activities, lack of journals and periodicals in libraries and above all very little
interest of young people for post-graduate studies and
doctoral research (PhD in future studies) and work in
the scientific research field.
State / Government. Next step in implementing this
framework is the government’s strategic orientation,
i.e. commitment and innovation, research and science
funding. Investing is just one side of the medal of BME
development strategy. Well-coordinated, national approach is essential. This segment will be the most difficult to change since the statistics do not show determination and commitment of previous policy options
towards science. According to the Federal Ministry of
Science and Education, the share of allocations for science as a% of GDP at the level of Federation of Bosnia
and Herzegovina has grown significantly over the period 2008-2013 year. Investments in this area in 1990 of
1.5% have never reached above this level. The largest
part of public and higher education institutions funding were in amount of 1.912.718 KM [7a] which is a
clear expression of the lack of focus of political structures in knowledge and science. Taking into account
that the scientific research funding lies on the Entities
jurisdiction, it is clear that changes and restructures are
required but are the most difficult.
Environment. Involvement of government can result
in supportive business and regulatory environment.
Members of society DMBIUBIH are also working on
writing proposals for changes legislative regarding sci-
foliamedica.mf.unsa.ba
Folia Med. Fac. Med. Univ. Saraeviensis 2015; 50(1): 18-22
SABRINA MUSTOO, LEJLA GURBETA: STRATEGIC FRAMEWORK FOR THE BIOMEDICAL ENGINEERING DEVELOPMENT IN B&H
entific research in our country. Bosnia and Herzegovina will have to work hard to create a favorable business
environment for investors and the first step is to gather
scientific elite under support body so application for
European grants can be made. According to the Federal Institute for Development Programming (2013)
on the ease of doing business, Bosnia and Herzegovina has dropped one place compared to 2013, and is
located at 131 position (out of 189 countries). [8] In
this year’s Index of Economic Freedom our country is
ranked among 185 country on 103 place with the score
57.3 points [8a] which is the same number of points as
last year.
University. Final, long term, step in strategic framework implementation refers to the study BME study
program creating, with the aim to produce and train
competent experts. In cooperation with the Society for
Medical and Biological Engineering in Bosnia and Herzegovina an important role is reflected in talent attracting. Taking into account the small Bosnian population,
it is necessary to consider the holistic strategy of talent
attracting, locally and internationally. International
BME experts can provide mentoring to young Bosnian
scientists. If our University provide a high quality study
program, this will result in increased number of foreign students, who may also affect BME improvement
in Bosnia and Herzegovina during their study period.
BME is a discipline that cannot be sustained within
the traditional professional organizational structure.
University of Sarajevo, as the largest and oldest educational institution in Bosnia and Herzegovina, has a
leading role in the intellectual and educational capital creation. However, the University of Sarajevo has
still no faculty / department / stream in BME filed. By
creating BME study programs University of Sarajevo
would be the only public educational institution that
can enable multidisciplinary training of students linking knowledge, experience and techniques in the wider
field of electrical engineering with biomedical practices.The funds should be directed towards organizing an
interdisciplinary program at the University of Sarajevo,
which would allow:
• Intellectual integration of medicine, electrical
engineering, mechanical engineering, IT, natural
sciences at the undergraduate and graduate level.
• Integration and Cooperation with the market
(health institutions, industry, etc....).
• The conditions in which the program staff and
students can work as part of teams for large
BME projects (regional and / or international
level).
• The conditions for staff and students mobility at
the prestigious world BME universities and institutes, in order to transfer knowledge in Bosnia
and Herzegovina.
Folia Med. Fac. Med. Univ. Saraeviensis 2015; 50(1): 18-22
BME study program should also provide students mobility in other countries, which could result in domestic BME engineers with wider knowledge and cultural
horizons and can ensure long term modernization of
healthcare system.
Conclusion
Technology has had a dramatic impact on every sphere
of life, including the medical care. As the BME has
evolved, in particular over the last fifty years, ethical
issues have become important regarding processing of
biomedical signals, biotechnology, biomechanics, biosensors, medicine, economics and biology.
Since the BME is still at its infancy in Bosnia and Herzegovina, initially it is necessary to thoughtfully and
strategically access creating a favorable environment
that will later provide sustainable BME development.
Business climate, government, university and support
body are key players in this process, and their balanced,
efficient and professional approach may be essential.
This article may be common start point for BME engineers, business entities and politicians in order to
present Bosnia and Herzegovina as a country that base
its development on knowledge, innovation and high
qualified engineers. Creating high-quality BME study
programs and, further, ensuring employment of BME
engineers Bosnia and Herzegovina will prevent drain
brain of its top students and outstanding experts.
In Bosnia and Herzegovina it is necessary to create a
favorable business environment for BME investments.
Flexibility and openness to BME innovations can become a trigger for the transformation of Bosnia and
Herzegovina in a competitive and prosperous economy.
On the other hand, an appropriate legislative framework is a must for intellectual property protection.
Investing in BME in Bosnia and Herzegovina should
attract foreign investments and develop new capacities
such as production of new drugs, new laboratories and
other medical and engineering facilities as well as modernize existing facilities. Thus, through an integrated
system of government support, regulatory framework,
research and development, and educated and qualified
engineers, Bosnia and Herzegovina could become initially regional and then European BME center.
Declaration of interest
The authors declare no conflict of interest for this study.
foliamedica.mf.unsa.ba
21
SABRINA MUSTOO, LEJLA GURBETA: STRATEGIC FRAMEWORK FOR THE BIOMEDICAL ENGINEERING DEVELOPMENT IN B&H
References
[1]
Berghmans S, Bisagni A, Bouillon R, Bovelet D, de Andres-Medina R, Damerval T, et al. European Medical Research Councils (EMRC). A Stronger Biomedical Research
for a Better European Future. Strasbourg :European Science
Foundation;2011.
[2]
Health Economics Research Group, Office of Health Economics, RAND Europe. Medical Research: What’s it worth?
Estimating the economic benefits from medical research in
the UK. London: UK Evaluation Forum;2008.
[3]
Colin M. Science economics: What science is really worth?
Nature 2010;465:682-684.
[4]
Chuan PL. Innovation policy around the world: Singapore Betting on Biomedical Science. Issues Sc Tech
2007;26(3):26-3/poh
[5]
US National Academies of Science. Rising above the gathering storm. Energizing and Employing America for a Brighter
Economic Future. Washington: National Academic Press;
2007.
[6]
United Kingdom. The Academy of Medical Science. Biomedical research – a platform for increasing health and
wealth in UK. London: The Parliament; 2011.
[7]
Bosna i Hercegovina. Ministarstvo obrazovanja i nauke
FBiH. Izvještaj o razvoju Federacije Bosne i Hercegovine.
Sarajevo: FMON; 2013.
[8]
Bosna i Hercegovina. Federalni zavod za programiranje razvoja. Lakoća poslovanja 2014. Sarajevo: FZPZ; 2013.
22
foliamedica.mf.unsa.ba
Folia Med. Fac. Med. Univ. Saraeviensis 2015; 50(1): 18-22