Michael Milken and the Five Insights for a Healthier Japan and World

Los Angeles — When Minister of Digital Affairs Taro Kono stepped up to the podium at the official residence of the United States Ambassador to Japan in Tokyo this March 2023, he came well prepared with anecdotes and examples underscoring the continuing challenges to Japan's digital transformation. In May, he spoke further about the issues at the Milken Institute Global Conference in Los Angeles. 

From the use of floppy disks to fax machines, Kono said, examples abound of outdated technology and processes still in use or required by Japan's rule books and bureaucracy. The theme of our Milken Institute Japan symposium this year in marked contrast was "New Era, New Opportunities." A change in Japanese mindsets, it was clear, also was needed to bring faster, sustainable change.

Here in Los Angeles at a "fireside chat," Kono also discussed his efforts to deepen digitalization and innovation. From digitalizing government services to encouraging private sector technological development, Kono is seeking to build a Japan of the future. Envision a nation characterized by a more robust, high-quality digital infrastructure to support citizens, public and private institutions, and internationalization.

Benefits of Digitalization 

The potential benefits of unleashing the power of digital technology, it occurs to me, find parallels in the ongoing astonishing opportunities and promise of bioscience. After leaving Tokyo, I finished reading Milken Institute Chairman Michael Milken's new book, Faster Cures: Accelerating the Future of Health, (William Morrow publisher, April 2023). It is available worldwide through online booksellers.

I serve as Chair, Asia Fellows of the Milken Institute as well as Senior Advisor, Global Markets for the Los Angeles-headquartered economic think tank.

The book is an account of the philanthropist's lifetime of work to accelerate medical breakthroughs. It makes powerful reading for those also exploring the lessons and benefits of cooperation and of overcoming a mindset of "that's the way things are done."

Drawing from Milken's book as well as his recent Wall Street Journal commentary piece, "Another Medical Revolution Is Under Way," I found five key takeaways that offer up lessons learned and hope for Japan and for our troubled, divided times. 

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Triumph of Science

First, The Triumph of Science. As recently as the 19th century, people suffered through gruesome surgeries without anesthesia, childbirth without antiseptic procedures, and all manner of terrible infections. Fortunately, Milken notes, medicine has advanced from that dark past to the prospect of a bright future that will transform society in the years ahead.

Pessimists have often predicted that disease would bring pestilence and doom. Science met these challenges in the form of antibiotics, polio vaccines, statins, genome sequencing, immunotherapies, monoclonal antibodies, anti-retroviral cocktails, robotic surgery, powerful new diagnostic scans, focused ultrasound therapies, artificial intelligence, CRISPR gene editing, and mRNA vaccines.

One result of all this progress is worldwide life expectancy has more than doubled in less than 100 years. In large parts of Asia, the gains have been especially dramatic. Japan is, of course, well known for its citizens' long life expectancy. 

According to the World Health Organization, life expectancy at birth in Japan increased to an average of 84.95 years in 2022—the fourth highest in the world. Only tiny-in-size Monaco, Hong Kong, and Macau had overall higher life expectancy rates.

There is also a remarkable economic benefit. In real, inflation-adjusted terms, the per-capita productivity of advanced economies is eight times that of the 19th-century average, Milken writes. Moreover, half of all economic growth over the past two hundred years, he notes, is directly linked to progress in medical research and public health.

The Importance of Data

Second, Data is Paramount. According to Milken, the driving force behind this progress is the astounding advance of our ability to produce, manipulate, store, retrieve, and transmit data. Faster, cheaper, more-communicable data has furthermore revolutionized medical research.

No longer is a lone scientist working at a laboratory bench likely to produce medical breakthroughs. Science is now a team activity. 

The teamwork to produce a new therapy often involves the collaboration of experts in multiple countries. They might speak different languages, yet technology knits them together as a seamless creative unit. The benefits of continued teamwork and cooperation across borders in bioscience are numerous.

Bringing Together Effective Strategies

Third, Progress Requires Effective Strategies. It is not enough that researchers are smart and dedicated. Cohesive strategies underlie most medical and public health solutions.

Milken's "Faster Cures" book explains the plans that helped produce such advances as microbiome sequencing, non-invasive surgery, faster vaccine development, and drugs developed by harnessing artificial intelligence, machine learning, and massive computational power.

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What's Next

Fourth, We Are Just Getting Started. The future looks incredibly exciting. Milken writes that we can now reasonably speculate about therapies that will one day give us the ability to clean tiny cancers from our bodies as routinely as going to the dentist to clean our teeth.

We can envision gaining immunity from dozens of viruses with a single vaccine. And we can foresee editing genes to eliminate many birth defects, perhaps one day growing new organs from patients' own cells and even slowing the aging process. All these would have been considered science fiction only a few years ago.

Preventive Medicine

Fifth, the Best Drug Is Prevention. Despite all this progress and exciting future prospects, we must address a number of remaining challenges. The first of these is health equity. Those of us in the wealthier nations live years, often decades, longer than the average African, Latin American, or South Asian.

Yet, even the regions that have made substantial longevity gains in recent decades still have remaining challenges. Even in the most developed nations, including the United States and Japan, too many people continue to destroy their health through neglect or abuse. 

That was underscored to me in the book's closing chapter on prevention. It is great when medical science develops a new cure. It is even better when we can prevent disease from occurring in the first place. 

A focus on improving health also must not ignore mental health.

There is reason for enduring optimism that Japan and the world will reap even more benefits from the ongoing, amazing revolution in life sciences. A Japan of the future that embraces digital transformation and reform can also be a nation where the future of health is marked by faster cures and full, meaningful lives for all.

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Author: Curtis S Chin

Curtis S Chin, a former US ambassador to the Asian Development Bank, is managing director of the advisory firm RiverPeak Group, LLC. Follow him on Twitter at @CurtisSChin, and @milkeninstitute

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