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Emerging therapies in the emerging world
  1. Ansaar T Rai
  1. Correspondence to Dr Ansaar T Rai, Department of Interventional Neuroradiology, West Virginia University Hospital, One Medical Center Drive, Morgantown, WV 26508, USA; ansaar.rai{at}gmail.com

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It's a numbers game, or so they say. “It's the economy stupid”, say others. The ‘economies of scale’ chime in the corporate gurus from Toyota to Microsoft. Any way you cut it, there is a gradual impetus among investors, entrepreneurs, and corporations to move east. That's where the people are—and not just a few but, oh, so many. With improving economics, so many people can buy so much stuff. Universities are not far behind; there is the Cleveland Clinic in Abu Dhabi, the Dubai Harvard Foundation for Medical Research, the West Virginia University Muscat Medical College in Oman, and the Johns Hopkins-managed Tawam and Al-Rahba hospitals in Abu Dhabi, to name just a few. These are just the US ventures; the English and the Europeans have a much longer presence and association. An influx of investors and the attention of corporations certainly benefit the region. Higher education and better healthcare can potentially piggyback on growth in the business sectors. Success, however, requires a deeper understanding of the ground realities. Take the people, for instance. Almost 3 billion—or over 40% of the world's population—reside in China and south-east Asia and another 8% live in the Middle East and Far East; thus, almost half the world's population is clustered in a comparatively confined geography, giving rise to mega-cities of 10 million or more. A hospital with 1000 beds is not uncommon. One hospital, for example, has 30 neurosurgery beds just in the emergency room and, overall, the neurosurgery service has 237 beds. A team of nine neurosurgeons performs close to 5000 procedures a year, and advanced imaging churns out 50 000 CT scans and over 20 000 MRI studies annually with less than half the number of scanners per 100 beds in a US hospital. Obviously the quality of care cannot be expected to …

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