CARI Analysis: Digital Payments No Longer a Luxury in the New Normal

Author: Imran Said Shamsunahar | Research Editor: Eleen Ooi Yi Ling
Webmaster: Nor Amirah Mohd Aminuddin | Research Director: Hong Jukhee

1) Health concerns driving increasing usage of digital payment services

The COVID-19 pandemic has led to increasing concern over the possible transmission of the virus through the handling of physical cash. It has generally been understood by scientists that the risk of viral transmission by banknotes is low as compared to other frequently touched objects.¹

The head of the German public health institute, Lothar Wieler, noted in March 2020 that “(viral) transmission through banknotes has no particular significance”, as airborne droplets from infected individuals are the main infection risk. Moreover, experts note that washing hands after touching cash or other objects may help to reduce the risk of transmission.²

Regardless of expert opinion, recent research by the Bank for International Settlements found a huge spike in Internet searches concerning viral transmission by hard cash during the COVID-19 pandemic (see Figure 1).³

Breaking down the searches by country, it was noted that searches were more prevalent where more small-denomination banknotes (the ones commonly used in everyday transactions) were in circulation relative to the GDP (see Figure 1).⁴

According to Capgemini Research Institute, health concerns caused by the pandemic have seen 46% of global consumers say they will increase their usage of digital payment systems in the next 6-9 months (see Figure 2).⁵

The research by Capgemini recommended that retailers around the world aggressively increase the adoption of e-payment systems such as digital payment wallets and contactless cards as consumers put more stock into health and safety practises by businesses.⁶

41% of respondents in the survey also noted that they would prefer to frequent stores that do not have touch-based self-checkout systems for the next six to nine months (see Figure 3).⁷

In response, retailers were also recommended to adopt autonomous self-checkout systems with mobile phones, as it allows consumers to practise social distancing and avoid as much physical contact at the point-of-sale as possible.⁸

2) Use of cashless payments are expected to boom during and post-COVID-19

Research by the Asian Banker has found that the share of cashless payments are expected to grow by 9% in leading economies in 2020, led by China, Japan, Singapore, and the UK (see Figure 4).

Bain & Company had raised their estimations of the share of global transaction values conducted digitally in 2025 by 5-10% in response to the structural changes caused by COVID-19 (see Figure 5).¹⁰

3) Not all digital payment options are risk free from physical contact

It should be noted that not all cashless payment methods are immune from physical contact and the risks of viral transfer. A 2020 study by van Doremalen et al (2020) found that COVID-19 survives best on non-porous materials, which could include credit/debit card terminals or PIN pads (see Figure 6).¹¹

This could prove problematic for certain digital payment options such as debit and credit card transactions, which generally require a signature or PIN entry at a merchant-owned device for larger transactions.

Contactless card options, on the other hand, do not require a PIN for smaller transactions. An April 2020 survey by Mastercard of 17,000 consumers in 19 countries worldwide saw contactless card transactions grow twice as fast as non-contactless transactions globally in February and March 2020. Mastercard attributed this to increasing concerns by consumers over health and safety at the point of sale when buying essential goods, as well as wanting to reduce time spent at stores by as much as possible. ¹²

Among their findings included:

• 46% of respondents globally swapped their top-of-wallet card for one that offered contactless. In the Asia Pacific, 51% of people made the swap.¹³
• 82% of respondents globally viewed contactless as the cleaner payment method, with 80% in the Asia Pacific saying the same.¹⁴
• 74% of people globally and 75% in the Asia Pacific stated they would continue to use contactless after the pandemic is over.¹⁵
• Data by Mastercard found 40% growth in contactless transactions globally in the first quarter of 2020. More than 80% of contactless transactions were under US$25, a range typically dominated by cash.¹⁶
• Mastercard saw the number of tap-and-go card payments at grocery stores and pharmacies grow twice as fast as non-contactless transactions globally and 2.5 times faster in the Asia Pacific alone.¹⁷

Digital wallets or other smartphone-based payment systems (such as stored card details or QR codes) are another solution due to the lack of physical contact required. Online banking is of course another alternative for a non-contact cashless payment system.

4) Digital Payments will spearhead the growth of Digital Financial Services in ASEAN

A joint study by Temasek and Google conducted prior to the pandemic found that Digital Payments were expected to spearhead the growth of the larger Digital Financial Services industry within ASEAN. The Digital Payments industry was expected to cross US$1 trillion by 2025, with e-Wallets alone composing US$114 billion (see Figure 7). It was believed that by 2025, digital payments would account for nearly one in every two dollars spent in the region.¹⁸

However, widespread usage of digital payments may have a long way to go. According to a January 2020 survey by We Are Social, only Thailand and Singapore saw a higher percentage of its population use mobile payment services monthly as compared to the global average of 27%, with Thailand measuring at 40% and Singapore at 31%, respectively¹⁹ (see Figure 8).

5) Digital Payments may not necessarily promote greater financial inclusion

Temasek and Google found that 104 million adults in SEA are fully Banked, meaning they enjoy access to full Financial Services. A further 98 million are Underbanked, meaning they have a bank account but lack access to credit, investment, and insurance services. A remaining 198 million in Southeast Asia are deemed Unbanked, meaning they have no bank accounts at all (see Figure 9).²⁰

In ASEAN countries such as Vietnam, Indonesia, and the Philippines, the unbanked compose the majority of the populace (see Figure 9). ²¹

Among the reasons for this can include issues of cost. In a sprawling region where physical infrastructure is lacking, it is prohibitively expensive for financial institutions to build physical branches that can serve all customers. Other challenges include the absence of public registers, identification systems and reliable credit information; basic prerequisites for financial institutions. Moreover, banking is a tightly regulated sector in many Southeast Asian nations, a legacy of the 1998 Asian Financial Crisis. Competition and innovation, as a result, have been stifled. ²²

Different consumer segments present different opportunities and can be best served by different players. Underbanked Consumers have been identified as the true growth engine of the Digital Financial Services industry. The report by Temasek and Google suggested that Consumer Technology Platforms (such as regional Internet platforms such as Gojek, Grab, Lazada and Sea Group) are best placed to serve this segment, due to their large customer base.²³

Contrary to popular narratives, serving Unbanked Consumers may prove to be the hardest undertaking. Acquiring customers in this segment can be expensive as compared to the returns made. Established Consumer Players such as telcos and retailers may be best placed to serve them through their extensive physical distribution networks.²⁴

Despite claims that digital financial tools such as e-wallets are a means to improve financial inclusion, a 2019 report by Boston Consulting Group (BCG) on e-wallets usage in Southeast Asia found that it was largely utilized by customers who already use traditional banking services. ²⁵

In Indonesia the same research found that 57% of banked respondents used e-wallets, compared with 26% of underbanked Indonesians and only 14% of the unbanked. In Vietnam, e-wallet usage was 42% among the banked and 17% among the unbanked. Thirty-one percent of banked Malaysians used them, but only 9% of the unbanked (see Figure 10).²⁶

The BCG survey also found that one of the biggest hindrances to widespread adoption of e-wallets in most Southeast Asian countries was acceptance by merchants. 56% of respondents across the region in BCG’s survey cited ‘not accepted by merchants’ as the main problem with using e-wallets. They also found that only an average of 28% of retailers in Indonesia, Malaysia, Thailand, and Vietnam accept e-wallet payments.²⁷

When analyzing reasons why merchant adoption of e-wallets was so low, BCG found that 58% of merchants across the region agreed with the statement ‘I do not completely understand this payment process’ as the most important reason for not accepting payments through e-wallets. Another 45% stated that inconvenience in processing the payments through this option was their top reason (see Figure 11).²⁸

6) Digital Payments platforms will still face a tough 2020

The global payments industry will see decreasing revenues in 2020, with a slowing global economy in the wake of shuttered businesses, restricted movements and closed borders contributing to a slump in global transactions. A March 2020 report by McKinsey projected that global payments revenue would decline by US$165 billion in 2020, 8% lower than in 2019 (instead of a 6% increase against the base of US$1.9 billion projected before the crisis) (see Figure 11).²⁹

A more pessimistic scenario, which would see a muted recovery by global economies, projected a decline in global payments revenues of 10-12% in 2020 as compared to pre-crisis levels. McKinsey determined that 80% of the decline would be due to a drop in the volume of global payments (see Figure 11). ³⁰

Different payment players will be impacted differently depending on their exposure to various sectors. An April 2020 report by PricewaterhouseCooper projected that payment platforms with large exposure to the aviation, tourism and hospitality, electronics and consumer durables sectors would be negatively impacted by the decrease in transaction volumes. Concurrently, those exposed to sectors such as physical retail, telecoms, e-Commerce and healthcare and pharmaceuticals could expect to see increases in consumer transactions. ³¹

7) Conclusion

The rapid spread of COVID-19 in the beginning of 2020 has meant that health concerns, particularly public worries about the transmission of the virus through the exchange of physical cash, are now a new factor in consumer’s choice of payment options. Although the scientific consensus thus far is that the risk of viral transmission of the virus remains limited, many retailers and consumers have sought to play it safe by increasing the usage of digital payments under the ‘new normal’.

ASEAN governments have also encouraged the adoption of digital payments. In early April 2020, the Monetary Authority of Singapore stated they were working closely with The Association of Banks in Singapore (ABS) to promote greater adoption of e-payments among individuals and businesses. Likewise, in early March Vietnamese Prime Minister Nguyễn Xuân Phúc requested the State Bank of Vietnam (SBV) to develop a pilot plan to popularise mobile payments, and later in April requested the Ministry of Information and Communication to join forces with the SBV to put mobile payments into circulation.³²

Not all digital payments options are completely immune from requiring some form of physical contact. Debit and credit card transactions often require a PIN entry or signature at the merchant-owned terminal for transactions above a certain amount. This may prove problematic, as a 2020 study by van Doremalen et al suggested that COVID-19 survives best on non-porous materials including credit/debit card terminals or PIN pads. Contactless card payments, on the other hand, often do not require a PIN for small transactions, and indeed on March 25, 2020, the European Banking Authority encouraged payment service providers (where possible) to raise their contactless payment thresholds to the maximum threshold of €50 per transaction.³³

Although studies have suggested a mass shift towards digital payments options in the wake of the ‘new normal’ (and which is expected to persist over the coming months), not all digital payments platforms are expected to benefit equally. A global slowdown brought on by supply chain disruptions and government-enforced lockdowns will inevitably cause a drag on global expenditure. Greater exposure to vulnerable sectors, including aviation, tourism and hospitality, and consumer electronics, will prove detrimental to revenues due to slumps on transaction volumes.

CARI Analysis: Healthtech investment in Asia Pacific
more than halved due to COVID-19 but opportunities remain

Author: Aznita Ahmad Pharmy | Research Editor: Eleen Ooi Yi Ling
Webmaster: Nor Amirah Mohd Aminuddin | Research Director: Hong Jukhee

1. 2019 saw an upward trend in global healthcare private equity investment with healthtech taking the third-largest subsector spot

The global healthcare sector saw increased private equity investment in 2019, with the value of total deals closed increasing by 14% to US$78.9 billion.¹ There were a total of 313 healthcare deals in 2019, with the average deal value showing an increase of 25% and a total of 27 deals in which the deal value exceeded US$1 billion.² A large portion of global investments went to healthcare providers, and biopharma, followed by healthtech.³

Across all the regions covered, healthtech⁴ was the third largest healthcare subsector. Described mainly as the convergence between healthcare and technology,⁵ examples of health technology (healthtech) include telemedicine, electronic medical record (EMR), remote monitoring and wellness apps.⁶ Total deal value in healthtech globally dropped to US$4.3 billion in 2019 from US$10.5 billion in 2018 but investment in healthtech tends to fluctuate over the long-term.⁷

• North America captured the biggest share of private equity activities worth US$46.7 billion (Figure 1).
• Intense competition for assets took place between many different entities, including large buyout funds, European funds, tech-focused funds and corporates.
• There were no mega-deals or large public take-overs.
• The provider sector remained the most active with deals 96 deals, equivalent to 60% of all deals in 2019.

• Total disclosed deal value in 2019 increased 10.7% to reach a new high of US$19.7 billion.
• Some investors pursued scale across nearly all verticals in retail health while many smaller provider assets in non-traditional retail health verticals are building scale and are expected to reach a size that appeals to private equity funds.
• The increase in total deal value was partially due to a US$10.1 billion carve-out⁷ of Nestlé Skin Health.
• The region continues to show the trend of biopharma assets making up most of the deal values in Europe.

• Private equity investment in the healthcare sector in Asia Pacific in 2019 fell 29% to US$11.5 billion but when viewed over the long-term, the region continues to display a growth trajectory.
• Investment in 2019 was more geographically diverse than before:
  • China, India and Australia represented 51% of the deals closed, compared with 90% in 2018.
  • Southeast Asia showed an increase of 21% in deals closed.⁸
• The healthcare provider sector saw the most activity, with 29 deals closed, worth US$4.4 billion.
• The three major emerging trends were:
  • the consolidation of healthcare providers to execute buy-and-build strategies and achieve scale.
  • investment in health-related digital platforms.
  • innovative solutions that would allow the region to close its healthcare gap.

• The South American and the Middle East regions saw a total of six deals.
• The only disclosed deal value in 2019 was the US$1 billion acquisition of Lumenis, an energy-based medical solutions provider, by Baring Private Equity Asia.

Even before the onset of the COVID-19 pandemic, private equity investors were concerned of a global recession in the near term, followed by geopolitical conditions.⁹ The global private equity investment of the healthcare sector provides a bigger picture of which the healthtech sector makes up a small but steadily growing portion. In the Asia Pacific region, investment in digital platforms was one of the trends observed in healthcare private equity in 2019.

2. Healthtech investment in Asia Pacific hit by COVID-19

With the COVID-19 pandemic causing repercussions on economies around the globe, investment in healthtech in the region has been affected as well.

• Healthtech investment in Asia Pacific declined in Q1 2020, a sharp contrast to the US which saw a strong start to 2020:
  • Asia Pacific’s healthtech investment in Q1 2020 fell 56% to US$703 million while its peers in the US saw its investment triple to US$3 billion (Figure 2). This was due to the region feeling the effects of the COVID-19 pandemic before the US.¹⁰
  • Although the impact from COVID-19 is beginning to be felt across healthtech’s investment landscape in the Asia Pacific region, the full impact has yet to be seen, and it would be difficult to ascertain the full extent of capital flight.¹¹

   

• China and Southeast Asia saw a sharp drop in healthtech investment:
  • China saw a 78% drop in healthtech investment in Q1 2020, followed by Southeast Asia, which saw its investment decline by 66%.
• India and North East Asia’s healthtech investment showed moderate growth:
  • The only regions which saw an increase were India and North East Asia which saw its investments increase 3.35 times and 30% respectively (Figure 3).

   

The investments garnered in Asia Pacific in Q1 2020 were mainly generated by two mega deals, which exceeded US$100 million each. One of the deals was struck in China, the other in India and together, the two deals represented 36% of total funding, which was down 4% compared to the same period a year ago.

The share of total funding excluding the mega deals in Q1 2020 also shrunk to 53% year-on-year. Meanwhile, the average deal value decreased by 31% to US$10.6 million, most likely reflecting a global downward trend in valuations.

In terms of total deal value, China leads the Asia Pacific region with US$280 million, followed by India (US$251 million) and South Korea (US$66 million).

Out of the ASEAN countries, only Singapore made it into the top six countries in receiving funding in Q1 2020 with US$41 million.

• Healthtech investment in the Asia Pacific region mainly targeted agnostic disease ventures (32%). Agnostic disease ventures are those that do not focus on specific diseases.
• Under disease-specific solutions, investments poured into chronic diseases (cardiovascular (9%), diabetes (8%)), oncology (11%) and preventive health (8%) (Figure 4).
• In Q1 2020, a total of 141 individual investors participated across 68 deals compared with the 182 individual investors that participated in 99 deals¹² in Q1 2019.
  
  

3. Healthtech investment trends in Asia Pacific show bright spots for startups that address COVID-19 needs

The COVID-19 outbreak is expected to have a substantial economic impact and accelerate the creation of new business models. It has already affected healthtech firms’ revenues and patients, making the development and adoption of patient-centric digital health solutions a priority for both public and private health sectors. The impact is expected to be felt across all the healthcare industry for 6 to 12 months and potentially beyond.¹⁵

Digital health solutions that address issues posed by the pandemic saw large increases in investments in Q1 2020; telemedicine’s deal value increased 8.47 times compared to Q1 2019, the largest increase among all healthtech services.¹⁶ The other two sub-sectors that saw an increase were health insurtech (42%) and patient solutions (18%).¹⁷ Other services such as remote monitoring, medical diagnostics and health management solutions saw an increase in investments.¹⁸

The pandemic has also led to the creation of a new category of health solution: contact tracing or tracking apps. Governments are introducing applications to track and trace contamination and adapt privacy laws. Table 1 shows some of the applications that have been rolled out in Asia Pacific.

Table 1: Tracking apps used by selected countries in Asia Pacific¹⁹

The decline in year-on-year healthtech funding did not stop the following startups from capturing a healthy dose of investment. Healthtech firms that are patient-centric managed to bring in larger investments (Table 2).

Table 2: Major healthtech investments in Asia Pacific in Q1 2020

Notes:

• Early stage: all deals up to and including Pre-A stage
• Growth stage: Series A, B & C stages
• Late stage: Series D & beyond stages
• Exit stage: all IPO and M&A deals

Looking at the progress of healthtech firms like Doctor Anywhere and Lunit, there are ways for healthtech firms to not only stay afloat during this time of uncertainty, but also pursue opportunities to improve patients’ quality of living and ultimately, save lives.

As mentioned before, the Q1 2020 results do not truly reflect the impact of COVID-19 on healthtech investments in Asia Pacific and therefore, we will look at more recent data obtained in the US since it is the largest healthcare market globally, to have some insight into what the future could portend for healthtech investments in Asia Pacific.

4. Outlook for the remainder of 2020 shows investment will continue with telemedicine anticipated to be a favoured asset

The US had its strongest start ever in healthtech investment in 2020 by bringing in US$3.1 billion during the first quarter, according to Rock Health data.

The COVID-19 pandemic hit the US in February 2019 and the twin crises of a global pandemic and massive economic shifts are expected to rapidly impact all market sectors, including healthtech.

A survey of 12 leading healthcare investors conducted between 16-20 March by Rock Health³⁰ provides an early indication of healthtech³¹ investment trends in the US going forward:³²

• • i. Access to capital will be limited
    Two thirds of the respondents felt that healthtech startups will have a “much harder time” raising capital in 2020 than they did in 2019. Sequoia Capital noted that COVID-19 has and will cause supply chain disruptions, reductions in growth forecasts and changes in hiring plans.

• • ii. Access to private capital won’t contract as rapidly as public capital
    Most of the investors surveyed will not be reducing the amount of capital they intend to invest in 2020; only three “somewhat agreed” to the statement that said they would deploy less capital than anticipated at the beginning of 2020.The advantage of several years of heightened VC and private equity (PE) fundraising is that firms collectively possess a large amount of dry powder (funds that have been raised but not yet deployed). This may, to some extent, help alleviate the near-term market shock on the availability of capital to entrepreneurs.

• • iii. Healthtech is in a unique position to expand the capacity of a strained healthcare system
    According to Rock Health, the acute mismatch between supply and demand is the most significant problem facing healthcare today, particularly the human capital (medical doctors and nurses) mismatch during the pandemic. Healthtech firms offer technologies that support the delivery of virtual healthcare, scaling the medical workforce, and the acceleration of R&D for diagnostics and treatments.Investors surveyed anticipate growth in remote monitoring, symptom checkers and triage tools (Figure 5). Telemedicine, in particular, has been deployed at the front lines of the pandemic. Rock Health’s annual Digital Health Consumer Adoption Survey found the use of live video telemedicine has increased 4.5 times in 2019 from 2015.

• iv. A dim outlook for IPOs and M&As in 2020
  An impending recession would no doubt diminish public investor appetite for initial public offerings (IPOs). All but one of the investors surveyed felt that the healthtech IPO window is shut for 2020. However, those same investors were slightly less aligned in their predictions about the M&A market. Two thirds of the respondents believe “market volatility will significantly slow down digital health M&A activity.”³³

The above findings provide a snapshot of how the COVID-19 pandemic has affected healthtech investment in the US and how it will affect future investments. In Asia Pacific, the following insights emerged:³⁴

• • i. Digital healthcare businesses have become a hidden gem
    Private equity investors and venture capitalists are seeking under-the-radar picks that include digital healthcare businesses. Healthtech is expected to remain a key focus of investors even after the pandemic subsides. According to Lip Kian Ang, a partner at a Singapore-based law firm, the healthcare, medical R&D and pharmaceutical industries will likely be high on the list of priorities for private equity companies for the next five-year plan.

• • ii. The rise of specific sub-sectors – telemedicine and online pharmacies
    Private investment firm Fundnel has seen a surge in investors enquiring about investing in healthtech. Telemedicine and online pharmacies have become especially popular for sector-focused venture capital funds that allow investors to diversify their allocations into specific themes.

• iii. The necessity of tech-based value-chain businesses
  The recent health crisis has highlighted the importance of keeping the supply chain going especially for vital industries such as healthcare. One venture capitalist said that COVID-19 had helped to “open up opportunities in weakened offline value chains” in any sector which continues to rely on traditional methods, and this may push the adoption of tech-enabled solutions.³⁵ Vynn Capital foresees the tech industry working more closely with traditional sectors as corporates will need to invest in improving the supply chain.

From observing the healthtech investment outlook for 2020 for the US and Asia Pacific, two similar points emerge:

• • i. Private investment into the healthtech sector will continue although with a few differences:
    
    
    • Investment in the healthtech sector in the US will be from venture capital and private equity funds that have already raised funds but have yet to deploy them.
    • In Asia, venture capitalists and private equity investors are looking to invest in under-the-radar picks such as digital healthcare businesses.

• ii. Telemedicine has become particularly popular among investors:
  
  
  • It was among the sub-sectors anticipated to see growth in 2020 according to investors surveyed in the US
  • Singaporean telemedicine firm Doctor Anywhere raised US$27 million in Series B funding in the first quarter of 2020.

5. Conclusion

Most ASEAN-level discussions at the moment are understandably focused on the containment of the COVID-19 pandemic but ASEAN must also plan for the future to be better prepared should a similar crisis occur again.

Healthtech has the potential to meet the evolving and varying healthcare needs of Southeast Asia.³⁶ The onset of COVID-19 amplified this point even further. A Deloitte report released in April 2020 anticipates the pause in healthtech investments in the US to be temporary³⁷ and this may also be the case in Asia and by extension, Southeast Asia. The COVID-19 pandemic has helped to highlight the importance of healthtech, which is now front and centre economically, politically, and socially. Under the current situation, emphasis on healthtech, particularly virtual health is expected to continue.

Intra-ASEAN COVID-19 tracking system

Outside of ASEAN’s official frameworks and strategies, the inclusion of healthtech in any regional measures whether to fight the pandemic or support a post-pandemic recovery plan could be beneficial. For example, the use of an intra-ASEAN tracking system would allow regional travel to safely resume while insurtech could expand coverage in a time of rising healthcare expenses.

ASEAN Health Sector Cooperation

As a regional bloc, ASEAN has several regional health mechanisms put in place by the ASEAN Health Sector Cooperation that covers areas including public health emergencies, epidemiology training network, big data analytics and visualisation, and public health laboratories network. ³⁸

ASEAN Economic Community Blueprint 2015 and 2025

The ASEAN Economic Community (AEC) Blueprint 2015 lists healthcare services as one of four prioritised sectors to be liberalised by 2010 and the subsequent AEC Blueprint 2025 focuses on strategic measures that would promote the development of a strong healthcare industry. ³⁹ In both the AEC Blueprint 2025 and AEC 2025 Consolidated Strategic Action Plan (CSAP), the promotion of potential high growth sectors such as health tourism and e-healthcare services is mentioned.

ASEAN Post-2015 Health Development Agenda 2016-2020

The ASEAN Post-2015 Health Development Agenda for 2016 to 2020 covers the shared goals, strategies, priorities and programmes of the health sector between 2016-2020.⁴⁰ For the succeeding health development agenda, it is recommended that healthtech is added to clusters related to healthcare system resilience and accessibility.

Recommendations for succeeding ASEAN frameworks

To include healthtech in future ASEAN frameworks, the following will need to be considered:

• The definition of “healthtech” needs to be properly defined in all ASEAN documentation going forward. The current definition of “healthtech” varies amongst member states, and the alignment will ensure that all parties share the same understanding of the definition of “healthtech” . This is crucial to prevent healthtech being left out of master plans or having duplicate entries.
• As healthtech covers a relatively large scope, prioritisation of relevant categories under the sector such as telemedicine, online pharmacies and remote monitoring should be done to ensure a more targeted and effective approach.
• The concept note on the promotion of health tourism and e-healthcare services developed under the CSAP should be developed further and include healthtech.
• The promotion of public-private partnership (PPP) investments for the provision of universal healthcare⁴¹ under the CSAP should be extended to specifically include healthtech as this can spur PPP investment in healthtech areas beneficial for the region.

Inclusion in the Consolidated Strategy on the Fourth Industrial Revolution (4IR)

It would be prudent to include healthtech in the proposed Consolidated Strategy on the Fourth Industrial Revolution (4IR) as well. ASEAN needs a proper framework for the development of its healthtech sector so as to not squander the progress that has already been made and to ensure the region is able to harness 4IR technologies to provide quality and affordable healthcare for its people.