US biotechs increasingly use sites like Australia to accelerate development, as Create Medicines did by moving from concept to clinic in under 12 months. What was once viewed with suspicion is now a key strategy to generate data faster and more cheaply, competing with the speed of China's ecosystem.

Electronic Health Record (EHR) companies have historically used proprietary formats to lock in customers. AI's ability to read and translate unstructured data from any source effectively breaks these data silos, finally making patient data truly portable.

We possess millions of data points on interventions, but they are useless to AI models because they're trapped in thousands of disparate EMRs in varied formats. The challenge is not generating more data, but solving the human incentive and alignment problems required to create unified data registries.

Through massive government investment in biotech infrastructure, China has become the global hub for early-stage clinical drug development. Both Chinese and Western companies now conduct initial human trials there to move much faster and at a significantly lower cost, giving China a strategic foothold in the pharma value chain.

Novartis's CEO highlights a surprising inefficiency: clinical trial nurses often record patient data on paper, which is then manually entered into multiple digital systems. This archaic process creates immense friction, cost, and risk of error, representing a huge, unsolved "boring problem" in biotech.

Biotech firms are beginning to selectively disclose clinical data, citing the need to protect R&D from fast-following competitors, particularly from China. This forces investors into a difficult position: either trust management without full transparency or discount the company's value due to the opacity.

To overcome the difficulty of running clinical trials in China, Zymeworks partnered with a local company, B1. This provided crucial access to a large patient population for indications like gastric cancer, significantly speeding up its global drug development program.

Amidst growing uncertainty at the US FDA, biotech companies are using a specific de-risking strategy: conducting early-stage clinical trials in countries like South Korea and Australia. This global approach is not just about cost but a deliberate move to get fast, reliable early clinical data to offset domestic regulatory instability and gain a strategic advantage.

China is poised to become the next leader in biotechnology due to a combination of structural advantages. Their regulatory environment is moving faster, they have a deep talent pool, and they can conduct clinical trials at a greater speed and volume than the U.S., giving them a significant edge.