Sustainable Development

Who owns the future of our health?

The Lower Manhattan skyline is seen in the distance during a weekly evening yoga class in a park along the Hudson River in Hoboken, New Jersey June 11, 2013. New York City is iconic in any weather, but the warm season adds a special flavour to its bustling streets, leafy parks and world-famous skyline. The summer is about to draw to a close, as fall begins in the northern hemisphere with the Autumnal Equinox on September 22. Picture taken June 11, 2013.

Image: REUTERS/Gary Hershorn

Johanna Ralston
CEO, World Heart Federation
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Future of Global Health and Healthcare

Why would a former Oxfam campaigner and a group of grassroots consumer rights advocates be sitting down with big government and big food to tackle obesity? And how can a tick in a box tackle one of the world’s newest and most complex health crises, the emerging obesity epidemic?

The Choices International Foundation was launched in the Netherlands by a former NGO leader and advocates for healthy nutrition to take a simple tool – on-pack labelling – and to work with governments, consumers and the processed food industry to nudge consumers – and companies – into healthier food options. It is a great example of how a health ecosystem is vital for addressing the world’s most prevalent and daunting health issues, especially in the area of non-communicable diseases (NCDs).

The past few months have been an extraordinary time for the future of global health, in ways that will play out over the next 15 years. In November, world leaders convened in Paris for COP21, where critical environmental commitments that will also impact human health were made, just two months after the adoption in New York of the Sustainable Development Goals at the UN.

Just as clear, however, is that the solutions that have worked in the past to achieve earlier goals around development and health including the MDGs – a north-south flow of funds driven through and into civil society and public sector organizations to deliver, with a role for the private sector that is often incidental to its core business – are not likely to be feasible or even desirable in achieving the health goals, given the complexity and interdependence of stakeholders in the health value chain.

A new model is needed, one that draws on lessons learned from the environmental movement and its successes in working across sectors, and one that focuses our value through the lens of ecosystem for health. The World Economic Forum recently issued a report, How to Realize Returns on Health, which proposes a shift to a return on health that complements and perhaps even overlaps with return on investment. The report maps out solutions involving all sectors and categories including, but not limited to health, and takes the concept of shared value one step further to align with the SDG target of ensuring “healthy lives and promote wellbeing for all at all ages” via ROI and ROH.

How to Realize Returns on Health report

In some cases, the marriage of the two is obvious – Bupa, a global insurer, builds a long term ROI by investing not only in employee health but in more innovative approaches such as its global Chief Medical Officer network, expanding the reach and time-frame of the ROH in ways that directly increase ROI. But what of businesses and NGOs that operate outside of health? And what is the relationship between the two when the old dynamics of business as sponsor and NGO as implementer are replaced?

The report supports a central pillar of both the SDGs and the Paris Agreement, that a “joined up” approach will not only tackle longstanding and emerging challenges around development and health, but will do so in ways that encourage a new model of coordinated and committed response from key stakeholders. This will require a change in how sectors partner and begs the question, what is the role of non-profits, advocacy groups and professional societies in this new environment? How can NGOs and the private sector share in accountability for these goals? The answer will determine who will own the future of health.

Civil society organisations (CSOs) play a central role in driving and ensuring success in achieving our common health goals. Given the degree to which health is affected by elements outside the health system, organisations engaged in adjacent areas including agriculture, the environment, education, and trade, are also essential links in the health supply chain. The World Heart Federation is an umbrella group representing heart and stroke organisations and medical societies across the globe and its aim is to reduce the burden of cardiovascular disease (CVD), the leading cause of death in the world including in low and middle income groups, where 80% of CVD deaths occur. The World Heart Federation advocates for and aligns with the WHO and SDG agendas and it operates on three levels:

  • Common strategies to ensure that policies in Geneva are translated into action in countries through offerings including CVD roadmaps
  • Strategic collaboration with like-minded groups such as NCD Alliance which the World Heart Federation co-founded with sister associations fighting diabetes, cancer and chronic respiratory diseases
  • Working across sectors through initiatives such as Healthy Heart Africa, launched with Astra Zeneca and involving ministries of health, hospitals, faith-based groups and insurers in several countries in Africa.

NGOs are central to the future of health. But no one sector can do this alone - the public sector plays a role in setting norms and a framework, NGOs serve as advocates, watchdogs, and service providers, and business fosters innovation and efficiency. Indeed, the future of health is owned by everyone.

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