Health and Healthcare Systems

The future of global health and healthcare: game-changers for impact

Surgeons perform a total knee arthroplasty operation in an operating room at the Ambroise Pare hospital in Marseille, southern France, April 14, 2008.   REUTERS/ Jean-Paul Pelissier  (FRANCE)

Image: REUTERS/ Jean-Paul Pelissier (FRANCE)

Nancy Brown
Chief Executive Officer, American Heart Association
Heather Bresch
CEO, Mylan NV
Lucica Ditiu
Executive Director, Stop TB Partnership
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Global Health

Nancy Brown

CEO of the American Health Association

As a leader in promoting cardiovascular health, what are some of the game changing innovations that you feel has still not reached its full potential to improve global health?

Precision medicine holds significant promise to diagnose, prevent, and treat cardiovascular diseases and offers the global health community tremendous opportunity to design treatments and products tailored to the individual patient.

Since precision medicine is personalized to a person’s specific characteristics, such as their genetic makeup, or the genetic profile of their condition, scientists and researchers are positioned to create bold interventions to combat leading healthcare challenges like cardiovascular disease.

According to a recent study, in the next two decades, the number of Americans with CVD will rise to 131.2 million – 45 percent of the total U.S. population – with costs expected to reach $1.1 trillion. Tackling these urgent threats with bold and innovative approaches like precision medicine is paramount to reversing this trend.

The whole premise of precision medicine is to intersect health equity or “leave no one behind” because it provides the best treatment to all patients. We must balance however the technological systems with the patient’s complex background and needs, such as culture, values, preferences, and beliefs.

In the era of “big data”, the global health community can improve health care worldwide, but only if we focus on the wider societal and global environment. The tracking and collection of data by consumers will only continue to grow through wearables, sensors and algorithms, so making this data accessible and actionable for scientific discovery in real and meaningful ways is the next frontier.

Precision medicine should be at the center and balanced with population-centered approaches.

Heather Bresch

CEO of Mylan NV

As the leader of one of the biggest pharmaceutical companies in the world, and a spokesperson for access to quality medicine worldwide, what ideas or solutions have we as a society not yet utilized to its full potential to improve the lives of the 2 billion people who live without access to essential medicine?

The term “access” can mean a lot of different things to a lot of different people, especially when it comes to delivering medicine. It’s multifaceted and varies widely depending on where you live. I like to think about it from a patient’s perspective:

  • Acceptability: I understand my risk for various illnesses and know what treatments exist. I am not embarrassed or afraid to seek help.
  • Accessibility: Medicines approved for sale in my country are available whenever and wherever I need them.
  • Availability: A robust and competitive marketplace encourages drug makers to bring products to market.
  • Affordability: I can afford the medicines I need because prices are fair and equitable or because financial assistance is available.

Every country has its own set of challenges when it comes to delivering healthcare. High-income markets, for instance, can sometimes get in their own way because their existing infrastructure makes it more difficult to implement new technologies. Whereas low- and middle-income countries are able to leapfrog and introduce groundbreaking healthcare innovations. Rwanda, for example, is using drones to help deliver medical supplies in remote areas.

As the four pillars above highlight, access is much more than making sure medicine is available behind the pharmacy counter. Think about the power of “acceptability.” More and more countries are introducing self-tests to help people quickly find out if they are afflicted with an illness – from Lyme disease to prostate cancer. These diagnostic technologies empower consumers to understand their health and equip them with the information they need to seek treatment.

As pharmaceutical companies, we need to consider the patient’s unique circumstances so when they do seek treatment they have access to their required medicine. For example, drugs for children produced in the West are often liquids that require refrigeration. But countries in sub-Saharan Africa often have limited cold-storage capacities or an inability to transport liquid in bulk. That’s why Mylan has developed heat-stable, taste-masked, dispersible tablets that can easily be incorporated into food. More innovations like these focused on the most basic forms of accessibility are needed to solve many of the real-world supply chain issues that patients face today.

The question for us as a society is how can we all come together, think unconventionally and develop innovative solutions that consider ALL facets of access? Because when we balance all of these areas of access – acceptability, accessibility, availability and affordability – we will be delivering not only essential medicine, but, more importantly, essential healthcare.

Dr Lucica Ditiu

Executive Director of the Stop TB Partnership

Why is 2018 the game-changing year for TB?

Mycobacterium tuberculosis (the bacteria that is responsible for tuberculosis (TB) emerged over the last 3 years as the biggest infectious disease killer in the world, and is responsible for a number of deaths that is higher than the number of deaths due to HIV and malaria combined - around 4400 deaths every single day.

Even though TB represents the perfect “combination“ of a very scary disease – it is airborne so everyone breathing is at risk - but curable in 6 months with a cocktail of medicines costing around 32 USD for the entire duration – very few people in the world are aware of the public health threat this disease represents in 2018.

Over the last 100 years, there was less and less awareness in a population about TB, less and less political interest, very limited funding, reduced research investments, almost no new tools to fight the disease, no special initiative and no focus of any President, no interest among celebrities or high net worth individuals. Silence. In this desert environment, mycobacterium tuberculosis continued killing, becoming resistant to the few drugs we have available, grew stronger and dangerous, showing how we fail as human beings in ending a disease that has been with us for thousands of years.

This is why a lot of our hopes are linked to the autumn of 2018, when Heads of State will gather in New York at the United Nations General Assembly first-ever high-level meeting on tuberculosis (TB) to accelerate efforts in ending TB and reach all affected people with prevention and care. The theme of the meeting is “United to end tuberculosis: an urgent global response to a global epidemic”.

Having Heads of States and many other leaders in the global health arena attending the one day event on TB will result in an ambitious Political Declaration on TB endorsed by governments that will strengthen action and investments for the end TB response. The Declaration will be combined with a strong multi stakeholders’ accountability mechanism, which has the potential of being THE game changer we need to End TB.

It is indeed only a one day meeting, but it will be the first time that the TB agenda would reach the cabinets of the highest level political leaders and decision makers.

It is the first time for many of them to hear that TB kills their people at an incredible scale, impacts their economies and development and in spite of being a very cost efficient intervention – for each dollar invested there is a 50-60 USD return - is not properly addressed. It is for the first time that they will understand that the TB response which is in place now, where the funding levels and the outdated tools we have are so inadequate, that we will not end TB before 2180. And if we don’t end TB, we will not end HIV/AIDS (because TB is the biggest killer of PLHIV), we will not impact AMR (as drug resistant TB is responsible for 30% of deaths due to AMR), and we will not reach UHC (as every year we have 48% of people with TB being missed by health services).

So, we better buckle up, unite, engage, and make this meeting a success!

This is the moment we drop everything else, and we work together - irrespective of whether we are from country programs, community and civil society networks, private sector, researchers, donors. There is no other way to end TB than UNITED. There is no other outcome of this fight with TB than SUCCESS. We owe it to us, we owe it to our world.

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