COVID-19 caused a public health rethink Image: Unsplash/Maxime
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- The COVID-19 pandemic exposed the vulnerabilities of global and national health systems.
- These COVID-19 practices could be adopted to create more resilient health systems in developing countries.
- Trailblazers identified cost-effective and globally applicable noncommunicable disease intervention and treatment pathways from which every country should benefit.
As the COVID-19 pandemic appears to be in transition, now is the optimal moment to reflect on lessons learned. More importantly, now is the time to consider what practices can be adopted from the pandemic response to create more resilient health systems in developing countries. COVID-19 offers a chance to reset health system priorities. It provides a leapfrogging moment for health systems transformation through innovation.
The COVID-19 pandemic exposed the vulnerabilities of global and national health systems. Already struggling healthcare systems shifted their resources to the pandemic response. This exacerbated the burden on people with noncommunicable diseases (NCDs) by delaying and disrupting their diagnosis, treatment and care.
NCDs, also known as chronic diseases, include cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. They remain the number one killer globally, causing nearly three-quarters of deaths worldwide. Every year, 17 million people under the age of 70 die from NCDs, 86% of these live in low-and middle-income countries.
NCDs 2030: Accelerating Change through Innovation
On the occasion of the G20 Bali leadership summit, where the strengthening of global health architecture and health systems are priority issues, the World Economic Forum releases NCDs 2030: Accelerating Change through Innovation. Through in-depth consultations with policymakers, industry leaders and leading academics from G20 countries, this white paper uncovers lessons learned from COVID-19 and the effective methodologies and innovation strategies that developed from it. The results inspire optimism.
Rapid pandemic response helped developing countries gain valuable time
In response to the multifaceted knock-on effects of COVID-19, developing countries reacted rapidly to NCDs management challenges by increasing health service provision and strengthening medicine supplies. Countries quickly adopted a system whereby selected hospitals were made designated centres for COVID-19 patients, while others maintained normal operations, treating NCD patients without COVID-19 symptoms. One example is the mobile cabin hospitals approach pioneered and adopted by China, Serbia, India and Indonesia.
By building dedicated COVID-19 facilities, NCD patients without COVID-19 symptoms were ensured medical services. People living with NCDs generally require timely and long-term medications. Extended 'long prescription' policies were rolled out at various local health commissions, while pharmaceutical companies responded with the launch of large NCD medication packaging.
People, prevention and technology
Moving over to integrated health systems will bring long-term benefits to developing countries, but it requires a three-pronged approach focusing on people, prevention and technology. Our studies show that, with thoughtful planning and careful implementation, some of these rapid responses can, and should, be made permanent to improve the equity, accessibility, quality, efficiency and resilience of health systems.
Examples of replicable responses include the many promising examples of people-centred integrated care models across the disease spectrum; innovative attempts to enable and mobilise community-level primary care for early screening and diagnosis; and smart integration with digital and technological advancements to increase health access and improve diagnosis and treatment.
Reshaping the diagnosis and treatment process in a people-centred way
One of the most critical features of integrated health systems is the patient-centred approach. Good examples include China’s Chest Pain Centres (CPC), which have a strong focus on reducing the onset-to-treatment time and raising the treatment efficiency of acute chest pain patients; its Metabolic Disease Management Centres (MMC), which focus on improving follow-ups and management of diabetic patients; and, its Cough and Wheezing Management Centres (CWMC), which focus on improving the quality of life of respiratory disease patients.
Focusing on early detection and diagnosis
The World Health Organization estimates that 30–50% of cancers can be prevented by reducing risk factors and implementing evidence-based prevention strategies. Though developing countries still lag behind on national-level, high-risk cancer screening programmes, we have found promising best practices in countries such as Mexico, Brazil, Colombia and Egypt, with programmes covering at least 70% of the population. This ranges from prostate cancer screening schemes in Mexico, Brazil and Colombia, to a breast cancer screening programme in Egypt. These countries have smartly raised public awareness, significantly improved access to screening services and provided end-to-end services post-screenings.
Improving efficiency by developing and applying innovative technology
The demand for telemedicine and AI-assisted decision-making tools existed before the pandemic, but the pandemic accelerated their progress. Whether it is supporting doctors’ clinical decision-making or helping patients access medical services, the role of technology is becoming increasingly prominent. It will inevitably play an even greater role in shaping the future of health systems.
Take the largest mobile health platform in Indonesia, Halodoc, as an example. Indonesia is the most populous country in South-East Asia and its doctor-to-general population ratio is lower than its neighbouring developing countries and significantly lower than that of developed countries. Halodoc’s users are provided with 24/7 access to doctor consultation services through chat, voice or video calls. Patients can have their medications delivered within 45 minutes, thanks to the integration of a ride-hailing service company and an e-commerce platform. Users are also provided with multiple payment methods, including government-funded insurance.
The benefits of AI in addressing doctor shortages and assisting clinical decision-making are clear. Firstly, AI can be used to improve the accuracy of diagnosis and improve treatment outcomes, especially at primary medical institutions. Secondly, AI is operable 24/7, with AI imaging solutions a good example of this. An experienced doctor needs one minute to assess ten CT scan images. AI technology, using image recognition, shortens this assessment time to a few seconds, while improving the accuracy of manual diagnosis by 15–20%. AI technology also standardises diagnosis, as discrepancies can be created by human factors, such as fatigue or inexperience.
There is still room for optimisation, but we already see trailblazers identifying cost-effective and globally applicable NCD intervention and treatment pathways from which every country – no matter its income level – can and should benefit. NCDs present an urgent global health challenge. Governments, private-sector industries and international organizations must work together to strengthen their collaboration, with learning and sharing at the heart of this ethos. There is no better time for the world to unite and align efforts under these principles.
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The views expressed in this article are those of the author alone and not the World Economic Forum.
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