What will 2018 bring for global public health? We asked the experts

13 February 2018
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Amid growing uncertainty and unease related to the global economy and stagnating resources for global assistance, what are the implications for meeting global health commitments in 2018?

We tapped our network of clients and health experts to find out. Here is what they said.

Note: Responses have been lightly edited for length or clarity.

Click here for part 2 in our series, exploring new opportunities for collaboration, breakthrough innovations and emerging voices that we predict will shape the global health agenda in 2018.

What are the greatest threats to global health in 2018?

There was wide consensus among respondents about two key threats that are keeping them up at night.

  1. The rapid growth of non-communicable diseases

“Rapid urbanization, worsening diets, increasingly sedentary lifestyles and aging populations are contributing to a rise in non-communicable diseases worldwide.” – Global NGO executive

“The rising prevalence of obesity and related diseases, such as diabetes.” – Global public health academic

Non-communicable diseases (NCDs), including cancer, cardiovascular disease and diabetes, alongside risk factors such as obesity and smoking, are the leading causes of death and disability worldwide and the burden is growing[1]. NCDs cause and perpetuate poverty in low- and middle- income countries by hindering productivity and taking people out of the labor market due to illness and premature death.

Public-private partnerships helping unite innovators, funders and regulators to address NCDs include:

• The Access Accelerated initiative, which brings together more than 20 biopharma companies to catalyze partnerships to address the rise of NCDs around the world.

• Cities Changing Diabetes program, sponsored by Novo Nordisk in partnership with University College London and Steno Diabetes Center, in which nine cities around the world are learning how to improve diabetes prevention, detection and care in their communities.

Indeed, NCDs will feature prominently in this year’s global health dialogue. This year, the United Nations will also convene the third high-level meeting on the prevention and control of non-communicable diseases, following meetings held in 2011 and 2014. While the date for the UN high-level meeting has not yet been set, the World Health Organization and the Government of Denmark will host an invitation-only, multi-sector Global Dialogue April 9-11 to explore new ways to address the critical gap in financing for national NCD responses, to take place in Copenhagen, Denmark.

The WHO just released the list of commissioners for the recently-established Independent Global High-level Commission on NCDs, which will be co-chaired by President of Uruguay, Dr. Tabaré Vázque and global health luminary Dr. Sania Nishtar.

In preparation for the UN high-level meeting on NCDs, the NCD community is planning a cadence of activities. Among these is the NCD Roundtable, a public-private coalition that advocates for greater U.S. leadership around global NCDs. As co-chair, Tina Flores of Rabin Martin is helping to facilitate engagement with the U.S. government and other key decision-makers on policy priorities in advance of the high-level meeting to drive more urgency around NCDs.

  1. Pandemic preparedness and global health security, including the threat of antimicrobial resistance

Emerging infections with international spread, especially [new strains of] influenza.” – Global public health academic

Ebola was a disaster…some say with a slow response but also due to a lack of proper surveillance and infrastructure. Zika was a bit better…however, are we ready to contain and prevent such epidemics? Do we have enough supply of medicines and technologies to deal with them?”  – Global NGO executive

As the world faces increased globalization, climate change, and the emergence of health threats such as antimicrobial resistance, it is only a matter of time before the next pandemic strikes. Low- and middle- income countries with weaker health infrastructures are particularly vulnerable, as they are least able to protect against emerging health threats.

However, pandemics are beyond the capacity of any single nation or organization to combat alone.

The private sector has an opportunity to partner with countries to help address these types of global health threats by sharing their technical expertise and strategic capabilities, such as in the areas of logistics and supply chain management, information and communications technology and data management. Led by Johnson & Johnson and the GE Foundation, the Private Sector Roundtable on global health security mobilizes companies from different sectors to support countries in protecting, detecting and responding to global health threats.

The Private Sector Roundtable serves as a focal point for multilateral institutions, governments and other partners who wish to work with industry on issues such as vaccines, supply chains, increasing laboratory capacity, advancing data and analytics and other areas critical to health security.  For more information, see this related blog post.

What are the greatest challenges to improving global health?

  1. A loss of global health dollars and a political commitment to make health a priority.

Reductions in donor investments in global health” – Global NGO executive

“The difficulty to translate global commitments into country-level policies and programs. Health is rarely a national priority, resulting in chronic lack of resources (human and financial)” – UN agency advisor

As political landscapes across the globe continue to shift, the United States government is prioritizing domestic issues and has threatened to decrease international aid. The resulting budget uncertainty from the world’s largest bilateral donor for global health has led to concern over long-term funding. While some country governments, like Norway, are stepping in, aid recipients will likely need to look inward to reassess their own healthcare expenditure and set up new mechanisms to finance services.

  1. Uncertainty over the adoption of new global health financing mechanisms.

“Innovative financing for health will not proceed as fast as some would like” – Global NGO executive

 vs.

 “Digital and financial innovations will overcome barriers” – Corporate philanthropy executive

While there have been several notable examples of new financing mechanisms for health, for example the Utkrisht impact bond focused on improving the quality of care among private maternity care providers in India, its use to finance health programs significantly lags behind that of access to finance, energy and environment and agriculture.

Using innovative finance models can change the entire health ecosystem so that it works more effectively by investing in prevention, incentivizing collaboration, building a culture of monitoring and evaluation to drive performance management and focusing on the achievement of outcomes. However, whether 2018 will be the year for innovative financing to establish itself as a meaningful funding stream for complex, global health interventions across a variety of geographies and therapeutic areas remains to be seen.

If you are new to the space, a few helpful resources:

• This report recently issued by USAID’s Center for Accelerating Innovation and Impact, which provides an overview of the shifting global health finance landscape

A primer on impact bonds from Brookings

A 2017 Lancet article on innovative financing instruments

A primer on blended finance (which includes innovative finance) from the OECD and the World Economic Forum

 

We want to know what you think! What threats to global health do you believe will interfere with global health priorities? What challenges will delay meeting current commitments? Please drop us a line at info@rabinmartin.com.

Click here for part 2 in our series, exploring new opportunities for collaboration, breakthrough innovations and emerging voices that we predict will shape the global health agenda in 2018.

 

[1] GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016; 388(10053):1659-1724

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