While newspaper headlines around the recent United Nations General Assembly were dominated by global policy and diplomacy narratives, representatives from the health sector working in government, NGOs, academe, civil society and the private sector were busy coming together around shared interests to address the world’s greatest health challenges. Two highly anticipated events included the first high-level meeting on tuberculosis (TB) and the third high-level meeting on non-communicable diseases (NCDs).
We were on the ground and observed several key themes:
Countries are charting their own course towards Universal Health Coverage
“Universal health coverage is a political choice… [It is] about ensuring nobody has to choose between health and poverty or death.” – Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, in his keynote remarks at a dinner hosted by the Access Challenge
On September 22nd, Indian Prime Minister Narendra Modi launched “Modicare”—the world’s largest healthcare program helping the country’s poorest gain access to healthcare. All eyes will be on India and other countries, such as Nigeria, beginning to pilot universal coverage schemes to assess the impact of universal health coverage (UHC) on key health priorities, including addressing the growing burden of NCDs.
Health constitutes a major element in many economies around the world and the drive toward universal health coverage will further boost the supply and demand for health and health-related services and goods. The new health economy emerges in an environment where international flows of people, goods, and capital have changed economies and industries.
Furthermore, young people make up 40% of the world’s population and are critical partners in achieving universal health coverage. To that end, we were excited to partner with the WHO, World Economic Forum, the International Federation of Medical Student Associations, International Pharmaceutical Students Federation, UN Foundation, and Women Deliver on “Youth For Health.” The event gathered stakeholders from within and beyond the health sector to spotlight the voice of youth in relation to prevention and control of NCDs, Ending TB and achieving UHC.
Panelists at the Youth for Health WHO event
Credit: Tereza Kasaeva
We expect that interest in UHC will continue to be high in the coming years, not least because all UN Member States made a formal commitment in 2015 to plan for UHC by 2030; Dr. Tedros Adhanom Gebreyesus has made UHC a top priority for the WHO; Kazakhstan will shortly host the WHO Global Conference On Primary Healthcare in celebration of the 40th Anniversary of the Alma Ata Conference in 1978 that sparked the UHC movement; and there will be a UN General Assembly High-Level Meeting devoted to UHC in September 2019.
Good health is good business
• Access Accelerated led a conversation, which Rabin Martin supported, on addressing the systemic challenges of NCDs facing governments and healthcare systems and looking towards opportunities to strengthen commitment and action at all levels. Speakers discussed the progress made in Kenya — an Access Accelerated focus country, and reaffirmed the commitment to decisive, sustained action on global and local NCD priorities.
Access Accelerated is unique in keeping patient voices at the center while working directly with national and county-level government leadership — critical since access issues are different in every country.
Credit: Access Accelerated
• Teva Pharmaceuticals, Intel Corporation and the International Alliance of Patients’ Organizations also discussed how to leverage the expertise of the private sector in their panel, The NCD Care Continuum: Taking Multi-Sectoral Action to Advance Management of NCDs, which Rabin Martin’s Jeff Sturchio moderated. Health challenges, like the NCD burden, require pragmatic, multi-sectoral partnerships, which offer opportunities for the private sector to build trust through collaboration around common goals. Incorporating patient voices must also be integral to these partnerships.
Digital health can greatly accelerate progress on NCDs if integrated into healthcare delivery
New technologies are able to expand access to healthcare, even in the hardest to reach areas. But digital health is not just about the latest technology. There is a continued need to focus on how digital health can complement existing systems.
At an event hosted by Novartis and Intel, The Broadband Commission for Sustainable Development launched a new report, The Promise of Digital Health: Addressing Non-communicable Diseases to Accelerate Universal Health Coverage in LMICs, that provides recommendations to help policymakers leverage digital technology to reimagine the way NCDs can be addressed.
Devices are becoming smarter at a lower cost, enabling new methods for diagnosing, treating and managing health issues and catalyzing more efficient and effective means for community health workers to support their clients.
However, there is still work at the implementation and policy levels, where healthcare providers must understand how to use the data for increased service delivery and efficient decision making, while policy makers need to understand the implications of large data sets to influence national and local policies.
Quality is a core component of healthcare
It is estimated that 5 million people die every year because of poor-quality health care in low- and middle-income countries, significantly more than the 3.6 million who die from not having access to care.
Associate Professor of Global Health at the Harvard T.H. Chan School of Public Health and member of Rabin Martin’s International Advisory Council, Margaret Kruk, presented these finding from the Lancet Global Health Commission on High Quality Health Systems at a special event at UNICEF. Surveying households in 47 countries, the Commission found that the care people receive is often inadequate. Poor-quality care is common across conditions and countries, with the most vulnerable populations faring the worst.
A key recommendation of the report is the need to think beyond the point of care and take a systems approach. The report argues for a move towards outcomes-based measures of health systems—including greater trust in the system and competent care, which incorporate patient perspective and user insights.
“We cannot judge health systems on inputs: number of doctors, number of clinics, number of antibiotics. Stethoscopes themselves don’t produce good care. We need to be judging systems on performance: the competence of care, the respect that patients get when in treatment, their health and trust in the system.” – Margaret Kruk
The need for quality, outcomes-based healthcare presents an opportunity for greater collaboration with the private sector by aligning interests between government and other actors who have a vested interest in improving population health.
Calls for greater accountability in private sector efforts to help achieve SDG goals
The UN Independent Accountability Panel for Every Women, Every Child, Every Adolescent recently launched a new report, Private Sector: Who is Accountable?, examining the need for accountability of the private sector in global health and calling on governments to establish greater regulation and accountability mechanisms.
“We have to mobilize the private sector as a real partner… the question is not if, but, how, the private sector is to engage.” – Mr. Børge Brende, President of the World Economic Forum
While the power of multisectoral collaboration and the need for greater engagement with the private sector is a stated priority for many governments, more needs to be done to build trust with UN agencies, national governments and civil society partners to enable closer collaboration around shared commitments in achieving the SDGs. In a National Academy of Medicine article, Katherine Taylor, associate director and director of global health training at the University of Notre Dame’s Eck Institute for Global Health, articulates:
“Global health leaders and organizations are frequently suspicious of the private sector’s motivations… this thinking is flawed. It views health in a silo and not as part of a system that is shaped by politics, law, environment, culture, and history.”
If you would like to engage with Rabin Martin on future global health events or engagements, please reach out to us at [email protected].
Lauren Diamond and Saroj Sedalia, of Rabin Martin, at the Access Challenge UHC Conference
Credit: Amanda Paige
Maria Schneider and Lucia Cordon, of Rabin Martin, at the UN Foundation’s 20th anniversary gala