It took a pandemic, but we’re finally having serious conversations about what sustainable health care looks like and the value of investment in health care.
Health systems across the world are stretched managing the response to COVID-19, along with other pressing diseases like cancer. The Organisation for Economic Co-operation and Development forecasts that health care spending will outpace gross domestic product growth for the next 10 years in most countries. Yet there have never been more tools at our disposal to make changes that can bridge gaps and ensure faster, more effective delivery of care.
Dr. Atul Gawande, professor at Harvard T.H. Chan School of Public Health, eloquently noted that investment in breakthrough innovation “has not been matched by investment in follow-through innovation to deliver these breakthroughs widely.” This must change. All the great innovation that is coming through does no one any good, unless these are delivered to appropriate recipients in a timely and efficient manner. Working together, local governments, implementers and the private sector can leverage medical innovation to build stronger, more resilient health systems to address these challenges.
Chile is a great example of both the challenge and what we can achieve through smart investments and meaningful partnerships. As of last year, the country lacked both centralized oncology testing infrastructure and genomic counseling capabilities. This limits the ability to test patients for genetic mutations driving their cancers, impeding the opportunity to understand which patients will and will not benefit from targeted therapy. Such uncertainty fuels inefficient health care choices.
To address this gap, the Chilean government is collaborating with a coalition of nonprofit and industry partners to build a national genomic profiling and genomic counseling cancer service. This will include a national lung cancer program that centralizes testing, analytics and reporting. The program will preserve tissue samples in a large biobank that, with the power of computing, can expedite and improve decision-making for how to treat new cases of cancer. Pfizer, Roche, Novartis and the Biobank of Universidad de Chile are part of the alliance, which aims to begin enrolling centers, healthcare providers and patients this month.
In Bulgaria, patients face long delays for medical appointments, which hinders screening programs, delays breast cancer detection and contributes in part to high rates of breast cancer mortality. One way to solve this is getting people who are at risk into the hospital system as soon as possible. We are partnering on programs to use smartphone-based self-diagnostic digital tools, which could help people spot abnormalities in their bodies and alert them to seek diagnosis or specialized medical care at early stages.
Portugal saw 2.8 million fewer contacts with hospital health care — face-to-face appointments, scheduled surgeries and severe emergency episodes — in 2020 and 2021, compared with 2019. And more than 169,000 fewer people were screened for breast cancer, driven in part by COVID-19.
My colleagues in that country are part of a locally driven collaboration to identify the causes of delays and model ways to better use resources to reduce patient backlogs. This allows hospitals to run simulations showing how reallocating resources during high-peak times can improve efficiency. While mapping out existing capacity in a partner hospital, we learned that they had empty beds throughout the week, which presented an opportunity to optimize capacity and help reduce the backlog caused by COVID-19.
In Ireland, we’ve joined a broader effort to validate the use of liquid biopsies, which require only a blood sample to detect the presence of a tumor. Our project prompted oncologists to perform a national survey of eight cancer centers of excellence to understand potential variations in managing lung cancer and potentially address them.
The road ahead is long and lined with challenges, but there also lie opportunities. Working together through multisectoral partnerships, we can adopt smart policies that facilitate timely intervention, new technologies and foster learnings about how best to reach underserved populations and ensure sustainable access to high-quality care.
Indranil Bagchi is senior vice president and head, worldwide value & access at Novartis.
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