It is time to discard approaches to global health that are broken, suboptimal or ill adapted and to take up dialogue across societies to pursue real progress
The COVID-19 pandemic clearly demonstrates that economic and social well-being is inextricably bound to the health of populations. In the months since the virus enveloped every country on the planet, we have witnessed economic hardship, social friction and human suffering on a scale perhaps unseen in our lifetime. After the virus is controlled, we will continue to feel its cascading negative effects on mental health, diagnosis and treatment of people with other diseases, access to care and health system sustainability.
The structures and systems that ensure healthcare delivery are significantly strained, exposing long-standing gaps, fissures and disparities that must be overcome in realising a future where all people have access to affordable, quality health care. There is now a brief opportunity for global leaders to cooperate to achieve a ‘Great Reset’ – a step forwards to a more resilient, cohesive, equitable and prosperous world. Regarding health care, will leaders choose to advance or allow the world to ease back into systems that are flawed but familiar?
Such decisions require urgent attention. Consider that current estimates project COVID-19 will push 71 to 100 million people into extreme poverty, measured at the international poverty line of $1.90 per day. In comparison, a 2017 report found nearly 100 million people are pushed into extreme poverty each year because of out-of-pocket health expenses. The health systems that existed before the pandemic caused the same level of financial harm to people – annually – as the pandemic. This is neither tolerable nor sustainable.
Seize the moment
As the world collectively moves towards a post-COVID era, let us seize this moment to reflect on lessons from the pandemic and intentionally apply them to improve healthcare systems. This is achievable. The World Economic Forum, through its Platform on Shaping the Future of Health and Healthcare, is running many initiatives to identify and overcome existing gaps and barriers in healthcare systems and shape the trajectory of related fourth industrial revolution technologies so they lead to a globally and societally beneficial future. I would like to describe a few.
Accelerating diagnosis and treatment: Rare diseases affect 400 million people globally. Tragically, 3 out of 10 children born with a rare disease die before the age of five due to a lack of diagnostic and treatment options. Applying fourth industrial revolution advancements in cross-border data flows, precision and genomic medicine, artificial intelligence and machine learning offers a path to faster diagnosis and more effective treatments, but also raises numerous governance and policy challenges. Leaders at genomics institutes in Australia, the United Kingdom, Canada and the United States have come together to work through these challenges to create a federated data consortium that serves as a model for other health institution collaborations.
Launching non-pharmaceutical interventions: 75% of mental health issues begin before the age of 25. Due to the significant impact of mental health disorders on education, work, relationships and housing, it is important that communities provide young people with services that are supported by evidence. Without these services, costs of care will increase over time. In collaboration with the Global Shapers, a community of leaders under 30, the World Economic Forum built and operationalised a universal youth mental health framework focused on awareness, prevention and affordable access.
Fostering sustainable systems: The cost of health care is growing at double the rate of gross domestic product. By 2040, the world will spend around $25 trillion every year on health care, representing a 150% increase since 2014. A global effort to transition to value-based health systems will support the sustained availability of quality, affordable care. The forum is running a collaborative global platform to facilitate knowledge exchange and co-creation of new interventions among those who choose to think past the status quo and guide the development of value-based health systems.
Rethinking marketplace dynamics: Limited global manufacturing capacity will be a primary bottleneck in COVID-19 vaccine availability. The supply produced will be further constrained by national obligations required of vaccine innovators and manufacturers who are pursuing bilateral agreements with governments. Although bilateral agreements are standard practice, they will crowd out poorer countries during the pandemic. Taking a multilateral perspective can open new markets and expand existing businesses, while ensuring that people in advanced, developing and frontier economies have access to vaccines. The MANAGE-COV (Manufacturers Alliance for Global Equitable Access to Coronavirus Vaccines) Consortium is establishing a global vaccine manufacturing network among those who choose to work towards the creation of an additional COVID-19 vaccine manufacturing capacity of several billion doses for populations in low- and middle-income countries.
Our initiatives highlight what is possible when leaders across governments, businesses and civil society make the choice to focus attention and resources on the difficult work of creating positive change in health care. To be sure, health care is complex, and the choice to assign resources to a Great Reset in health care may not result in immediate political or profitable returns to decision makers. However, these choices will reap critical societal returns and, fundamentally, the Great Reset is about building a new social contract that honours the dignity of every human being.
Let us not maintain approaches we have seen are broken, suboptimal or ill adapted for a healthier and more globally beneficial future. Instead, let us begin dialogues across societies, meaningfully assess where we are as a planet and as a people, and decide how we can move from this time of global crisis to a new era. Real progress is possible. The first step is in choosing to pursue it.