Expert insight

5 Questions to James Pfitzer

9 September 2020

With more than 20 IFPMA member companies, Access Accelerated is the largest collective industry effort to address inequities in non-communicable disease care.

Access Accelerated recently launched its Year 3 report, chronicling the initiative’s collective efforts in 2019 to advance access to NCD prevention, treatment and care in low- and middle-income countries. To mark this occasion we sat down with Dr. James Headen Pfitzer, Director of  Access Accelerated, to take stock of the achievements and the challenges ahead.

  1. Prevention of chronic diseases is a global challenge, so why are locally-tailored solutions so important?

Non-communicable diseases (NCDs) are undoubtedly a global challenge that require a global commitment to overcome, but at Access Accelerated, we view our work through a local lens. Solutions to a problem as complex as NCDs aren’t one-size-fits-all because each community, city and country is unique in its social, economic and environmental development.

To effectively build trust and maintain accountability, public health programs must be responsive to local needs and address the very different challenges and barriers that inhibit NCD prevention, treatment and care across different contexts at all levels. It is particularly important to establish meaningful collaboration and open communication at all stages of program development, execution and evaluation with local stakeholders and leaders but also more broadly with people, so that there is ownership of the solution.

For these reasons, strong local ownership and engagement is one of the six cross-cutting principles of Access Accelerated. Our model unites local stakeholders and global supporters — from the Ministry of Health to academic institutions to the private sector — to forge sustainable solutions. For example, we work with the City Cancer Challenge (C/Can) to advance quality cancer care by empowering local city leaders to define their own needs and craft solutions that respond to the unique local context.

At the end of the day, solutions can (and should) scale and cross borders but adapting to people’s specific needs will always be instrumental to long-term success. 

  1. What has COVID-19 tought us about investing in health systems and how can this be applied to NCDs? 

At Access Accelerated, we have long advocated for increased investment in health systems to advance NCD prevention, treatment and care. We know that health systems in low- and middle-income countries urgently need the resources, trained health workers and policies to support the growing number of people living with NCDs.

COVID-19 has taught us that when global health crises emerge, we need systems in place to ensure that NCD care continues to be delivered to everyone, no matter where they may be. We’re also seeing that health literacy, a crucial tool for awareness and prevention of NCDs, is important for rapidly responding to new infectious diseases – especially when co-morbidities can lead to more severe outcomes.

Like the fight against NCDs, the fight against COVID-19 cannot be won alone and we need the right investments in people, policies and partnerships in place to meet health needs. 

  1. In LMICs, patients often have a delayed or slower access to treatments. How is AA working with partners to address potential bottlenecks?

Supply chain disruptions in LMICs have an enormous impact on how people living with NCDs manage their conditions and seek care. For instance, the NCD Alliance of Kenya’s Caucus of People Living with NCDs recently issued a public statement with key “asks” for the government of Kenya, including “to build a resilient supply chain of essential NCD medicines and commodities; ensure their availability, affordability, and accessibility at primary health facilities; and support access by PLWNCDs who cannot physically visit pharmacies or hospitals.”

Access Accelerated draws from the needs and lived experiences of people living with NCDs to address supply chain challenges head-on. In addition to working with partners like the NCD Alliance, we also work alongside country health authorities to identify gaps in the supply chain. In 2019, our partners at PATH conducted an end-to-end “Journey of the Pill” supply chain assessment to identify bottlenecks that are reducing the availability of NCD medicines, equipment and supplies in Kenya. The assessment, which was validated by the Kenya Ministry of Health, maps tracer medicines using batch numbers from the time of manufacture or entry into the country to the time of dispensing to patients.

In Ghana, we’re working alongside PATH and the Ghana Health Service to conduct a similar assessment, with data collection and analysis taking place this year to help pinpoint strengths and inefficiencies at all levels in the supply chain.

  1. How can digital health solutions help empower communities prevent and treat chronic illnesses? 

Digital health is a key pillar of our work at Access Accelerated, alongside primary care and supply chain. Incorporating an integrated digital service model can empower patients, relieve the burden on health care professionals and yield valuable data that provides insights on costs and outcomes of care.

Through our program, we’re supporting the development of a mobile app that supports diabetes and hypertension patients to adhere to treatment. This app generates reminders for health checkups, integrates a self-assessment tool for NCD risk factors, uses geolocation to suggest nearby health facilities, and provides reminders to patients for their chronic disease management. However, it’s not the technology alone that makes a difference — it’s the decision-making that results from it. That’s why this app in Vietnam will be integrated into the NCD health information system, providing policymakers with real-time data on successful approaches and the hypertension burden.

Such promising solutions inspire Access Accelerated and our member companies to continue exploring the role of digital health at global, national and local levels.

  1. With 10 years to go to meet the Sustainable Development Goals, what should the focus be and how can the private sector help?

Released in July, the annual SDG Report by the UN found that the poorest and most vulnerable people are being hit hardest by the effects of the COVID-19 and an estimated 71 million people are expected to be pushed back into extreme poverty in 2020.

Now is the time to double down on our global public health commitments and efforts to reduce silos, build resilient health systems and support the movement towards attaining the SDGs.  We must take collective responsibility across sectors to mitigate impacts from COVID-19 ensuring we keep the needs of people at the center of what we do.

Access Accelerated works in LMICs because similar inequalities have been laid bare by the NCD crisis. The NCD burden is most acutely felt in LMICs, where millions of people living with or at risk for NCDs lack access to quality and consistent medical care and medicines, and are twice as likely to die prematurely from preventable, treatable conditions. Over the next decade, health systems strengthening will be critical to bridge this gap.