The what and why of UHC and Pharma nexus
This oped was first published first on PharmaBoardroom on 12 December 2018.
At least half of the world’s population cannot obtain essential health services, according to a 2017 report from the World Bank and World Health Organization. And each year, large numbers of households are being pushed into poverty because they must pay for healthcare out of their own pockets. This is what Universal Health Coverage (UHC) has set in its sights to tackle. It has become a global drive to deliver UHC by 2030 that rests on the idea that patients, wherever they live, should be able to receive the quality health services they need without suffering financial hardship.
For almost 100 million people health expenses are high enough to push them into extreme poverty, forcing them to survive with just 2 $ a day. These persons mostly live in Sub-Saharan Africa and Southern Asia. However, many persons in more affluent regions such as Eastern Asia or Latin America increasingly suffer financial hardship because of their out-of-pocket health expenses for health services and linked to the lack of income should they have to stop work.
It is no surprise then to see that strong, sound, financially sustainable health systems generate a healthier and more productive society. One that can access education and gain skills, enabling a country and its people’s participation in a dynamic global economy. Health, in this sense, brings wealth to families, and builds stronger economies, thus indirectly impacting governments’ annual health expenditures.
This is why UHC has gained so much traction and was adopted by world leaders at the United Nations (UN) three years ago as one of the United Nations’ 17 Sustainable Development Goals (Goal 3). This is not just a highfalutin idea. It is really catching on: India has recently announced its new National Health Protection Scheme, called Ayushman Bharat, which will benefit 500 million people and establish 150,000 health and wellness centres. Brazil has already submitted a list of 10 commitments itis making on UHC.
The R&D-based biopharmaceutical industry can and does also play a role. First and foremost, by discovering new medicines and vaccines to prevent and treat diseases. It is phenomenal to witness how innovation has fundamentally altered the healthcare landscape in barely two generations. Over the course of less than 50 years, innovation in medicines and vaccines have: turned fatal illnesses like HIV/AIDs into chronic conditions; slowed disease progression for rheumatoid arthritis; cured a disease such as hepatitis C; helped to prevent previously widespread childhood illnesses such as rotavirus, chicken pox and pneumococcal disease; reduced mortality rates for cardiovascular and diabetes patients around the world, and; revolutionized the care for some cancer patients with personalized therapies that have improved outcomes and extended life.
But our industry is much more than a supplier of medicines and vaccines and is increasingly pioneering ways to overcome the multiple barriers to accessing quality healthcare. Indeed, the weapon that Dr Tedros, the Director-General of the World Health Organization (WHO), is inviting us all to deploy is to “make our partnerships even deeper and stronger”.
There is strong support among the biopharmaceutical companies and associations that are members of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) for developing more public-private collaborations to deliver products and services more efficiently and widely and thus to accelerate progress towards reaching UHC in 2030.
Today, we are involved in more than 300 health partnerships that are working towards innovation for diseases that disproportionally affect people living in the poorest parts of the world, train healthcare professionals, build infrastructures, and pioneer ways to overcome barriers to accessing quality healthcare.
But before we get carried away, we need to acknowledge that “Business as usual” is unsustainable given the likely and known rise in demand for medicines and vaccines. We need to discover smart(er) ways to overcome current barriers to access such as lack of skilled healthcare workers, procurement and logistics failures. We share the view that improving the supply chain to deliver primary care, mainly in low-income countries, can provide better and cheaper access to the innovative medicines required to treat the scourges of cancer, diabetes, cardiovascular disease and, increasingly, mental illness.
IFPMA today is working with governments, public health authorities, professionals and other stakeholders to show how our industry is and can do more to contribute to deliver UHC. For example, a new ground-breaking partnership such as Access Accelerated brings together over 20 biopharmaceutical companies committed to tackling the growing burden of non-communicable diseases in low and middle-income countries. By collaborating with governments and with partners such as the Union for International Cancer Control (UICC), the World Heart Federation and the World Bank, Access Accelerated co-creates scalable and sustainable solutions to improve people’s health.
Thanks to global efforts from partners and a collective push from the biopharmaceutical companies, progress on health service coverage can already be seen. But progress will be hampered as long as UHC is absent. We will know that we have made progress when we no longer talk about the “cost” of treatment – and the “cost” of prevention – but instead when we truly view health as an investment.