Wednesday, November 26, 2014
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Health Care’s New Frontier

BEIJING – Developing countries face a seemingly insurmountable hurdle in providing health care to their rapidly growing – or, in some cases, rapidly aging – populations, especially as health systems become increasingly over-burdened and infections and other diseases spread. Because access to medicine in these regions is a multifaceted challenge, it is best tackled by several parties.

Lasting, collaborative relationships among pharmaceutical companies, governments, nonprofit organizations, and community leaders are needed to help disadvantaged populations overcome their health-care challenges. Together, these parties should take a binary approach, addressing both “hardware” factors (which remain constant, such as physical distance to treatment centers and elongated supply chains) and “software” factors (the intangibles that vary greatly in each region, such as the role of family and cultural beliefs).

These principles are especially true in places like China’s rural Xinjiang province, where life expectancy is stunted at 67 years (compared to 73.5 for China as a whole), and lack of access to health care undermines well-being. Xinjiang covers nearly 650,000 square miles (1.7 million square kilometers), but it is home to only 21 million people, many of whom are members of nomadic tribes. From an economic standpoint, Xinjiang’s resilience is crucial to China’s economic growth strategy – it is seen as the country’s gateway to the west.

But the reality is that maintaining the livelihood and well-being of this area’s population and those in other rural parts of China is a serious challenge. Throughout rural China, the spread of infectious diseases – particularly hepatitis B, which affects millions – reflects a lack of hygiene education. The health ministry cited a 9.5% increase in deaths caused by infectious diseases from 2011 to 2012. Moreover, there is a serious shortage of health-care workers – just 1.3 per 1,000 rural inhabitants in China.

Free medicines are only part of the solution. We need to go beyond donations and reduced-pricing schemes to build sustainable health-care systems with strong distribution channels and education programs for the public and for health-care workers. Without these components, the model collapses.

Through public-private partnerships, we can leverage unique strengths and be better equipped to expand access to health care. This can create a symbiotic relationship, offering benefits to government, business, and the local community.

For example, Novartis’s Jiankang Kuaiche (“Health Express”) program in Xinjiang is a partnership between Novartis and the local government that aims to expand access to medicine, build capacity, and educate the public. Health Express achieves this by training local physicians in prevention and treatment of infectious diseases and educating primary and middle-school students on health and hygiene via a traveling caravan that moves from school to school.

During a recent trip to Xinjiang, I met several physicians from rural hospitals who had received training through Health Express. They told me that in the past, hepatitis patients had to travel for hours to be diagnosed and treated at a city hospital, while many others who were unable to make the journey suffered without treatment. Now, with physicians trained in infectious diseases, hepatitis treatment is possible in rural areas of Xinjiang, and patient outcomes have improved significantly.

I also met with school children at Urumqi Dengcaogou Boarding School, which is situated in a rural area outside of the provincial capital. The students were proud to be able to bring their new health-care knowledge back to their families. They told me how they had told their parents to quit smoking after learning about the consequences of the habit on health.

These children join more than 500,000 others in Xinjiang who have participated in the educational component of Health Express. By targeting schools as hubs for health-care education and shaping students into health ambassadors for their families and friends, we can reach an even greater number of people in Xinjiang’s nomadic communities.

Xinjiang means “new frontier,” and right now, we are at the edge of a new frontier in delivering sustainable health-care solutions to communities where limited resources and infrastructure constrain access to health care. These multidimensional, scalable interventions help to bridge the gaps in developing regions.

But neither corporations nor governments can do it alone. They need to work together to achieve the best possible outcome. We also must abandon the idea of a one-size-fits-all model for expanding access to health care and adjust our approaches to ensure the best fit with local health priorities and customs. With education and prevention, capacity-building, and new kinds of partnerships, we can continue to improve access to health care in Xinjiang and beyond, boosting well-being throughout the developing world.

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    1. Commentedjack lasersohn

      You might consider one more idea.
      It is apparent that the cost of technological innovation in pharmaceuticals and devices will soon exceed what the US is willing to pay, as the traditional 'payer of last resort'. Spreading that cost over a much larger world population is the only solution in the long run to continued increases in the marginal cost of such innovation. Reducing the innovation price premium in the US while modestly increasing it in the developed world is the first step.
      However, such cost sharing will not be politically acceptable in the developed world without some burden sharing by the developing world.
      One goal of your efforts in the developing world should be to tie current discounts on medicines to automatic price increases in the future based on increasing per capita GDP as well as to explicit recognition of home country IP under WTO.
      This kind of exchange will address the legitimate current concerns for access in the developing world while ensuring that fair cost sharing for expensive innovation will be available in the future, when it will be needed.

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