In an ideal world, the access to health is a right and, in many cases, it is materialized in the access to quality medical care that protects people’s lives. This includes the prevention, diagnosis, treatment, and the necessary medical support to guarantee the wellbeing of the population.
Currently, the management of health converges in the search to build sustainable models that aim to optimize resources in a cost-efficient logic but that also achieve results that protect the lives of many people and generate greater coverage.
We have repeatedly heard about the importance of promoting healthy habits. After all, it is better to prevent illnesses than to cure them later. This is not only true for patients but also for healthcare systems. Imagine how much financial and human resources can be saved if healthcare programs focus their efforts on health education and disease prevention before patients require hospital care and advanced therapies?
Dr. Julio Frenk, current President of the University of Miami, and Octavio Gómez Dantes, addressed the issue in a study published in 2016 in the journal of the National Institute of Public Health of Mexico. They referred to the need to find a balance between health promotion and disease care, emphasizing how great health systems implement programs and policies to keep their population healthy and, in the event of illness or injury, facilitate access to quality healthcare services. However, in most systems, disease care has been prioritized over building healthy environments and promoting healthy behaviors.
The article by Dr. Julio Frenk and his team provides a historical analysis of the shift from the emphasis on personal hygiene and public health to an emphasis on disease and care. The article also discusses how “The current epidemiological transition has increased the concern for the dominance of curative approaches to health conditions and their financial consequences.”
It is alarming to look at the figures because, according to the World Health Organization, non-communicable diseases are responsible for at least 60% of deaths worldwide and most of these are concentrated in developing countries. The treatment of these diseases is considerably more expensive than the treatment of other more common diseases like common infections. According to the latest report from the International Diabetes Federation, by the year 2021, there will be an estimated 537 million cases of Diabetes Mellitus worldwide and direct healthcare costs for diabetes are already approaching one trillion dollars. If curative care continues to be prioritized in the fight against these illnesses, healthcare systems will become financially unsustainable.
Therefore, a balance between healthcare and disease care is necessary. This analysis shows that the main challenge for health systems in this century is to avoid divisive reductionism and embrace the richness of different perspectives through integrative actions, and this is where public-private alliances take on special importance.
The WHO’s vision recognizes the importance of innovation and collaboration between sectors and contemplates new business models in the provision of services. This represents a great opportunity for governments and private companies, but above all a great benefit for the population who will be able to feel the effects of public-private collaboration by significantly improving their health care.
A great example of this collaboration has been the interest shown by governments and companies in the fight against hepatitis C. According to the WHO, 71 million people in the world live with this illness and the vast majority are unaware they have it. Therefore, it is vital to implement diagnostic campaigns that encourage patients to get tested and receive appropriate treatment.
Advances in treatment have made it possible for this disease to be cured in up to 98% of cases with drugs that are administered in a few weeks, but efforts are still needed to increase its diagnosis. The campaigns developed in some countries between governments, the medical community, and pharmaceutical companies have been successful. Thanks to these alliances, fewer patients require specialized medical care in health systems, reducing the burdens of care and possibly be able to eradicate this disease in the future.
It is time for a new narrative that highlights innovation and the value of collaboration in tackling health challenges. It is time for a much more transparent approach to problem solving, involving all members of the sector, the medical community, patient groups, patients, caregivers, governments, and companies. It is time to review and develop a healthcare system that can deal with chronic diseases, aging, and a high demand for pharmaceutical expenses. It is also time to review how public-private alliances can be used to face challenges; and -above all- to move from a curative system to a preventive one. Currently, this environment is tackling the COVID-19 pandemic that has significantly affected healthcare spending across the world and it represents a major challenge for the health sector. But this pandemic represents a great example of collaboration at all levels as mentioned above, which has allowed for rapid access to COVID-19 vaccines and has reduced the severity and mortality of the disease.
Dr. Adolfo Hernández Médico, pediatra y epidemiólogo
Javier Marín Director Senior LLYC de Healthcare Américas
