Host 1:
Welcome to Insight Exchange, presented by LEK Consulting, a global strategy consultancy that helps business leaders seize competitive advantage and amplify growth. Insight Exchange is our forum dedicated to the free, open, and unbiased exchange of the insights and ideas that are driving business into the future. We exchange insights with the brightest minds of the day, the most daring innovators and the doers who are right now rebuilding the world around us.
Host 2:
The Covid-19 pandemic brought about health, economic, political, and environmental challenges and exposed global disparities caused by income, age, race, sex, and geography. But it also allowed for innovation in science and medicines development, distribution, and delivery. We now have reached a time for reflection and have the opportunity to embed any positive changes from the pandemic responses, a part of our global health and healthcare systems moving forward. This joint strategic outlook by the World Economic Forum and LEK Consulting aims to unite stakeholders across different sectors, industries, and geographies to a shared vision for health and healthcare by 2035. In this episode, we discuss what is the vision for health and healthcare by 2035, what are the key issues and barriers to face, and what are the solutions to address these issues? To provide insights on these topics, let's welcome Adrienne Rivlin and Nivedita Sen. Adrienne, Nivedita, please introduce yourselves.
Adrienne Rivlin:
Thanks very much. I'm Adrienne Rivlin. I'm a former Medical Scientist and I'm now a Partner at LEK Consulting. I was also a Co-author on this report with the World Economic Forum entitled Global Health and Healthcare Strategic Outlook Shaping the Future of Health and Healthcare.
Nivedita Sen:
Hi, I'm Nivedita Sen. I'm the Community Lead for Health and Healthcare Industries at the World Economic Forum. And ask Adrienne mentioned, a Co-author for this report.
Host 2:
Thank you both. So to start out, could you give us some understanding of the purpose of the strategic outlook and give us some insight on the status quo in health and healthcare?
Nivedita Sen:
Yes, of course. The last few years has been particular with first the outbreak of Covid-19 and then a geopolitical as well as socioeconomic crisis. What this outlook does is bring together the expertise and the vantage point we have at the World Economic Forum as the leading international organization for public-private cooperation to reflect on the implications of some of these challenges of the past few years and its impact on health and healthcare, what it means for health and healthcare systems, both in terms of some of the negative impacts, but some of the positive impacts as well that we saw over the course of the past few years. So it reflects on the past few years with a vision to a goal for 2035 and where we want health and healthcare to be in 2035.
Adrienne Rivlin:
I think that's right Nivedita, and I think what I would add is that that's really juxtaposed with the medium to long term trends that we're seeing on the more industry side of things where the longer term trends of continued investment into the life sciences space, for example, in areas like precision medicine, biomarker strategies, some of the exciting advancements in AI, for example, are really driving forward the potential for healthcare to transform people's lives all over the globe. And so it's a disappointment, like you say, that we've seen a lack of a focus in the last year as other more pressing issues have come to the fore geo-politically.
And I think we hope very much that it will galvanize those public sector and private sector stakeholders into action around some of these really significant issues that we are facing from a healthcare perspective, whether that be around continuing to expedite our development of therapeutics and vaccines for other types of infectious diseases or cancer or in other areas with very high unmet need, whether it's to make sure that we appropriately address issues of inequality in healthcare or whether indeed it is to improve healthcare education and literacy amongst the populations of the world.
Host 2:
So speaking of that, tell us what is the vision for health and healthcare for 2035?
Adrienne Rivlin:
In the report we've outlined for strategic pillars that we think are really important to make sure that our stakeholders and indeed everyone around the world in the healthcare space are focused on. And I would say that these are the firstly equitable access and outcomes. And I know Nivedita has a particular passion for this, but this is all about making sure that there's equal representation, access and outcomes for all, and not an unfair bias or prejudice just towards more high income countries. I think the second strategic pillar is around healthcare systems transformation. And I suppose this is particularly important given what we have seen over the last two years from a Covid perspective and the immense strain that our healthcare systems faced as a result of that pandemic. So this pillar is all about structuring resilient healthcare systems for high quality care, again, for the medium and longer term.
Thirdly, technology and innovation. I think making sure that we foster an environment that supports innovation in science and medicine really broadly defined is really important in order that we can expedite some of those exciting advancements that we've been talking about so far. And then finally, environmental sustainability. I think climate change has been discussed. It's also a focus of area for the World Economic Forum. And so making sure that we embed environmental sustainability into the way that we think about healthcare and climate change particularly, is increasingly important. Nivedita, from your perspective at the World Economic Forum, how do you tend to think about these strategic pillars? Are there any that are more important that we focus on, or do we see them all being equally as important going forwards? What do you think?
Nivedita Sen:
Thanks, Adrienne. I don't think there's a lot of focus. There needs to be a lot of focus on all of these four issues because together they can help us achieve a healthier global population. And when we think about health, I think it's important to talk about equity as an underlying issue over here. And as you mentioned, Adrienne, equitable access and outcomes is particularly close to my heart. What makes us healthy is a lot of times mostly things which are outside of care and hospital settings. So it's things like access to clean air, to water, and our living conditions that determine our health conditions. So it's important that we focus on these things as well and ensure equity within our living conditions, which will help us in overall improved health outcomes. Secondly, as we saw during the pandemic, increased strains on health systems is not something that the world generally was prepared for.
So we need to prepare for unexpected circumstances, both health emergencies like a pandemic, but also other kinds of emergencies, perhaps like war, which put increased strains on health systems. Health workers burnout has been a critical issue for healthcare systems as well. So that's something we need to address and look into as well. And then finally, when we touch upon the aspect of climate change, health is at the center of this. Climate change has an impact on health through increased in vector bond diseases, infectious diseases, antimicrobial resistance. So that's something we need to think about having an integrated approach to tackling both health and healthcare challenges as well as climate change.
Adrienne Rivlin:
And Nivedita, in the report we discuss the role of different stakeholder groups as we think about those different strategic pillars. So for example, the relative role of employers, for example, versus governments. From your perspective, how important is it that we all seek to try to work together in order to address, for example, the equity issue that you were discussing?
Nivedita Sen:
I think public-private cooperation and especially cooperation among various stakeholders is critical to solving most of these issues. So what we do in the report is we do actually flag issues where perhaps there is a higher burden on the private sector and issues where there's a higher burden on the public sector. And then there are issues where both need to come together equally, such as funding gaps. But then when we talk about issues which are like regulatory divergence, we need more public sector involvement. And supply chain issues, I think there's a lot that the private sector can do to help address this. So all of these issues are interconnected and it's only with public-private cooperation bringing different stakeholders on board that we can actually resolve these. We cannot solve these issues in silos.
Adrienne Rivlin:
I think that's absolutely right, and I think one of the other areas that comes across really strongly in the report is the disparities between physical and mental health as we think about equity. From my perspective, I think if there is a silver lining from the pandemic, perhaps, it is that we have increasingly focused our attentions on the mental health side of things. And it does seem to me, at least from the conversations that I'm having with my clients and more broadly in the space, that the advancement of mental health alongside physical health no longer has quite such a stigma attached to it and indeed that people feel that it's okay now to be talking more about mental health as well as physical health. And we know what a burden and a strain the pandemic has placed on people. And at least from my perspective, I hope that the focus on the mental health side of things will continue going forwards.
Host 2:
So you've both mentioned several of the issues we need to look at. Are there any additional barriers that one may face when approaching this 2035 vision?
Nivedita Sen:
Perhaps a couple that I could mention as well. One of them has been around representation in health data, and that's a critical component of achieving equitable access and outcomes. We need health data to be representative of the diversity in the population, which is not something that we see currently. So I think that's an issue that we need to address as well. And the other is perhaps a shift in care at home models. So while there are a lot of advantages of these decentralization models with digitalization, we cannot also lose focus on the importance of community workers and family members in providing at-home care. So I think it's balancing both the advancements with digital health, with community family support, the offline help, I think, which are critical components.
Adrienne Rivlin:
And I think I would add just a few other points. I guess we constantly talk about the need for more money and we're spending in this space, but I suppose within the context of the current macroeconomic environment that we are facing right now with very high levels of inflation in many countries around the world, and with ongoing geopolitical instability in Russia, Ukraine, and elsewhere, the reality is that we probably will have significant challenges in funding going forward, and that is likely to put more pressure on healthcare systems. I think we've talked about some of the challenges that Nivedita has mentioned around labor shortages, but this issue about burnout in our workforces is so important. In every country around the world, we read regularly about nurses and doctors going on strike or people even the profession because of the pressures that have been put on them, the problems in terms of recruiting new workers into the healthcare workforce. And by healthcare workers, I mean everybody who is involved right across the spectrum, not just the physicians, but all of the allied healthcare workers.
And so I think for us, we really need to try to get a grip on the healthcare worker's shortages and make sure that our healthcare systems are appropriately resourced in order to be able to deliver the care, whether it's in primary care or in the community, in secondary care, in tertiary care, in hospitals or indeed elsewhere. And also make sure that we're staffing up for the longer term rather than just to fill a short term gap.
I think the other issue that has come to light, which could scupper our intention of achieving the vision that we have in the World Economic Forum report is around supply chains. So we saw the immense strain that supply chains came under through the Covid pandemic, and indeed, it is still the case that many supply chains in the healthcare sector continue to be under strain, not least because of problems in getting some medical products and devices out of countries like China that supply a good portion of the world, but also just because of continued problems in shipping and in aviation, Covid lockdowns, et cetera.
So I think from my perspective, that's another key area in terms of challenges that we need to face up to. I think the other thing for me Nivedita, and I'd love your thoughts on this, are just around the ability to, and maybe this is more of a positive thing that came out of Covid, the ability to get those private public stakeholders together in order to try to overcome some of those things. I guess from your perspective, bringing those people together at Davos next week is going to be one element of what you do, but I think at the World Economic Forum, you focus on perhaps lots of different ways to try to get those stakeholders together in order to overcome some of those challenges. Is that right?
Nivedita Sen:
Yes. That's at the crux of what we do Adrienne, and thank you for flagging that. I think there has been a lot of positives as well, which we need to learn from and which we need to perhaps carry forward. We did have the fastest vaccine development in history as this report flags, but that was also possible because we had regulatory convergence around deployment of vaccines. So this was a remarkable example of public-private coming together to solve for a crisis and the potential this holds.
Adrienne Rivlin:
I couldn't agree more. I work quite a bit in the vaccine space, and I think what was particularly encouraging was the speed and rapidity of that collaboration, as you pointed out. Particularly I would say from the regulatory community who have perhaps unfairly in the past come under undue criticism for being too slow in their response. But actually I think what the development of those vaccines and indeed the therapeutics actually that go alongside the Covid vaccines specifically, I think what that shows really is that, as you've said, when there is a concerted effort on the part of not just the regulators but wider government stakeholders, the private sector, the patient communities, et cetera, to participate in trials and such that we really can make a considerable improvement in the way that we go about thinking about bringing innovation to patients. And I really hope that we can try and find ways.
And I know at the World Economic Forum, you are thinking about that constantly. But I really do hope that we can try and find ways to carry that mindset and culture shift through into other areas that so desperately need our attention as well. We often forget about some of the biggest killers around the world, cardiac disease, stroke, et cetera, and they are also in desperate need of our help. So I know that's an area that you are focusing on too, but I suppose from my perspective, that's my biggest wish, I think, and something that I think the World Economic Forum I know has in its sight.
Host 2:
I hear that you've stated some really clear issues and challenges and barriers, and you're actually getting to a lot of the solutions. So let's talk more about the solutions. Are there any case studies that you speak on regarding the solutions to address these issues?
Nivedita Sen:
Yes, and that's perhaps the unique point about this report. We lay out a lot of different levers that can help unlock the goal that we have envisioned for 2035. And these levers include global collaboration, policy and advocacy, patient empowerment and cross industrial collaboration among others. But what really brings these levers to life are actual case studies that we see that we illustrate in this report. And it's about scalability of these case studies that we think can help us reach to these solutions. So to perhaps give an example on cross-industry collaboration, we do have a case study on a tie-up between a health company and a digital company coming together to provide solutions for at-home care.
Now this again, does not come at the cost of digitalizing everything. And we do have other barriers that remain with respect to ensuring, especially older populations and providing at-home care with them, that things need to be digital friendly, that there must be a community care and the family care component of it. So there has to be a personalization of digitalization as well, which we need to factor. And that's when you bring two industries together, core health industry company, and then a core digital company who have the scalable abilities to come together, that is what they can together achieve. And that's a remarkable example of global collaboration.
Host 2:
Anything else to add to that, Adrienne?
Adrienne Rivlin:
Well, I think there are several potential solutions that we have highlighted in our report and maybe I could take each one of those in turn and Nivedita, please jump in and add your comments as well. So I think the first point that we've been discussing today is about cross-industry collaboration, and that's the case study that Nivedita has talked about. What happens when you bring and facilitate the collaboration of different companies from different industries coming together, all with a view to solve a very particular problem within the healthcare space on the part of the patient, the provider, et cetera. The second point that we highlight as being absolutely critical from a solutions perspective is about our ability to collaborate globally and our ability to try to overcome any barriers that may exist between countries. So for example, regulatory communities working harmoniously across borders. A third area that we focus on is around policy and advocacy.
And this I think is really an important lever to try to drive more systematic change and consistent change. And we have some great case studies talking about that in our report. Patient empowerment, absolutely key. And I'm sure, Nivedita, you want to say something about this. So the idea of the democratization of the patient and bringing the patient voice right to the forefront of the development of some of these solutions. For too long we have been developing solutions to some of these healthcare issues in something of a vacuum. And I think we're getting better at listening to patients and understanding what patients actually want. Another area that we have talked about is thinking through very carefully the types of solutions that could be decentralized. So whilst we are clear that there are some barriers that could be overcome if we are able to work harmoniously across the borders, and that implies centralization, actually there are other areas where decentralized model becomes really important and actually localization of solutions right down even to the community level, nevermind the national or regional level, becomes really important.
And then perhaps finally just two more solutions sets that we've discussed in the report. One is around innovative funding models. So we know that many of the most innovative pharmaceutical or more broadly bio pharmaceutical products that are coming to market can be very expensive. And so an ability to find innovative ways to be able to fund those or innovative ways to be able to fund healthcare system infrastructure more broadly, is going to become really important, especially as we think forward to the 2030s. And then finally, digitization as Nivedita has been mentioning, thinking about how as a global community we can most effectively use different forums of digitization to bring to bear the full force of the innovation that we see, particularly to lower and middle income countries where for example, telehealth types of services might be into rural communities, emboldened by our ability to use video conferencing and teleconferencing more effectively could really expedite the improvement in healthcare into some of those communities. Nivedita, I don't know if you'd agree with my summary, but perhaps from a policy and advocacy perspective or a patient empowerments perspective, anything you'd like to add?
Nivedita Sen:
Yes, Adrienne, absolutely agree with everything you just mentioned. And maybe I can add one bit more around the climate change and health issue as well. It's an issue that requires public-private partnerships for its resolution and the case study that we highlight in the report, it is a unique example of a lot of health and healthcare players, ones who are competitors in the world who have come together to really solve for an issue because they all align on the issue here around supply chain optimization, circularity, and as well as minimizing some of the waste that we see in the health and healthcare sector.
So these players who are competitors in the health industry have come together to form a partnership to jointly address this. And I think that's a remarkable example of what we can achieve when we get people together. And then as you mentioned Adrienne, on patient empowerment, we have an example from South Africa talking about health and wellness programs where we have healthcare companies tying up with other wellness programs as well as other benefits where really the patient comes at the center of controlling their health and it's a reward system case study where the patient is benefited by healthier habits.
And actually, there's a lot of data around this case study showing how it has improved health outcomes, how it has in improved lifespan with over a 50-year time period. So it's really interesting to see what you can achieve in terms of improving people's health when you give power to them and more personalization abilities. And maybe another aspect on digitalization, I think while it is a solution for a lot of places and countries where there is internet connectivity, it would remain a challenge for countries or regions where there's still no internet connectivity. And the report flags some of this as well through a case study where we showcase solutions in rural remote areas in Southeast Asia and in South Asia, where with a basic mobile phone, which gets updated when there's a data connection, which may be once in a few months, but it can also act as a powerful tool for patient empowerment. So I think that's an interesting case study that we flag in the report as well.
Adrienne Rivlin:
And another one that I really like Nivedita in the report, and maybe you could say a few words about it, is the example from India with the ABDM. It brings together the theme of digitalization with that of the importance of policy and advocacy. And that initiative there by the Ministry of Family and Health Welfare in India through their National Health Authority, I think is one of the most exciting and large scale foundational infrastructure projects for the digital health landscape. Anything you wanted to add on that, because I find it particularly fascinating.
Nivedita Sen:
Yes, you're right. It's a very big project and it brings together public sectors and given the regulatory divergence in India, I think it's a remarkable project of healthcare data optimization. It's a case study that's in development and it's been scaled in some of the states. And we are also increasingly getting a lot of private sectors from the health and healthcare sector in India involved. So it'll be interesting to see how that maps out over the next few years. And you can go and read the report on our website www.vforum.org. Just type in Global Health and Healthcare Strategic Outlook, and you should be able to look at the report. Happy reading.
Host 2:
Wonderful. Well, Adrienne, Nivedita, we really appreciate your insights. So let me summarize what we're seeing here. In the last three years, the world experienced a major pandemic, multiple geopolitical conflicts and the climate and energy crisis effect, which have had a detrimental impact on health and healthcare globally. In a time where barriers are complex, involving multiple stakeholders and competing priorities, it is increasingly important to work together and define clearly what the vision for health and healthcare looks like in 2035. And while the vision for health and healthcare in 2035 is ambitious, it is achievable. To get their stakeholders across sectors, industries and geographies need to catalyze long-term change at a system level. Thanks again to our LEK and world economic experts, Adrienne Rivlin and Nivedita Sen. We invite you to connect with us and learn more about our Global Health and Healthcare Strategic Outlook. Together we can shape the future of health and healthcare.
Host 1:
Thank you, our listeners, for joining us today at the Insight Exchange presented by LEK Consulting. Links to resources mentioned in this podcast can be found in the show notes. Please subscribe or follow for future episodes wherever you listen to your podcasts. Also, we encourage you to submit your suggestions for future insights online at lek.com.
