The business of improving global health

The dramatic success of the Millennium Development Goals (MDGs) in driving advances in human health will be hard to follow. In just 15 years, child mortality was nearly halved, and malaria deaths declined by 60 per cent. Today, nearly 15 million people worldwide receive treatment for AIDS, helping them continue to be productive members of society, compared with only about 10,000 people in 2000, when the MDGs were launched.

Can the new Sustainable Development Goals (SDGs), just adopted by the United Nations to guide global development efforts for the next 15 years, replicate the MDGs’ success? The strong track record of the MDGs certainly gives grounds for hope. But the new health-related goals are broader and more ambitious than before. And the public-health situation is in many ways more challenging than in 2000.

The new SDGs set a lofty goal: For the first time, world leaders have vowed to reduce premature deaths from chronic illnesses such as cancer, heart disease and diabetes. This is a tall order at a time of rapid population growth and rapid ageing. Chronic diseases are the main — and growing — cause of death in both settings. And more than two billion people still lack access to essential medicines.

To achieve the new targets, we must find creative new ways to address the world’s biggest health challenges. Above all, we must develop new business models that allow society to better harness the know-how, creativity, and drive of private enterprises to help improve public health. Companies share the responsibility for meeting these new goals, but they also need support from governments and other organisations to ensure the greatest positive impact.

The demographic challenge is daunting. A billion people joined the human race in just the past 12 years. Another billion or so will join by 2030, bringing the world’s population to 8.5 billion, according to UN estimates. The fastest-growing segment of the population is people over 60, a group that is expected to grow by 500 million people, to 1.4 billion, in 2030.

Older people are more likely to develop chronic illnesses, which now account for 63 per cent of all deaths worldwide. The World Health Organization predicts that the proportion will reach 70 per cent in the next 10 years, with most of the deaths occurring in developing countries. Some 28 million people die from chronic diseases in low- and middle-income countries each year, accounting for roughly three-quarters of all deaths caused by chronic disease globally.

Developing countries’ health systems are already stretched. They often lack medicines, resources and know-how to treat chronically ill patients, who may require years or decades of treatment. For example, there are only four oncologists in Ethiopia, a country of some 97 million people. Moreover, many developing countries face a double disease burden and must wage a simultaneous battle against infectious diseases such as malaria, tuberculosis and HIV/AIDS.

Clearly, more resources will be needed to tackle these challenges. But in the wake of the global financial crisis, development assistance for health from governments and private donors has plateaued at about US$35 billion (S$49.7 billion) annually, after growing more than 11 per cent per year from 2000 to 2010. And less than 2 per cent of that money was directed at combatting chronic diseases.

‘Social business’ approach

The long-term nature of chronic diseases, and the complexity of providing better treatment for patients in the developing world, calls for innovative solutions.

Companies possess the capabilities and the global scale to play a stronger role in addressing public-health challenges and achieving the objectives of the SDGs.

Some corporations are beginning to explore new “social business” approaches that will allow them to meet the needs of people and society in the developing world, while at the same time covering their costs, or even making a small profit.

Moneymaking social ventures are self-sustaining and have the potential to grow, bringing benefits to more and more people. They are a potentially powerful complement to philanthropy, which has underpinned much recent progress in public health.

For example, my company, Novartis, is launching a portfolio of 15 essential medicines to treat diseases including diabetes, respiratory illnesses, and breast cancer.

The aim is to make these medicines available to people of modest means in developing countries at a cost to local health systems of US$1 per treatment per month.

We will start in Kenya, Vietnam, and Ethiopia. It is a small first step, and we will learn as we go, with a goal of expanding to 30 countries in a few years.

To overcome the many hurdles to success in low- and middle-income countries, these new types of business ventures will likely need to explore innovative forms of collaboration with governments, non-governmental organisations, and other companies. Such collaboration has already shown that working across traditional boundaries, making creative use of technology, and developing pragmatic solutions can yield impressive results.

Bringing healthcare to everyone on the planet is a great challenge. It will take imagination, cooperation and hard work. Greater involvement by businesses could increase the likelihood of getting there by 2030.

ABOUT THE AUTHOR:

Joerg Reinhardt is chairman of the Novartis Board of Directors.