Investing in our Future: A Roundtable Discussion
Health Issues Mediaplanet sat down with six industry pioneers to discuss the future of global healthcare delivery.
Mediaplanet: What is one of the most influential global health innovations happening in our world?
Stephan A. Bart Sr., M.D.: The advancement in the treatment and refinement of cancer continues to be one of the most significant innovations impacting global health. The prototypic cytotoxic compounds that were the hallmark of cancer therapy are now being replaced or augmented by more focused, less toxic treatments. These are far easier for the patient to tolerate and in many cases much more effective in treating their disease. Supporting this advance in research are the efforts by global authorities in recognizing the importance of these compounds and moving them through the approval process in the least time while maintaining the appropriate safety diligence.
Gustavo Doncel, M.D., Ph.D.: According to UNAIDS, an estimated 21.8 million people have died from AIDS since the initial outbreak of HIV infections in the 1980’s. Since then, huge strides have been made in treatment. Thanks to the development of antiretrovirals, HIV positive men and women who have access to these life-saving medications are able to manage their disease and live longer, healthier lives.
Dr. Abebe Aberra: Advances in diagnostic technology are very exciting, especially ones that make it cheaper, quicker and easier to detect pathogens and reach the right diagnosis. One particular innovation we are watching right now is the HemoGlobe, which was designed by undergraduate engineering students at Johns Hopkins University to detect anemia. A hemoglobin sensor is connected to a cell phone, which displays a reading and also texts the data to a database, creating a map of anemia cases that can be used to direct resources where they are needed most.
Pape Amadou Gaye: There have been so many innovations; drugs and vector control to address malaria, medications to reduce maternal hemorrhage and deaths and simple technologies to save the lives of newborns. But perhaps information and communication technologies—or ICTs—have been the most meaningful. They open up the world of telemedicine and empower health workers and individuals to learn more. The power is not in the technology itself, but in the way it puts people at the center of health care delivery.
Dr. Mark Ansermino: Innovation in global health can be segmented into technical innovation, social innovation and business innovation. These segments overlap but the most influential innovation is in business. We need business models that will ensure healthcare can be affordable for everyone, everywhere. Innovation is really about the democratization of healthcare. How can people access the care they need and how can technology enable that equity in care?
Mark Stibich: It is essential that patient safety be addressed and improved universally. A global focus on healthcare associated infections (HAIs) has led to investments in patient safety to acquire innovative new technologies. For example, portable germ-zapping robots that pulse xenon UV light quickly destroy pathogens in patient environments. By eliminating dangerous microorganisms in the environment, the chance of someone getting an infection is reduced. Not only does this protect the patient, but it results in a reduced use of antibiotics and therefore less antibacterial resistance. This is already happening in many sites and these hospitals are reporting fewer infections after using pulsed xenon UV disinfection robots. This investment in patient safety will spread worldwide and could ultimately greatly reduce the risk of HAIs.
MP: How can readers show their support for global health?
SB: One of the most direct means of supporting global health is for readers to become aware of clinical research trials taking place in their communities and investigating whether they can participate in these programs to assist in the advancement of medical knowledge. The work being done bridges a wide variety of diseases—and many trials are conducted utilizing healthy populations prior to their progression in actual patients with a specific disease. It is critical that our public participate in research so that new and potentially groundbreaking treatments are not lost or delayed in development. Many times over the past 20 years of my medical career, subjects entering research have learned valuable insight into their own personal health status, as well as played a role in the advancement of medicines to be used globally.
GD: They can encourage their congressional representatives to continue supporting global health funding, particularly for family planning/contraception and HIV prevention research.
AA: The global health community has united around the Millennium Development Goals—continuing after 2015 as the Sustainable Development Goals—but achieving them requires commitment from individuals, communities and governments. We need all hands to support these efforts. Readers can educate themselves about global health issues like malaria, tuberculosis and HIV/AIDS, support organizations that work with local communities to strengthen health systems and advocate with their governments to maintain and increase support for research and international cooperation.
"Know that global health is truly global—it affects the rich, the poor—it knows no borders."
PAG: The first step is to care about it. The next step is to learn more. Today the average American thinks the U.S. spends 28 percent of the federal budget on foreign aid. It’s actually only 1 percent. Also, know that global health is truly global—it affects the rich, the poor—it knows no borders. Talk to decision makers and let them know that global health is important to you.
MA: Innovative models of delivery are required for healthcare to be affordable and accessible – even in developed countries. By supporting and embracing new models that are being pioneered in the developing world, such as mHealth, we can ensure a sustainable health system for our children.
MS: Educate yourself about global health issues. If you are traveling overseas, try to understand what’s going on in the areas you may visit. If you or someone you love is going to a U.S. hospital, evaluate the facility’s infection rates and ask your physician to send you to the safest facility.
MP: What is one aspect of global health that has affected you or your community?
SB: One of the most concerning aspects that not only affects our community, but also affects almost every community is the emergence of resistant strains of various pathogenic species of bacteria and other organisms. The emergence of resistance has been caused by mutational changes in the organism which although likely to occur naturally, have been thrown into overdrive given the overuse of antibiotic medications. Evidence of this can be seen in occurrences of organisms like Methicillin Resistant Staph Aureus (MRSA) which now has breached its former confines of hospitals and other care facilities and penetrated into communities at large. As many organisms develop lethal strains, it is of the utmost importance that we develop vaccines to prevent the diseases. The only way to get these vital vaccines approved is to perform the research that allows the evaluation of their safety and efficacy and this requires volunteers from the general public. If we don’t then certainly we will suffer greatly as a society.
GD: The HIV epidemic has devastated entire communities in Africa. Close to home, many of us know someone who is HIV positive, or even someone who has died from AIDS-related complications. Unplanned pregnancies can also be considered a global health issue—children who are born to women and families who are unable to care for them are more likely to become ill and be developmentally affected. I would love to see a world where women and families are able to plan their pregnancies so that every child born is welcomed and can be cared for.
AA: As a medical doctor and senior health advisor, something I’m very interested in is how we can more effectively encourage lasting behavior change, on both an individual and a national level. This is something we must continue to investigate because otherwise even the most brilliant intervention will lose its impact. Just as we need to support individuals in adopting practices that will improve their health—sleeping under mosquito nets to prevent malaria, or in countries like the U.S. avoiding junk food—we also need to support countries in adopting and then actually implementing evidence-based policies that improve public health, with a special focus on underserved areas.
"Just as we need to support individuals in adopting practices that will improve their health—sleeping under mosquito nets to prevent malaria, or in countries like the U.S. avoiding junk food—we also need to support countries in adopting and then actually implementing evidence-based policies that improve public health, with a special focus on underserved areas."
PAG: Growing up in Senegal in a malaria endemic region, I saw so many preventable deaths from malaria. I lost friends and relatives. I had malaria often, though I thought it was nothing at the time. Later, I realized how devastating malaria is not only to health and wellness, but also to social and economic development. Our tremendous progress—especially through investments in interventions such as mosquito nets treated with insecticide and effective medications delivered by frontline health workers—has allowed communities to thrive, and some countries to prosper.
MA: As an anesthesiologist, innovative sensor technology such as pulse oximetry has radically improved the safety of anesthesia in my hospital. This technology could also have a tremendous impact on a global scale. In low-resource areas, many clinics and hospitals don’t have pulse oximeters. If they were available in every operating theatre and every emergency room, thousands of lives would be saved. Millions more could be saved if pulse oximeters were provided to frontline healthcare workers around the world.
MS: Globalization is having a huge effect on local communities because deadly pathogens such as MERS can now strike anywhere. Every community in every part of the world is now at risk of exposure to multidrug resistant organisms, as these bacteria and viruses are being transported globally. It’s imperative that hospitals take measures to eliminate deadly microorganisms before they can harm patients and that they have technologies and plans in place to address emerging threats. These issues touch every hospital and community health center in the world.