A shortcut to accelerating the achievement of Universal Health Coverage
Digital is not an option, it is a must to achieve Universal Health Coverage
Von Ann Aerts
In the last decade, we have seen a dramatic shift in focus in the global health community: noncommunicable diseases (NCDs), which were once thought of as a problem largely confined to the wealthiest nations, have quickly become one of the most pressing health issues of our time everywhere.
By using technology more effectively, we can provide better and faster healthcare to more people. Photo: © Novartis Foundation
In low- and middle-income countries (LMICs), chronic conditions such as heart and lung diseases, cancers and diabetes are placing an unsustainable amount of pressure on already over-stretched health systems, causing more than 41 million deaths per year. Although NCDs are ubiquitous, LMICs are hit hardest, with 85 per cent of these deaths occurring in such settings.
Without a significant shift in how we approach the management of NCDs, the problem will continue to worsen, devastating families, placing an ever-increasing strain on economies, and hampering many countries achieving Universal Health Coverage.
Digital is essential for tackling NCDs
At the 73rd United National General Assembly 2018, leaders from around the world agreed on a mandate for tackling NCDs, and agreed that – among others - digital technology must become an essential part of health systems, just as fundamental as hospital beds are.
The ComHIP program uses digital technology to bring care closer to where people live. Photo: © Novartis Foundation
Evidence from around the world has shown that digital works. By using technology more effectively, we can provide better and faster healthcare, that is:
- More empowering and accessible for patients
- More efficient for providers
- More cost-effective for health systems
Last September, the Broadband Commission Working Group on Digital Health – co-chaired by the Novartis Foundation and Intel – released their latest report, ‘‘The Promise of Digital Health: Addressing Non-communicable Diseases to Accelerate Universal Health Coverage in LMICs’ which offers recommendations and best practice examples to policy makers and other stakeholders, to help them reimagine how digital health can address NCDs.
The report, referenced at the UN High Level Meeting on NCDs as an important tool, sets out six practical building blocks for countries to realize the full potential of digital health. The guidance offered is crucial for avoiding barriers such as siloes and interoperability, which have often prevented digital projects from reaching scale in the past.
Success is dependent on scalability
The Novartis Foundation has used digital technology throughout its initiatives for the past decade, with the ambition to design solutions that are scalable and sustainable through integration into national policy.
For example, earlier this year, the Ghanaian government announced the scale-up of our telemedicine model across the country. The program’s success hinged on the use of one of the simplest and most widely-available forms of technology: the mobile phone. The program enabled community healthcare workers to connect with specialists via a 24-hour teleconsultation center, improving quality of care, avoiding unnecessary referrals and reducing transport times and costs for patients. The national scale of these telemedicine services now provides access to better quality healthcare for over six million people, many living in remote areas.
The Telemedicine program in Ghana shows the potential of simple technology to transform healthcare. Photo: © Novartis Foundation
Our Community-based Hypertension Improvement Program (ComHIP) in Ghana also used digital technology to bring care closer to where people live. The program set-up hypertension screening points in commonly accessible places, outside of the health system. Local shopkeepers were trained to measure blood pressure and digital technology linked positively screening person to the health provider. This simple digital system successfully ensured a coordinated care pathway for hypertension patients, that improved blood pressure control rates and patient outcomes. SMS reminders were used to empower patients to self-manage their blood pressure and risk factors. The Ghana health authorities have now also committed to scale this successful innovative service delivery model to other areas in the country, including the capital city.
The Casalud model in Mexico
One of the most important benefits of digital health is that it can offer a holistic management approach for addressing NCDs: from distributing educational materials to encouraging prevention, enabling earlier diagnosis, ensuring communication across the healthcare pathway, and empowering patients to self-manage their conditions more effectively.
This is the rationale behind the Carlos Slim Foundation’s CASALUD model, which was incorporated into Mexico’s national strategy to reverse the rise in NCDs and integrate digital throughout the continuum of care. The Ministry of Health launched three digital health programs as part of this approach, centered on prevention and evidence-based disease management. By incorporating digital health in its national NCD strategy, Mexico has now seen some impressive results: more than 1 million adults have been adequately screened, a national NCD information system has been set up with data on 1.8 million patients, and 17,000+ health professionals have been trained.
Digital technology must become an essential part of health systems, just as fundamental as hospital beds are. Photo: © Novartis Foundation
Digital health as shortcut towards Universal Health Coverage
For LMICs in particular, digital health should be seen as a shortcut to accelerating the achievement of Universal Health Coverage and ensuring that everyone can access the health services they need without suffering financial hardship. In many countries, widespread mobile coverage provides a significant opportunity to “leapfrog” high-income nations by adopting newer solutions more rapidly.
As a global healthcare community, we must see it as our responsibility to continue collecting evidence to demonstrate just how effective technology can be for transforming healthcare delivery and tackling major challenges such as NCDs. Only then will we see the mindset shift needed to drive policy change and ensure digital becomes part of every healthcare system worldwide.
Let’s work together to seize and leverage the opportunities digital health is presenting, in the interest of people, patients, societies, healthcare systems, governments and all other partners.
Dr. Ann Aerts, Head of the Novartis Foundation. Ann Aerts has been Head of the Novartis Foundation since January 2013, where she has played a key role in devising new policy recommendations. She has the responsibility of heading an organization committed to having a transformational and sustainable impact on the health of people in low-income communities. Ann holds a Degree in Medicine and a Masters in Public Health from the University of Leuven, Belgium, and a Degree in Tropical Medicine from the Institute of Tropical Medicine in Antwerp, Belgium. In 2014, Ann was nominated by PharmaVOICE as one of the 100 Most Inspiring People in the life science industry. Ann has authored numerous publications and is a member of the Broadband Commission for Digital Development, the Governing Council of the UN Technology Bank for Least Developed Countries and the International Advisory Board of the Commonwealth Centre for Digital Health. Email