Healthcare is a field that is used to change and innovation when it comes to science, but less so when it comes to systems. It’s also a field used to coping with complex challenges. But COVID-19 has brought many of these challenges to the surface in ways that we can no longer ignore.
Today the world faces a pandemic with consequences the size and speed of which we’ve never seen in our modern society. Political turmoil, economic downturns, overcrowded hospitals, overworked healthcare workers and nearly 540 thousand lives lost. Why wasn’t today’s health system better able to cope with COVID-19 and how will access to healthcare be impacted moving forward?
The Challenge of Reaching Patients in Today’s Health System
As a young infectious disease doctor working for the World Health Organisation at the frontlines of the HIV/AIDS epidemic, I never imagined that 30 years later I’d be seeing many of the same issues I saw then. This time, right in my backyard.
For centuries, hospitals and health facilities have been the central pillar of health systems. Yet the world has radically changed. So has the size of our population and the type of diseases that impact our lives, many requiring lifelong, chronic medical treatment. Through it all, the healthcare sector has remained mostly unchanged, generating a significant void outside health facilities and a deluge of cases inside. Hospitals can no longer do the job alone.
Most health systems don’t have the infrastructure, the network and the capacity to communicate with patients when they leave the hospital or the clinic. In the case of a pandemic, this made it very difficult to preemptively help vulnerable clusters prevent disease or to quickly identify and isolate the infected. Outside a pandemic, this long-ignored gap makes it close to impossible to follow patients in their care and treatment journey. The result is poor treatment adherence and less than optimal medical outcomes.
Moving forward, as has been made abundantly clear during COVID-19, solutions are needed more than ever to complement the existing health system and close these dangerous gaps affecting patient’s access to care and treatment. The private sector, including pharmaceutical companies, are well positioned to expedite the change that is needed.
Adapting to the New Reality
Out of the 24 countries where Axios currently manages access programs, the large majority were significantly affected by COVID-19. Using personalised and secure mobile technologies for patients, physicians and pharmacists, we were able to reach our patients and their physicians and take the necessary measures to reduce potential exposure to COVID-19 while continuing their treatment. This digital ecosystem allows us to reach and follow up with our patients when they leave the health facility to ensure that they are compliant with their treatment. Our programmes are a drop in the ocean, but they illustrate a technology-led approach that can be replicated across the health system to optimise treatment outcomes by improving adherence while alleviating some of the burden on health facilities.
Exploring complementary “brick and mortar” methods for supporting chronic treatment management, such as retail pharmacy outlets, will also be important to address patients’ fear of infection when visiting typical clinical environments like hospitals. A recent study published in Nature’s Primary Care Respiratory Medicine Journal of Chronic Obstructive Pulmonary Disease (COPD) patients in Egypt found that community pharmacists played an important role in a patient’s decision to stay on treatment.
Another access area affected by COVID-19 is treatment affordability. The economic repercussions of COVID-19 are being felt at all levels – from cuts to national healthcare budgets to lower consumer spending power. The result will be a need for access solutions that reach more broadly across the patient population in both developing and developed countries and for a wider range of products.
To get medicines to the greatest number of people, including the poorest, in the most sustainable way, segmenting by ability to pay will be critical. Segmenting enables wealthier segments to essentially ‘make up’ for lower prices paid by poorer segments, enabling the whole population to benefit while maintaining an acceptable ROI for the pharmaceutical companies behind many of these initiatives. Including multiple stakeholders such as charities, patient groups and non-governmental organisations will further help ensure the sustainability of these affordability-based solutions.
COVID-19 is not yet over and it will not be our last pandemic. The healthcare challenges we face today are also not going away. It is time to modernise our health systems and adapt it to the changing world. It is time to expand the meaning of healthcare providers and their reach beyond the hospital, embracing telemedicine and alternate care and treatment delivery models. It is time to embrace innovation and multisectoral global collaboration.
Every day, I, together with much of the world, applaud the efforts of our health workers. Let’s honour their work by creating an environment where they can truly do the best for patients. Let’s honour the thousands of lives lost to COVID-19 by building a better system to facilitate access to healthcare for generations to come.
Dr Joseph Saba currently serves as chief executive of Axios International. He is an infectious disease physician and former clinical research specialist and program officer at the World Health Organisation.