Opinion: Searching for the Next Generation of Sustainable Health Care
By Harald Nusser, head of global patient solutions at Gilead Sciences
Two decades ago, a global health crisis — the HIV/AIDS pandemic — spurred a wave of creative thinking in how health services and medicines should be delivered in areas with limited resources. Today, the COVID-19 crisis is bringing with it new waves of innovation in profoundly difficult circumstances.
The pandemic has laid bare the health inequities between and within countries — inequities not only in access to vaccines and medicines, but just as importantly in the health and financial systems that are essential to delivering care.
Despite talk in recent years of global health security — the notion that health systems should be robust and resilient enough to stave off emerging health threats — it is clear that our pre-pandemic solutions have fallen far short of the challenge. As a result, we now face growing global health insecurity, in which the destabilizing impact of unequal health threatens the safety and well-being of all nations.
As many people know, Gilead played a crucial role in access to innovation for people living with HIV and viral hepatitis. The prevention and care of these diseases have long been subject to health delivery challenges. Global Patient Solutions, the Gilead business unit that I lead, is charged with driving measurable progress toward health equity and the Sustainable Development Goals for health. We do this by developing global programs and collaborations across a broad range of therapeutic areas.
It is with these goals in mind that global health experts Carlos Passarelli of UNAIDS, Homie Razavi of the Center for Disease Analysis Foundation, Osman Waheed from Ferozsons Laboratories, and my Gilead Sciences colleague Betty Chiang, came together to discuss new approaches during last month’s United Nations General Assembly session. The dialogue — hosted by Devex — focused on sustainable models that could usher in a new era of progress in global health.
This frank and challenging discussion revealed several insights about the future of health care delivery, and these insights are particularly welcome as I settle into my new role at Gilead. Here are a few takeaways:
1. The need to put the community first. It’s important to bring local leaders in the countries and regions we serve to the table where decisions are made. In doing so, we can also mobilize political will — a key ingredient to success, emphasized Passarelli.
Chiang pointed out that a "community first” mindset helps us to avoid reinventing the wheel. Local communities know their needs, resources, and potential solutions better than anyone, even during novel emergencies like COVID-19.
2. The value of partnerships between private sector entities. While public-private partnerships are rightly regarded as essential, we should also consider the potential of partnerships between private organizations. For example, we’ve partnered with nine manufacturers, including Osman Waheed’s Ferozsons, to produce generic remdesivir, which is used in COVID-19 treatments — as did other pharmaceutical companies to scale up COVID-19 vaccine production. Collaboration within the private sector can help ensure quick access to prevention and treatment in low- and middle-income countries.
3. The value of end-to-end solutions to make sustainable gains. For example, scaling up vaccine production a hundredfold will do little if the vaccination programs and health care infrastructure aren’t in place to deliver them. When tackling complex health issues, we must consider every step of the health care ecosystem from manufacturing and financing to diagnosis and last mile delivery.
These takeaways reflect the types of programs and partnerships that Gilead is building today. For example, one of my team’s current priorities is strengthening disease prevention services in primary care. Prevention — including education, vaccines, and preventive medicines — is essential to making health care systems sustainable by averting the high costs of disease management.
We are supporting efforts to increase disease awareness among primary care providers, end transmission of hepatitis B from mothers to babies, and prevent people from acquiring HIV through the expanded implementation of pre-exposure prophylaxis. And we’re creating more robust measurement systems to better track the impact of these efforts, so that we can learn and adapt.
Other areas that are core to our mission include disease elimination — permanently reducing the burden on health systems by eliminating diseases that are highly preventable or curable — and building new partnerships to tackle overlooked health threats, including cryptococcal meningitis.
Over the next several years, Gilead’s GPS team will evaluate and report on our progress, sharing lessons from successes as well as where we’ve fallen short of our goals. I look forward to further dialogue with our partners, new and old, as we listen and learn and walk this journey together.
The views in this opinion piece do not necessarily reflect Devex's editorial views.
