A moonshot in health care thinking

A moonshot in health care thinking

Five years ago, I described Gastein’s European Health Forum (EHFG) as “a marketplace of good ideas to drive the health reform agenda forward” and spoke confidently of our collective ability to implement and manage these ideas. Today, as we celebrate the 25th anniversary of the EHFG and come together for the first time in a hybrid form, the mood may be more sober, even somber. Yet we remain more determined than ever to make a quantum leap in our thinking and, importantly, in our planning on how to deliver health for all.

The world is clearly in a permanent crisis: war in Ukraine, a climate emergency, an energy crisis, runaway inflation and a surge in migration caused by hunger, famine and civil unrest. And it all adds up to the grim legacy of the worst pandemic in a century, a new monkeypox-related public health emergency, and the virtual certainty of worse crises to come. Consider antimicrobial resistance (AMR).

Health systems in Europe and around the world are under great pressure. Long-standing funding issues to deal with an aging population requiring ever greater care are intensified by high inflation, staff shortages, ever-longer queues for diagnosis and treatment and, moreover, in addition, shifts in spending priorities of policy makers towards defense and security. The liberal world order and, with it, democracy are in danger of collapsing.

Nevertheless, there are reasons to be optimistic about the ability of the global community to come together to better manage crises. Earlier this year, the WHO Executive Board, based on a resolution I proposed, agreed to establish a new standing committee on health emergency prevention, preparedness and response – an echo, if you will, from the new EU body, the Health Emergency Preparedness and Response Authority (HERA). The World Health Assembly has agreed to a historic increase in contributions from Member States to the WHO budget. Instead of 17 (sic!) percent, they will represent 50 percent of the total

budget. And there is an intergovernmental process in place to negotiate a new legally binding instrument to better address health emergencies more effectively. Then there was a partial lifting of the ADPIC (Intellectual Property Waiver) agreement, which I consider as a sign of good faith towards the countries of the South that equity in access to vaccines for all is a crucial objective. . This month we witnessed the official launch of the Financial Intermediary Fund (FIF), a $1.2 billion fund designed to address critical health system gaps in low- and middle-income countries (LMICs) and help overcome the glaring inequalities in health that continue to widen.

No comfortable consensus but a big leap forward

However, these small steps are insufficient to meet the challenges we face. I fervently hope that this year’s EHFG will set the bar high by restarting the process of thinking about the once unthinkable, shaking us out of what a colleague described as “our European bubble”, proposing/adopting solutions radical responses to these multiple health challenges. and, last but not least, don’t be afraid to disagree. We don’t need another cozy consensus between well-meaning policymakers and stakeholders gathering dust on a shelf at the Berlaymont like those so-called visionary reports on the future of Europe. What we need is what I call fire: heated debate and a bonfire of old certainty platitudes. That’s why we call for a moonshot when it comes to new ways of thinking about health care.

Mariana Mazzucato, one of our keynote speakers and chair of the WHO Council on the Economics of Health for All, says it best when she talks about putting health for all at the heart of government decisions on investment and innovation while keeping the common good in mind. It calls for moving from a “healthy” economy to an economy based on health for all. It is indeed time to stop measuring economic success as GDP growth and start measuring it in terms of human and environmental well-being.

This means a new social contract around very different socio-economic models. Of course, human societies are not yet ready to evolve into what the young Scottish philosopher, William MacAskill, calls “effective altruism” (making charitable giving work best). But current trends in health and energy use can only mean millions of deaths worldwide and even planetary depletion.

The great financial crisis of 2008 ushered in a period of misguided austerity. By contrast, the COVID-19 pandemic and now war in Ukraine has seen even “frugal” countries like mine ease or even abandon what Professor Mazzucato calls “false budget constraints”. But we need to go further and adopt state budgets that are tailored to deliver desired outcomes with real value – including better health for all and shared well-being. Genuine ESG thinking needs to be at the heart of policy making.

A true European health union

In my view, this year’s forum should serve as a call to action for government ministers and others to learn from the current and impending pandemic and other crises: think outside the silo, collaborate, common sovereignty, solidarity above all. By bringing together so many actors from health and other policy areas, the EHFG can set the agenda to extend and complete the European health union.

A large majority of the European population is in favor of greater EU competence in crisis management, rejecting at the same time the fortress Europe approach. In addition to addressing pandemic preparedness and response, including vaccine supply, Europe is spearheading measures to promote the digital transformation of healthcare delivery – and it’s only just begun. This must be at the heart of the overall EU health strategy that DG Health will present to Gastein on September 28.

The same goes for the future role of the European pharmaceutical sector, including R&D and competitiveness, and barriers to market entry. And we should not forget the need to make medicines more affordable and easily accessible in many EU-27 countries. Europe has only just begun to discuss new ways to finance health care and, in the context of antimicrobial resistance, to encourage the discovery of new and effective antibiotics. Greenfield thinking on innovative financing is at the top of our agenda here.

All of this, one might add, is fine, but do we have the professional staff to provide the improved care and treatment that we promise ourselves in Europe? Shortages of GPs, nurses and hospital consultants are growing at an alarming rate. Thus, the Commission and the governments of the Member States, which have the greatest competence in this area, must work with public bodies, including trade unions, to design viable strategies to recruit, retain and train a greater number of professionals. motivated.

This is why this year’s Forum should ask the fundamental question: the European Health Union – if not now, then when. In view of our society and the challenges of the world, we could say to ourselves “if not now, it will be too late! “.


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