SDIS21: What are the challenges in making healthcare more sustainable? – World Economic Forum

In recent years, the world had made substantial progress on Sustainable Development Goal 3 targets - good health and well-being - but COVID-19 threw us far off track.

Firstly, the pandemic itself: 225 million cases and 4.6 million deaths worldwide (as of this writing) and rising as more contagious variants spread. In the US, this led to a reduction in life expectancy of 1.87 years on average with greater reductions among people of color. And although we developed effective vaccines and therapeutics in record time, vaccine inequality and misinformation/disinformation have kept shots out of the arms of too many.

The pandemic has halted or reversed progress in health and shortened life expectancy.

Image: UN

Meanwhile, the pandemic's impact continues to multiply. With disruptions to health services worldwide, weve seen a "third wave" of loss of people suffering from non-COVID diseases, like cancer and rare disease, according to Forum experts, along with new outbreaks of preventable diseases like measles. Over-prescription of antibiotics has accelerated the need to address antimicrobial resistance. Lockdowns, fear and grief have created a surge in anxiety, depression and other mental health concerns.

The COVID crisis created a mental health crisis.

Image: Statista

And with a disproportionately devastating impact on communities of color, the elderly and society's most vulnerable, the virus has highlighted the structural weaknesses of not only our economic systems, but also, more critically, our health systems, as World Economic Forum experts put it. This includes healthcare workers, who are in dire shortage and facing mental health crises themselves.

As the pandemic continues, were now facing another, potentially more destructive health crisis: climate change. We know the coronavirus was caused in part by our increasingly unsustainable relationship with nature and air pollution is linked to greater risk of COVID infection and death. Beyond COVID, rising temperatures, biodiversity loss, water pollution and extreme weather events will continue to cause harm not only to the planet but also to human health and longevity yet another reason why addressing climate must be part of the COVID-19 response.

Air pollution is one of our greatest health threats.

Image: WHO

SDG 3 is ambitious, setting out to reduce or eliminate a number of health-related problems, including:

Many health indicators were moving in the right direction before the threat of COVID-19 emerged, says the UN's Sustainable Development Goal Report 2021. Maternal and child health had improved, immunization coverage had increased and communicable diseases had been reduced, although not fast enough to achieve the 2030 targets numbers highlighted this time last year.

Now, much of that progress could be stalled or reversed, says the report.

A decade of progress on SDG 3 could be stalled or reversed by COVID-19.

Image: UN

In 2020, 35% of countries reported interruptions in reproductive, maternal, newborn, child and adolescent health services, along with nutrition services, contributing to as many as 228,000 additional child deaths and 11,000 additional maternal deaths in 2020 in South Asia alone.

Prior to 2020, we saw steady reductions in mortality from both communicable (HIV, TB, malaria) and non-communicable diseases (cardiovascular disease, cancer, diabetes) but, here, too, COVID caused disruptions in routine care. For example, an estimated 1.4 million fewer people received essential care for TB in 2020 compared to 2019 a 21% reduction.

Disruptions in HIV treatment will likely lead to more deaths.

Image: The Global Fund to Fight AIDS, Tuberculosis, and Malaria

In the first three months of 2021, between 30% and 40% of malaria-endemic countries reported some level of disruption to services involving malaria diagnosis and treatment. A 10% disruption in access to effective treatment in sub-Saharan Africa could lead to 19,000 additional deaths," the UN report notes.

Above all, these challenges underline the need to make more progress on achieving universal health coverage (UHC) which is essential to beat COVID-19, as well as reduce inequality and poverty. Prior to the pandemic, improvements in UHC were seen across the board, with significant progress made in sub-Saharan Africa between 2000-2017.

As we work towards expanding UHC, we should take lessons and insights learned from the past year and a half such as the important role of digital healthcare and data in healthcare delivery.

The application of precision medicine to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseasesand disease in general.

But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.

The World Economic Forums Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access across borders to sensitive health data for the treatment and diagnosis of rare diseases.

The data will be shared via a federated data system: a decentralized approach that allows different institutions to access each others data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.

The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).

The views expressed in this article are those of the author alone and not the World Economic Forum.

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SDIS21: What are the challenges in making healthcare more sustainable? - World Economic Forum