Rethinking Healthcare for 21st Century Challenges
Updated: Jun 7, 2021
We interview experts in public health and non-communicable diseases (NCDs), policy makers and thought leaders on 21st century challenges for healthcare systems in Asia-Pacific, and how to prepare for them.
by John Battersby, Regional Account Director
Preparing ASEAN’s/ APAC’s Healthcare Systems for the 21st Century
While the Covid-19 pandemic has shown the world that the individual men and women who staff our healthcare systems, from specialist consultants to janitorial staff, are essential to life, it has highlighted the institutional shortcomings of many of those systems.
It has also distracted the world, and particularly the world’s politicians, from the even more deadly and systemic problem posed by another, currently sidelined, pandemic that has threatened to overwhelm the world’s healthcare systems for more than a decade.
The systemic shortcoming which I refer to is the ‘acute care model’, what most of the world’s healthcare systems are built on; a hangover from the beginnings of public health services in the late 19th and early 20th centuries.
This sidelined pandemic is one of the non-communicable diseases (NCDs) — in particular cardiovascular disease (CVD) and diabetes — that was straining many national systems to breaking point long before Covid-19 hit us.
For Bridges M&C, this is a topic close to our hearts (pun intended). It is also one which we have had the opportunity to discuss with many of Asia-Pacific’s leading public health and NCD experts and policy makers, in our role as a medical communications agency specialising in regional campaigns focused on disease awareness and public education.
21st Century CVDs: How we got here The development of public healthcare systems in the 20th century allowed society to make great strides in improving the world’s health. Advancements in sanitation, education, healthcare and technology lifted millions out of poverty, controlled and nearly eliminated many communicable diseases, contained famine, reduced infant mortality, and led to an unprecedented increase in overall life expectancy. However, those very successes gave rise to new challenges which we must recognise and take steps to tackle in the 21st century.
The increase in life expectancy means that society as a whole, not just individuals, is getting older. By the middle of this century, for the first time in human history, there will be more people over age 60 than under age 15.
While we have reduced the number of deaths caused by poor sanitation, famine and infectious disease, the number attributable to non-communicable disease (NCD) has increased exponentially; driven mainly by our increasing age and weight.
Cardiovascular disease (CVD) is now the leading cause of death globally, but the broader impact of CVD on the survivors of major incidents like strokes and heart attacks, as well as those coping with chronic conditions such as heart failure (HF), coronary artery disease (CAD) and peripheral artery disease (PAD), has not been as well documented thus far; particularly in the middle-income countries of the Asian Pacific region.
As population aging accelerates across the region, policy must take steps to proactively address age-related health challenges; in particular the growing socioeconomic impact of CVDs on patients, caregivers, healthcare systems, and society as a whole. Action points for building future healthcare systems
The general consensus of the key opinion leaders (KOLs) we spoke to is that there are four areas for action where policy change and increased societal recognition are needed. These include:
Focus: A shift from an acute to a preventative care model. One that instead of building increasingly large and centralised acute care facilities and funnelling already critically ill patients to them, builds more widely distributed primary care facilities with the aim of identifying and managing NCDs earlier, and where possible preventing or delaying their onset.
Awareness: Meaningful policy action on CVDs must promote awareness and education amongst the general public, patients, caregivers, and healthcare professionals in two key areas to drive:
1. Healthy choices that reduce the risk of developing CVDs and related health challenges, and
2. Informed choices on the available strategies for managing chronic CVDs and related health challenges.
Innovation: Innovation in therapeutics and technology is moving faster than ever before and policy makers must recognise that novel solutions are likely to play an increasingly important role in enabling aging populations to maintain independence while they manage their chronic CVDs and related health challenges in place.
Collaboration: Effectively addressing the direct and indirect impacts of CVDs will require policies and platforms that engage a wide range of actors, including government agencies, health systems, the private sector, non-profits, multilateral organisations, and advocacy groups.
This is article is part one of a six-part series by Bridges M&C discussing healthcare systems and cardiovascular disease in the APAC region.