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To Save Healthcare Systems, Focus on Patient Outcomes, Global Health Leaders Urge
- Global leaders from the healthcare sector unite to appeal for a new model of healthcare delivery in response to rising costs and dissatisfactory patient outcomes. The value-based healthcare model would track and pay for healing, instead of treating, patients
- Signatories include the Chief Executives/Presidents of Kaiser Permanente, Medtronic, Novartis, Qualcomm Life and Takeda Pharmaceutical Company, the Minister of Health of the Netherlands, the Chief Executive Officer of the National Health Service England and Harvard’s Michael Porter
- The model will be implemented in four pilot markets in 2017, beginning in Atlanta, USA, where the start was announced on 25 April, and later in the Netherlands, Singapore and the People’s Republic of China.
- Download the full report here
A diverse group of leading stakeholders in the $7.6 trillion global healthcare sector are calling for a major overhaul of healthcare systems, designed to deliver improved patient outcomes at lower cost. The proposal hinges on “value-based healthcare”, a patient-centric system that focuses on outcomes that matter to patients across the care spectrum. The recommendations are presented in a new World Economic Forum report, Value in Healthcare: Laying the Foundation for Health-System Transformation, released today in collaboration with Boston Consulting Group, and to be implemented in four pilot locations, starting in Atlanta (USA) this year.
Shifting the focus of healthcare to outcomes would enable health systems to address the rising costs, the signatories say. “Value-based care represents our best chance at ensuring that health systems of the future can deliver those outcomes that matter to patients at sustainable, long-term costs,” said Arnaud Bernaert, Head of Global Health and Healthcare Industries at the World Economic Forum.
Supporters of the appeal for a value-based healthcare approach include Omar Ishrak, Chairman and Chief Executive Officer, Medtronic, Joseph Jimenez, Chief Executive Officer, Novartis, Michael Porter, Bishop William Lawrence University Professor, Harvard Business School, Edith Schippers, Minister of Health, Welfare and Sport of the Netherlands, Simon Stevens, Chief Executive Officer, National Health Service England, Bernard J. Tyson, Chairman and Chief Executive Officer, Kaiser Permanente, Rick Valencia, President, Qualcomm Life, and Christophe Weber, President and Chief Executive Officer, Takeda Pharmaceutical Company. It is the first time that such a diverse group of leaders have aligned on a system-level approach to healthcare reform. (See quotes below.)
The report suggests three foundational principles to provide the basis for value-based care:
- Measuring outcomes and costs, i.e. the systematic measurement of the health outcomes that matter to patients and the costs required to deliver them across the full cycle of care
- Focusing on population segments that are clearly defined, and the health outcomes and costs associated with them; and
- Customizing segment-specific interventions, developed to improve value for each population segment
Four key enablers of value in healthcare support and facilitate the reorientation of health systems around these three principles:
- Informatics – including shared standards and new capabilities that enable the routine collection, sharing and analysis of outcome data and other relevant information for each population segment
- Benchmarking, research and tools – including systematic benchmarking for continuous improvement; identification of variations in responses to treatment and of emerging clinical best practices; new data sources for research and innovation, and new approaches to clinical trials; and the development of sophisticated decision support tools for clinicians and patients
- Payments – including new forms of compensation and reimbursement that help to improve patient value
- Delivery organization – including new roles and organizational models that allow providers and suppliers to adapt to new opportunities and innovations, provide better access to appropriate care and engage clinicians in continuous improvement
The report emphasizes that national political leaders and policy-makers have a central role to play in accelerating the transition to a value-based health system, a point stressed by several of the signatories.
To put its recommendations in practice, the Value in Healthcare project has begun working with 20 payer, provider, supplier and government organizations in the US state of Georgia on a pilot project to create a comprehensive value-based approach to heart failure in the Atlanta metropolitan area. “As the Mayor of the City of Atlanta, I am excited to host the first pilot program to focus on value-based healthcare with the World Economic Forum and our private sector partners,” said Mayor Kasim Reed of Atlanta.
“Over the next several months, the Atlanta working group will design a roadmap for implementing value-based health care for patients with heart failure, and will then put our work to the test, and see real-world examples of how value-based health care can affect outcomes. We have a bold vision: to become a national leader in heart-failure survival in the United States while improving the quality of life and reducing the cost of care for our residents. This pilot program lays the groundwork for us to achieve this audacious, but attainable goal."
In addition to the Atlanta project, three more regional pilots will be conducted this year in the Netherlands, Singapore and the People’s Republic of China. The report and call to action were prepared by the World Economic Forum in collaboration with The Boston Consulting Group (BCG).
"Does the Trump administration even think about Africa"?
The question on how the Trump administration’s policies will impact Africa was met with mixed reaction Wednesday during a briefing at the African Utility Week Conference underway in Cape Town.
The panellists, all leading experts in investment, grappled with questions like "does the Trump administration even think about Africa?" This amidst continuing speculation of US president Donald Trump’s policy plans for the African continent and growing concerns over the future of foreign aid projects and big projects steered as part of Power Africa under the previous administration. Vacancies in key senior portfolios for Africa fuels these concerns because a few months into his term Trump has not yet filled the position of assistant-secretary of state for African affairs. US media earlier reported J. Peter Pham as a favourite for this job.
On Tuesday leading investment analysts were also cautious on this topic.
Head of natural resources at Exotix Partners in the UK, Andrew Moorfield, said there is so much emotion in talks about Trump that he would rather focus on the “knowns” which are the markets. In Moorfield’s analysis there is some possible good news for African economies.
Moorfield referred to the low rate environment in the US. He said the last 12 months shows a post-Trump bump, but it is now falling again. According to him US rates is expected to remain low in the medium term with some consequences for Africa. This situation, he says, “creates a favourable and stable climate for African investment”.
This he explains is because investors generally reach for yield expectations for low and stable US rates also encourage investors to move to emerging and frontier markets because the stability reduces risk premiums associated with a potential flight to quality.
"The US dollar has been weakening since January, consistent with Trump’s stated preferences threatening foreign investor returns through continuing depreciation, "he explained.
It is common cause that one of Trump’s key plans is to invest in US infrastructure and this, Moorfield projects, will buoy commodity demand generally which will benefit African economies as demand for oil, gas minerals and metals will grow.
According to him Africa has lots of natural resources but is low on capital. “So if Trump executes his plan and invests in infrastructure the effect should be that it would buoy commodities and will benefit African economies.”
So the good news, says Moorfield, is that commodities have a wonderful multiplier effect. "And the multiplier effect is in the country of extraction, and that is Africa. So it can be a massive benefit."
Moorfield furthermore explained in terms of price recovery there can be a multiplier effect from a low base. "Commodities index at a low level and any price rises coming from a low base have an enhanced multiplier effect as they magnify the net revenue above the costs." He explains low interest rates will spur further investment in infrastructure including gas, mines and power on the continent. "So in this context opportunities will increasingly emerge to take advantage of an improving investment environment in selected African markets. Investors look for higher yields, and it is currently in the frontier markets."
Another panellist and author of the book "Frontier: Exploring the top ten emerging markets of tomorrow, Gavin Serkin told delegates four of the best ten places in the world to invest is in Africa. This includes Nigeria, Ghana, Kenya and Egypt. Responding to the question is the Trump administration talking about Africa; Serkin said he would hope so. "It looks like business as usual but I think there is a lot going on. I think it is on the radar, just down on the list.
Leading investment expert Jerome Booth in turn said investing in emerging markets is contrary to popular belief, a smart way to reduce risk.
Over 7000 decision makers from over 80 countries are attending the three day conference and expo where the latest developments, challenges and opportunities in the power and water sectors will be under the spotlight.
Over 300 experts will over three days discuss innovative solutions to the continent’s energy and water challenges and the exciting opportunities for utilities and industry players.
The conference ends Thursday.
Written by: Alicestine October
Close Skills Gaps to Prepare Africa's Workforce for Tomorrow's Jobs
- Every year for the next three decades, 15-20 million increasingly well-educated young people are expected to join the African workforce
- Employers across the region identify skills gaps as a major constraint to their ability to compete in the global economy
- In South Africa alone, 39% of core skills required across all jobs will be wholly different by 2020, while 41% of jobs in South Africa are susceptible to automation
- Read the full report here. For more information about the World Economic Forum on Africa, please visit wef.ch/af17
With more than 60% of its population under the age of 25, sub-Saharan Africa is already the world’s youngest region and, by 2030, it will be home to more than one-quarter of the world’s under-25 population. As this young population – the best-educated and globally connected the continent has ever had – enters the world of work, the region has a demographic opportunity. But the region can only leverage this opportunity by unlocking latent talent and preparing its people for the future of work.
A new report launched by the World Economic Forum aims to serve as a practical guide for leaders from business, government, civil society and the education sector, and finds that the region’s capacity to adapt to the requirements of future jobs leaves little space for complacency. While a number of African economies are relatively underexposed to labour market disruptions at present, this picture is changing rapidly. This window of opportunity must be used by the region’s leaders to prepare for tomorrow.
Key findings from the report, which includes new data from LinkedIn, are:
- While it is predicted that 41% of all work activities in South Africa are susceptible to automation – as are 44% in Ethiopia, 46% in Nigeria and 52% in Kenya – it is likely moderated by comparatively low labour costs and offset by job creation. Despite this window of opportunity, the region’s capacity to adapt to further job disruption is a concern.
- Employers across the region identify inadequately skilled workforces as a major constraint to their businesses, including 41% of firms in Tanzania and 30% in Kenya, while others say they feel less pressure (9% in South Africa and 6% in Nigeria). However, this pattern may worsen across the region in the future. In South Africa alone, 39% of core skills required across occupations will be wholly different by 2020.
- This skills instability often stems from the fact that many jobs in the region are becoming more intense in their use of digital technologies. Average ICT intensity of jobs in South Africa increased by 26% over the last decade, while 6.7% of all formal-sector employment in Ghana and 18.4% of all formal-sector employment in Kenya occurs in occupations with high ICT intensity.
- Some of the most common types of higher-skilled employment on the continent include business analysts, school teachers and academics, commercial bankers, accountants, human resources, marketing and operations specialists, customer service specialists, advertising professionals, information technology workers and software and app developers, according to LinkedIn’s data.
“Across the continent, substantial potential exists for creating high-value-adding, formal-sector jobs in a number of areas. However, to realize this potential, closer dialogue between education providers and industry is needed to align and optimize the region’s demand and supply of skills,” said Nicolaas Kruger, Chief Executive Officer of MMI Holdings and Chair of the Africa Skills Initiative.
The initiative, part of the broader efforts of the Forum’s System Initiative on Shaping the Future of Education, Gender and Work, serves as a platform to help change this. It provides new insight, brings together business efforts to address future-oriented skills development and supports constructive public-private dialogue for urgent and fundamental reform of education systems and labour policies to prepare workforces for the future of jobs. The Africa Skills Initiative is inviting businesses in partnership with government, civil society, and the education and training sectors to make quantifiable commitments to skill, upskill or reskill 1 million people by 2018 and 5 million people by 2020 in Africa, the Middle East and other regions.
“The data show that, to prepare for the future of work, the region must expand its high-skilled talent pool by developing future-ready curricula, with a particular emphasis on STEM education; increase digital fluency and ICT literacy across the population; provide robust and respected technical and vocational education; and create a culture of life-long learning, including the provision of adult training and upskilling infrastructure,” said Saadia Zahidi, Head of Education, Gender and Work and Member of the Executive Committee at the World Economic Forum.
Africa's Prosperity Tied to Powerhouse Pair South Africa and Nigeria
- Size does matter: The fortunes of Africa are tightly bound to those of its two largest economies, South Africa and Nigeria, and the continent will not prosper unless they succeed
- Global economic shocks, notably the commodity price crash, have hit both of these countries and they must learn from the setbacks and set about fostering growth in new ways
- Switching from a heavy reliance on foreign investment to more intra-African trade is a clear priority
- Follow the 2017 World Economic Forum on Africa at http://wef.ch/af17
Tackling Africa’s massive social challenges is impossible without harnessing and coordinating the power of its two largest economies, South Africa and Nigeria, said Kuseni Douglas Dlamini, Chairman of Massmart Holdings, South Africa, at the World Economic Forum on Africa, which opened today in Durban. Dlamini pointed out that the two economic powerhouses together contribute 60% of the gross domestic product of sub-Saharan Africa. “Africa cannot succeed unless they succeed,” he added.
However, neither South Africa nor Nigeria is currently on a high-growth path. The global slowdown has clearly had a profound effect, but the countries’ leaders need to consider whether they have fully applied the principles of inclusive and sustainable growth. One example of effective leadership would be a redoubled effort at regional integration. At present, only 10% of all Africa’s trade is intra-African – the lowest ratio of all continents in the world. If this could be boosted to 20% it would make meaningful inroads into creating jobs and tackling poverty.
Haruki Hayashi, Executive Vice-President and Regional Chief Executive Officer, Europe and Africa, Mitsubishi Corporation, United Kingdom, said that South Africa and Nigeria should be “leaders, drivers and role models” for other African countries. This does not necessarily mean they shouldn’t be competitive – after all, the African market is a huge one with many trade and development opportunities for both. Hayashi said that policy consistency, political stability and turning back the tide of corruption are imperatives to South Africa and Nigeria assuming a leadership and mentoring role on the continent.
Danladi Verheijen, Co-Founder and Chief Executive Officer of Verod Capital Management, Nigeria, said that diversification of economies is a priority for many countries, but particularly for Nigeria, given its heavy reliance on its oil resources. He said oil has been seen as fuelling the Nigerian economy, but it should instead be seen as “lubricating” it. “Quick wins” are important to kick-starting growth away from current low levels.
Geoffrey Qhena, Chief Executive Officer of the Industrial Development Corporation of South Africa, said that Africa’s larger economies could, counter-intuitively, benefit from global moves towards protectionism. Rather than remaining reliant on imports in many sectors, countries like South Africa and Nigeria with the capacity to build new industry and manufacturing sectors could do so – with obvious long-term benefits for themselves and their neighbours. It might be important to collaborate on such initiatives and leaders need to engage and iron out their differences regarding impediments to cooperation.
The 2017 World Economic Forum on Africa takes place on 3-5 May in Durban, South Africa, under the theme Achieving Inclusive Growth through Responsive and Responsible Leadership. The meeting convenes regional and global leaders from business, government and civil society to explore solutions to create economic opportunities for all. It will also provide insight from leading experts on how Africa will be affected by the onset of the Fourth Industrial Revolution, particularly in terms of safeguarding the region’s economies from negative disruption and exploiting opportunities for further growth and development.
Access to medicines: lessons from the HIV response
Just two decades ago, HIV/AIDS treatments were prohibitively expensive and accessible in only a few affluent countries. But remarkable reductions in costs have enabled treatment expansion that has reduced mortality and transmission. Today, first-line HIV drugs cost less than US$100 per person per year, a 99% reduction from more than $10 000 in 2000. The number of people receiving HIV treatment doubled in just 5 years, from 9 million in 2011 to more than 18 million today.
Download PDF Access to medicines: lessons from the HIV response