Everyone knows (and hopefully agrees!) healthcare is a crucial part of any community’s social fabric. Receiving timely care from your healthcare system when you need it most says a lot about your community and peoples’ attitudes towards each other. However, despite access to appropriate healthcare being a fundamental UN principal, it is something low, middle and high income societies struggle to deliver.
The 2016 Rhodes Healthcare Forum sought to explore ideas on how this could be improved in the future. The theme this year was Optimisation or Innovation: Making meaningful gains in healthcare. This central theme aimed to acknowledge that there are huge gains to be made in healthcare through both creative new strategies as well as optimising existing approaches.
We considered why many new innovations fail to be translated into the promised clinical benefit and what could be done to facilitate this. We also discussed how optimisation of existing strategies will continue to contribute significant benefits to healthcare globally. The forum achieved a fantastic balance of examining both sides of how we can make these desperately needed gains and deliver them globally.
The 2016 forum saw 30 speakers and panellists join 90 delegates for a weekend conference at Rhodes House. Panels and breakout sessions covered a diverse range of topics including the integration of genomics into healthcare systems, the increasingly digital future of healthcare, the tension between market opportunities in drug development and the needs of public healthcare systems,and how innovation divides global health and potentially increases geographical disparities. Keynote addresses provided speakers an opportunity to speak passionately about their own experiences and beliefs on health and healthcare. One-on-one mentoring sessions allowed scholars to gain insight and advice on how to proceed with their own ideas and careers.
Health starts much earlier than the hospital
One central idea that pervaded many of these discussions was a need to separate health from hospital care. Esther Dyson (Executive Founder, Way to Wellville), in the opening keynote for the conference, laid out how many countries focus their health budgets and went on to challenge us to change how people view health. We will only be able to make sustainable, meaningful gains in health, if we focus on ‘health’ as something you invest in to prevent illness, rather than focusing on ‘healthcare’ where you spend once someone is already ill.
This theme of prevention was revisited numerous times in different ways. Abdul El-Sayed (Michigan & Oriel College 2009) reflected on his desire to exact meaningful change through policy in his role as Executive Director of the Detroit Health Department during his dinner address. Samir Sinha (Manitoba & New College 2001) developed this further, outlining the importance of health advocacy in achieving meaningful change. He discussed the successes and challenges he faced as a geriatrician advocating for a healthcare system that can better meet the needs of an ageing population.
The Digital Future of Healthcare panel explained the role digital health, remote sensing and big data can play in maintaining health. The need for Big Pharma to develop preventative medicines was also acknowledged in the Drug Discovery panel. Industry experts discussed how they have begun to work with health systems on where to focus their efforts rather than creating products in isolation that did not necessarily reflect the greatest clinical need.
Undoubtedly re-orientating health budgets and research priorities is not something that can happen over night but with a concordant effort from health professionals across the sector, meaningful change can be exacted.
Health is truly global
Throughout the conference we were grounded through opinions voiced from the floor and speakers. Agnes Bingawaho, (former Minister of Health for Rwanda), brought an important and passionate perspective to all discussions. She highlighted the importance of including developing nations in the conversation about the future of healthcare, be that digital health or drug discovery: “If you’re not at the table, you’re on the menu. Don’t get eaten!” Quarraisha Abdool Karim (Associate Director of CAPRISA) argued that perhaps innovation does not reach people in need on the ground because it is targeted at the “white Caucasian male”. Quarraisha advocated a need to innovate in a way that allowed developments to reach all people.
Recent world events, including the UK’s decision to leave the EU and America’s election of President Elect Trump have the potential to significantly impact health and healthcare around the world. The potential impacts were acknowledged frequently by speakers as well as specifically in a breakout group hosted by Michael Stein (South Africa-at-Large & Lincoln 1988). Hearing about the implications of Brexit on clinical trials, drug approval and other practical aspects of healthcare in the EU and UK was alarming. Moreover, while the financial and economic implications are important, hearing industry experts lament how potential restrictions on the freedom of movement of people could affect the sector were worrying. In advance of any firm Brexit policy, there are already reduced job applications in many UK biotech and related sectors. With people and the sharing of knowledge repeatedly identified throughout the weekend as crucial to development, stifling healthcare innovation through restricted access to human capital may be a greater threat to healthcare than access to more traditional capital markets.
Not a regular conference
For many, the conference distinguished itself from other events by engaging everyone in the dialogue. People felt like they were contributing to be part of a collective movement striving to create impact, rather than passively absorbing information as is common at other conferences. The interaction between generations of scholars or speakers, whether 4 or 40 years apart, complemented the feeling of meaningful collaboration. This was particularly evident in the Ideation Session.
The Ideation Session saw attendees work in small groups to come up with healthcare strategies for the future. Groups adopted the persona of different individuals from around the world with a range of healthcare needs and then developed a way to improve the individual’s or community’s health or healthcare system. The benefit of diversity shone through as people shared suggestions based on very different experiences and from sectors throughout the healthcare spectrum. Groups seemed to develop ideas incorporating the role and support, a community or network can play in helping each other. The ability to organise such collective action through technology and mobile devices also emerged as a powerful and practical way to facilitate such connections. Strategies were often preventative aiming to improve the health of a group and prevent hospitilisations, rather than specific drugs to address a particular health need.
We would like to thank the Rhodes Trust for hosting such a great event, fellow committee members and Rhodes staff for organising everything and the incredible speakers/panelists/breakout facilitators and Scholars for their thoughts and contributions to the weekend. We look forward to the 2017 conference and encourage anyone who thinks they will benefit, or be able to contribute to come along.
The Rhodes Healthcare Forum is a conference held annually in early November. The forum aims to forge connections between current Scholars and world leaders and foster debate across important aspects of healthcare, from lab science to public health, from clinical medicine to global health. Dates for the 2017 conference will be confirmed shortly. We are currently looking for Scholars keen to form a committee to shape and execute a vision for the 2017 conference. Please contact conferences@rhodeshouse.ox.ac.uk for further information.