As we look back on another successful year for the Novartis Foundation, I can say that our part in the healthcare conversation in low- and middle-income countries (LMICs) has truly changed. Moving from grant funding specific projects, we are now actively engaged in achieving systemic change by addressing complex health challenges, together with global and local partners from diverse disciplines and sectors. Such solutions can help accelerate the achievement of Sustainable Development Goal 3: to ensure healthy lives and promote well-being for all, at all ages.
How do we truly tackle the dual disease burden of chronic and infectious disease? How do we not just hold leprosy in check, but finally eliminate it? How do we intelligently adopt and adapt technological advances to improve healthcare? The answers to all these questions are the basis of the remarkable work we have done this year at the Novartis Foundation. We are now looking far beyond just improving access to quality care, training or capacity building – we are exploring comprehensive and multidisciplinary ways to truly strengthen health systems and public health policies that improve health.
Better Hearts Better Cities
In 2016, we started building a new initiative to address hypertension and its cardiovascular complications in a comprehensive way: not only by improving clinical practice and strengthening health systems, but also by addressing the underlying determinants of cardiovascular disease with public health policy interventions. You can read more about the initiative here.
Broadband Commission Working Group Report on Digital Health
Within the Broadband Commission, we convened the working group on digital health with leading global digital experts and policy makers to develop recommendations for the institutionalization of digital technology within national health systems. The development and implementation of a national digital health strategy makes it possible for digital health to reach its full potential and address the health priorities of a country, instead of leading to a fragmented landscape of different, albeit well-intended, digital health solutions that are not interoperable. You can read more about this project here.
Along with our partners, we have pioneered two innovative models to address hypertension in low-income communities: this year we launched the Communities for Healthy Hearts Program (CH2) in Ho Chi Minh City, Vietnam, and continued to learn from the Community-based Hypertension Improvement Project (ComHIP) in Ghana. Both aim to bring hypertension detection and management closer to local communities by maximizing hypertension screening and education opportunities outside the health system, placing screening stations in local shops, pharmacies and other businesses. Both incubator models are designed to take into account the reality of patients living in urban low-income settings and leverage digital health to empower patients and connect healthcare providers at different levels of care. To generate evidence that these models work, we are measuring both patient and population health outcomes, as well as the cost-efficiency of the ComHIP and CH2 interventions.
We are very proud to be part of these programs – and people beyond our teams have taken notice as well. ComHIP for example, has been referred to as one of the most innovative and promising models to increase access to non-communicable disease (NCD) care in low-income settings in the Lancet and by the Access to Medicines Index.
Beyond these two models, we have also launched the Hypertension Working Group of the International Consortium for Health Outcomes Measurement (ICHOM), tasked with defining standard health outcomes for hypertension in low-income settings. ICHOM is a consortium between Harvard University, the Boston Consulting Group and Karolinska Institute, and the standard set for hypertension outcomes in LMICs will be the first set ICHOM specifically develops for low-income settings.
And let’s not forget the amazing success of the telemedicine model we pioneered with our partners in Ghana: it continued to scale-up to another five regions, with a view for national coverage by the end of 2017. This pioneer model in the Amansi West region was selected by the national health authorities – out of seven other telemedicine models – to be rolled-out and form the basis for the national telemedicine services in Ghana.
We continued working towards eliminating leprosy and malaria, and in 2016 we marked 30 years of commitment by the Novartis Foundation to the fight against leprosy. Our comprehensive strategy toward zero transmission involves the Leprosy Post Exposure Prophylaxis (LPEP) program, currently running in eight countries. Its strategy is now included in the revised WHO Global Leprosy Elimination strategy. In addition, we continued our search for ways to accelerate leprosy diagnosis through digital health with the validation and further roll-out of LEARNS in the Philippines. But to make real progress and cover the last mile toward elimination, it will be essential to detect infected people earlier. To do so, we initiated collaborations with the École Polytechnique Fédérale de Lausanne (EPFL) in Switzerland for the preclinical validation of a molecular leprosy diagnostic test and with FIOCRUZ in Brazil to identify the best sampling method.
We showcased progress of our leprosy programs at the 19th International Leprosy Congress in Beijing by presenting 11 abstracts in scientific sessions on Novartis Foundation-supported leprosy initiatives. We also continued our efforts to build evidence on how malaria can be eliminated in Namibia, through Targeted Parasite Elimination (TPE).
Over the past few years, the advent of digital health has led to an increased integration of digital health solutions into programs aimed at improving health in low- and middle-income countries (LMICs). However, translating this potential into scalable, evidence-based, integrated solutions that yield long-term health improvements remains a challenge, and there is an ongoing need to share experiences.
In June 2016, we therefore convened global digital experts, private corporations and governments at a dialogue event on digital health in Ghana. Co-hosted with the Ghana Ministry of Health and the Ghana Health Services, the event showcased the Novartis Foundation-supported telemedicine and ComHIP programs, sharing key factors for scaling digital health solutions – specifically the importance of local ownership.
We also continue to use our convening power to further explore solutions to NCDs, which have become the main health problems in low-income communities. In November 2016, we hosted the third NCD Dialogue jointly with the London School of Hygiene & Tropical Medicine, this year focusing on the importance of person-centered care. We explored how bringing patients and their families to the center of new models of care is essential to improving the management of hypertension and its complications. If you missed the event in person, you can watch a recording of the webcast here.
In February 2017, we also organized a dialogue on the new focus area of the Novartis Foundation: urban health. We convened urban planners, urban health professionals, academies of science, civil society and policymakers in Cape Town to discuss multidisciplinary approaches to address the enormous challenge of improving urban health and creating healthier cities in Africa.
As I look ahead to 2017, I believe we are well on the road to finding new ways to address the growing needs of populations and health systems in low-income settings for years to come. Let’s continue down this path together.
The Novartis Foundation would like to thank the following photographers and organizations for the wonderful imagery across our Annual Report:
Nana Kofi Acquah,
Andre Malerba and
Terres des Hommes