Condition Analysis / Tailoring Healthcare Policies to Unique Economic Realities

Tailoring Healthcare Policies to Unique Economic Realities

By AMN | 18th October 2023

AMN - Tailoring Healthcare Policies to Unique Economic Realities

On 12 October 2023, in the presence of three French Ministers, the Minister for Europe and Foreign Affairs, the Minister of Health and Prevention, the Minister of Higher Education and Research, and WHO’s Director-General, France released its Global Health Strategy for 2023-2027.

In order to achieve the UN's Sustainable Development Goals (SDGs), particularly SDG3, which is focused on ensuring healthy lives and promoting well-being for all, France is urging national and international organisations, as well as governments, to support the creation of a new global health system, known as, One Health.

The global strategy aims to reduce health inequalities and through the One Health approach be better equipped at preventing and preparing for future global health emergencies. The group is concerned that environmental problems will have an impact on health systems.

What is One Health

The One Health approach emphasises collaborative efforts across multiple disciplines on a global scale to achieve optimal health for humans, animals, and the environment. It emerged in response to the spread of zoonotic diseases between species and a growing understanding of the interconnectedness of human, animal, and ecological health. Their viewpoint is based upon that animals and humans share similar diseases and can be treated with related drugs. They caution the need to avoid unnecessary treatment, especially considering the risk of drug resistance in infectious microbes.

The concept of One Health, originated in 1964 when veterinarian Calvin Schwabe coined the term "One Medicine" to stress collaboration between veterinarians and physicians. The Wildlife Conservation Society's 2004 conference led to the creation of the Manhattan Principles, highlighting the links between humans, animals, and the environment. The H5N1 influenza outbreaks, spurred organisations like the American Veterinary Medical Association and the World Health Organisation to endorse the One Health approach. In 2019, U.S. Senator Tina Smith and Representative Kurt Schrader introduced the Advancing Emergency Preparedness Through One Health Act, aiming to establish a coordinated plan within federal agencies to address zoonotic diseases and prevent outbreaks. Additionally, International One Health Day was designated on November 3, further emphasising the significance of a unified approach to global health challenges.

The One Health Commission (OHC) was chartered in Washington, D.C. in 2009 as a 501(c)3 non-profit organisation. Its mission is to connect individuals and create relationships across human, animal, and environmental health sectors, as well as to educate the public about these issues with the intent to improve global health. Roger Mahr was the founding CEO and since 2013 the current executive director is Cheryl Stroud, a veterinarian.

The One Health Initiative includes the American Veterinary Medical Association, American Medical Association, Centers for Disease Control and Prevention, United States Department of Agriculture, Vétérinaires sans Frontières/ Tierärzte ohne Grenzen and the United States National Environmental Health Association, UN, The Food and Agriculture Organisation of the United Nations (FAO), WHO, The World Organisation for Animal Health (OIE) headquartered in Paris, France.

Nine goals have been set for the organisation, including sharing research findings at biannual meetings, identifying knowledge gaps in the field, involving policy makers, creating a Bio Threats Scanning Group to link One Health and global health security, sharing data, acting as a reference network for the government, fostering collaborations, and putting policies into place, as well as raising awareness on One Health Day.

One Size Fits All

The release of France's Global Health Strategy for 2023-2027 is a significant event, highlighting the growing emphasis on global collaboration in healthcare. However, it's crucial to recognise that healthcare policies cannot be a one size fits all, even among advanced nations. Various factors, such as access to care and medicine, affordability, the quality and ongoing training of a nation’s medical and health workforce, innovation constraints, choice, informed consent, bureaucracy, and corruption, create disparities in healthcare systems across countries.

Consider the availability of cutting-edge cancer therapies. The majority of individuals think Australia's healthcare system is superior. Despite this many cancer sufferers need to leave Australia to obtain more advanced cancer treatments in countries such as Germany and Turkey. These treatments range from Nano knife technologies, to cryoablation and more. These treatments are mainstream in Europe while in Australia are either in clinical trial stage or not available at all. The expense of these therapies is another consideration; in certain circumstances, patients spend up to AU750,000 for them. It begs the question, where does this leave those who cannot afford such treatments. This lag in adopting innovative treatments and their subsequent costs can impact overall health outcomes and economic productivity of a nation and therefore ensuring a global health and wellbeing for all, no matter what age is a pipe dream.

Removing Bureaucratic Barriers & Corruption

Bureaucratic hurdles pose a significant barrier to the efficient functioning of healthcare systems. Excessive red tape not only hampers the decision-making processes but also inflates costs unnecessarily. These resources, instead of being tangled in bureaucratic complexities, could be channelled into initiatives that genuinely enhance patient care and advance medical research. It's essential to recognise that the ones best positioned to identify these inefficiencies and streamline the system are the medical professionals and healthcare experts working at the forefront of patient care. Their firsthand experience equips them with valuable insights into the practical challenges faced by both healthcare providers and patients, making them well-suited to inform and guide the necessary reforms. By empowering these professionals to actively participate in shaping healthcare policies and dismantling bureaucratic obstacles, nations can unlock the full potential of their healthcare systems, ensuring that resources are efficiently utilised to benefit those who need it most: the patients.

Indeed, numerous health-focused non-profit organisations and social enterprises are making significant strides in addressing healthcare challenges with either minimal or no government funding or intervention. For instance, organisations like The Purple House in Alice Springs have pioneered innovative solutions, such as providing essential kidney dialysis services to Aboriginal communities in the area. These initiatives showcase the power of community-driven efforts and innovative approaches to bridge healthcare gaps, often circumventing bureaucratic hurdles. By harnessing the expertise of dedicated professionals and leveraging local knowledge, more efficient, adaptive and tailored services can be created to meet the specific and evolving needs of communities, ensuring that healthcare reaches those who need it most. Such grassroots initiatives highlight the importance of empowering local communities and fostering collaboration between various stakeholders, including healthcare professionals, volunteers, and social entrepreneurs, to create impactful, sustainable solutions that can serve as models for broader healthcare reform.

Moreover, corruption poses a serious threat to the integrity of healthcare systems. When profit and power take precedence over public welfare, it results in misallocation of resources, poor-quality care, and unequal access to essential services. This undermines the very foundation of an efficient healthcare system and hampers economic growth.

Clean Up Our Own Backyards First

Addressing global healthcare disparities remains a monumental challenge, especially when billions of dollars are purportedly being spent, yet basic medicines are still out of reach for 3.5 billion people worldwide. The situation is further complicated in countries like France, where a once exemplary healthcare system now struggles under the weight of both a long-standing influx of asylum seekers and an inability to bolster their infrastructure to meet the needs of both newcomers and their established populations. The solution, it seems, lies in self-reflection and reform. Nations must focus on:

  • Cleaning up their own healthcare systems from within
  • Ensuring its populace has access to essential services
  • Eradicating corruption and conflicts of interest
  • Drastic improvements in allocating resources and reprioritising policy focus
  • Prioritising the well-being of its people over corporate and political interests, NGOs, and bureaucratic red tape
  • Concentrating resources on efficient, impactful healthcare investments
  • Addressing misdiagnosis and mis-treatment issues
  • Placing patients at the core of healthcare
  • Health care being led by on the ground doctors

Australia is in a perfect position to successfully meet the health needs of its people by committing to these methods. Collaborative efforts across sectors and disciplines require effective governance, communication, and coordination, which are often hindered by bureaucratic red tape and corruption.

Our global focus needs a rethink. We are being pressured to accept systems that offer no strategic plan, no intricate details, how funds will be spent, who are the decision-makers and how will they be held accountable, etc., instead of focusing on the issues of saving lives by providing basic medicines to the 3.5 billion people living in poverty, on top of which there are the millions of asylum seekers. Nations should be cooperating to clear international minefields (especially those who took part in the conflict in that region) and putting an end to the illegal trafficking of asylum seekers. In addition, rescuing innocent children from worldwide child trafficking for sexual exploitation, and creating critical infrastructure and utilities programmes, particularly for health, housing, and water supplies, for Third World and war-torn nations as well as countries that will be adopting asylum seekers must be our top priorities.

While global collaboration in healthcare is essential, it must be coupled with a recognition of the diverse needs and challenges faced by different nations. Addressing issues such as access to care, bureaucracy, and corruption requires a holistic approach that aligns economic incentives with public health goals, ensuring a more equitable and sustainable healthcare system for all.

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