[Music]
hello bonjour in ahoy
i'm roger hilton defense and security
research fellow at globetech
coming to you live from the 2021
globetech bratislava forum
it's day one and it's my pleasure in the
future for the next three days to be
bringing you video highlights
recaps and all of the major updates from
our international conference
we have a rockstar lineup of speakers
and moderators and we really hope you
look forward to watching us in the
future
we started bright and early with our
annual european defense roundtable
and launched globesec's future security
and defense council
following the official welcome presented
by our masters of ceremony
we heard a keynote from slovakian
president suzanne chaputova
on building back better we were then
privileged to hear a video message
from his holiness pope francis who spoke
to our world audience
on the merits of hard work and
compassion
staying in central and eastern europe
both the president of poland and croatia
delivered keynotes and stressed the need
for global solidarity
in times of crisis shifting to a topic
of the future
an energetic debate on the state of the
future of transatlantic relations in the
digital sphere took place
while on our second stage the global
perspectives on how to fight kovid and
emerge from the pandemic stronger
also happened finally to wrap up the day
the prime ministers of austria and
slovakia
as well as the deputy prime minister of
czechia discussed the european recovery
plan and how to jump start the
continental economy
for more information on our other
world-class panels
make sure to check our website and our
various social media channels on
facebook and instagram
see you on day 2.
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[Music]
ladies and gentlemen welcome the
moderator of the first session of day
two
sarah wheaton
good morning everybody thank you for
joining us bright and early for this
panel on redesigning healthcare systems
in the wake of
coven 19. and before we get started with
our panel
i would like to introduce his excellency
vladimir
lengvarsky he's the health minister of
slovakia
please
nice to meet you please take the podium
ladies and gentlemen distinguished
guests
it's the great honor for me to be here
on this great globe sec forum
and i'm pleased to address you today
with the remarks on the lessons learned
and the way forward especially in terms
of reshaping the health care
system it is
doubtless that the resilience of the
health system has been strongly
challenged
by the outset of the pandemic however a
concise approach to health policy
enables
us to bounce back and regain lost
grounds
the health emergency has also caused
that the house architecture
has been put in the spotlight with the
adamant call of
its re adjustment first of all
the pandemic has shown that we have to
review the approach to preparedness and
strength strengthen
the precautionary measures
by taking into account to two key
factors the adaptive
ability of health system and the
importance of considering the
socio-economic challenges
from this perspective the social
determinants of the health
will shape a major impact on the ability
to reduce health
inquires secondly this pandemic has
widely exposed to the mental health
related
matters so that further investments
in the strategy strategies centered at
mental health
is prominent and preventive measures
will be crucial
in eliminating the social pathologies
derived from isolation a lack of social
interaction
thirdly it is indispensable to look
further towards to data
harmonization so that reporting is
performed
in a unified way and the equal
indicators
are being reported at international
level
the importance the importance of having
an accurate data is critical
in the moment of making responsible
decisions
in order to reach the correspondent and
prevent
the potential third way third wave from
bringing another standstill
we have to implement technologies which
have brought considerable results
such as waste border tasting for
revealing the concentrated incidence of
the coronavirus infection
as well as sharing the best practice and
fostering expert
exchanges alongside facing new variants
increased sequencing capacities
capacities
are inevitable also with regard to
travel related summer season
speaking about the collective immunity
the key role
has to be attributed to targeted
vaccination campaign
for the purpose of raising awareness
minimizing the vaccine hesitancy
and even tackling the misinformation
on a broader scale and from the
strategic point of view
the hospital network optimization is
another important step
which will largely contribute to
healthcare performance improvement
moreover it is designed in a way that it
will bring about
not only the high quality but also
accessible healthcare for the patients
on the site of dignified working
conditions for the healthcare
professionals
on the other apart of
apart from that it will also reinforce
the long term
and after care as well as provide better
conditions for the patients suffering
from the chronic diseases
lastly in light of today interconnected
world
the effort of tackle efficiently the
presence health emergency have to
orchestrate it globally in the close
cooperation with the world health
organization
which stands as a strategic health
pillar with mandated governance
in the european union as the cornerstone
of partnership and trust because
the only road to the future is the road
taken together thank you for your
attention you so much mr health minister
for joining us
we know that you have a very busy
schedule so we will forgive you if you
can't stay for the
for the panel
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[Music]
all right and without further ado on
with the on with the panel
so um joining us online we have two
participants
franchesca colombo she is the head of
the health division at the oecd
we have johanna hanefeld who is joining
us from berlin
and she is the head of international
health protection at the robert koch
institute in
germany here with me
i have martin smatana he's the associate
fellow for economic growth and
sustainability program here at globe sac
and gabriella grom is public policy lead
for the mid-europe region
at msd so thanks to all of you thanks to
all of you for being here in person
thanks to those of you who are watching
online uh and i like to keep things
interactive so you have several
different ways to engage
and ask questions for those of you who
are in the room you can raise your hand
and once i give you the floor you can go
up to the microphone here
you can also use the globesac app which
has a way to type your questions using
slido
um and if any of you are connected by a
zoom to the virtual studio that's also a
way
to ask a question so actually let's
let's kick things off
um with a poll to help you
you know get warmed up with with slido
um
so just to kind of set the stage um we
have a poll
about where i want to hear your view
about what will be the most
important urgent challenge for
healthcare systems over the next
three years so in this kind of postcovid
recovery period
so covet induced backlog of chronic
disease management
antimicrobial resistance mental health
long-term care and preparing for the
next pandemic so let me know what's most
urgent
in your view and we'll check back in
with the results later
um and francesca if i could actually go
ahead and start with you
on that long-term care point i know that
the the oecd
recently did um did a study uh
of huge survey of european uh or no
i'm sorry not european citizens people
around the oecd countries
and long-term care emerged as as uh kind
of a pretty big concern no
sure absolutely and i think uh the
pre-existing
weaknesses in the uh aged care sector
and the long-term
care sector have been brought to the
fore really by
the pandemic because let's remember that
those who
suffer the most in terms of death but
also in terms
of the most serious conditions are the
people who are
elderly the people with preexisting
conditions with the people
with with health issues and
unfortunately the sector the
the aged care sector was already prior
to the pandemic
characterized by some structural
weaknesses
in terms of quality assurance mechanism
in terms of availability of enough and
also trained health professionals and
workforce in terms
also of infection control systems
so i think the pandemic and that's the
case for the elderly care sector the
long-term care center
you mentioned but it's probably more of
a broader point the pandemic has
revealed some
some pre-existing weaknesses of our
health system
and brought to the fore the need really
to address and improve
um you know the why health system work
for the future
thanks and and gabriella um
as far as as managing these chronic
conditions
you know what should we be thinking
about as people kind of emerge maybe
feel safe
uh going to a doctor without a mask on
that sort of thing
yeah so i think first of all it's uh
it's um i i see that there is a lot of
impact on the crisis
from the pandemic in a negative way and
we need to restart therapy
so we have seen that for example the
number of diagnosis in cancer
went down by 40 percent which puts a
huge backlog in place
of when we think about patients which
are not taken care of
patients which especially in oncological
conditions come too late potentially for
their treatment or for a
kind of a good kind of course of the
disease
disease and cure men so i think
we now are in a situation that we need
to restart things as
far as fast as possible and that goes
for
chronic uh patients as well as also for
for patients with acute diseases on the
other hand i see
also that it's a huge opportunity to
think about
our prevention goals and how much we
think about prevention how much we think
about
immunization overall uh in
under normal conditions so now we of
course we have to clean up all what the
the pandemic costs but at the same time
we need to look into
what were the areas which came out now
that have not been so strong in our
health care systems
and this is this is not only treatment
but it's also prevention
so it's both angles which we need to be
very clear on
and martin you've been taking a close
look at some of the lessons that we that
we can already learn
and and you've seen some things some
you've learned some things already about
kind of
the importance of of prevention and
having kind of a good baseline of
of health care right um yes so at
lobster we've
been working on paper which summarizes
lessons learned and
one of them and just to continue
gabriel's ideas was that
when we look into the most successful
countries we figure out that in most
cases they have
several trades in common and one of them
was that they really ramped up the
their diagnostic capacities right so
just to expand it uh in terms of the
number of tests done they made it
affordably accessible
and well all you need to do is just
replace copied with
breast cancer or prostate cancer because
it is virtually the same
the successful management depends uh if
you can catch the disease at early stage
which is linked to the
the diagnostics and the secondly uh and
this is one of the very few positives of
kovit is that illustrated that
heavy investment will repay in time the
only difference between kovit and
stabilization diseases is actually that
kovitt fast forwarded
um the relationship between a risk
factor diagnostics and
and actually a result uh which is uh
either hospitalization and the death
so kowitz showed us that it can work and
it actually brings return on money which
is in most cases the reasons why
payers or ministries refuse to to invest
because all they see is that i will
do and pay 50 tests and i will find just
one positive but kovy demonstrated
clearly that it is worth it
all we need to do is just to make it uh
accessible
uh affordable and uh well let's say
strategically placed within the health
system
and and do you have a clear sense of of
where europe is as as far as advancing
their diagnostic capacity and
are things equally kind of in an equal
situation or
are are they are are we seeing east-west
divides north-south what's going on
there
well unfortunately this is not something
that will be unified even though there
are some attempts
and this is another large lessons
learned i really strongly believe and
there is a strong opinion that eu
commission should
have let's say greater world in health
policies and health management health
system and which is rather funny coming
from me because i was a member of
social protection committee on behalf of
slovakia for five years and i was one of
the guys who really struggled to make
sure that eu commission does not have a
strong word
but pandemic showed us that we need a
unified unified approach rather than
some disconnected strategies
including diagnostics because i think
that ministries
and prime ministers need to hear from
the top that this is a priorities works
and you need to find funding
because exactly as you said there is a
great this connection between uh
what type of tests are available uh what
age groups
can get the test uh starting with uh
genetics and genomics ending with
all cities and mris you can imagine so
unfortunately there is a great uh
variance and this need to be tackled
well i want to put a bookmark
in that idea of a health union um and
but gabriella
definitely had some thoughts on the
apartment and i really wanted to
to contribute with this because what we
did we have collected some data
and the data is about how long it takes
for a patient
from the first time when you see the
first symptoms for example if you have
lung cancer if you start to cut to cuff
and so on
to the time when you really get the
treatment you need
and we have screened it across europe
and we see that especially in central
eastern europe
we see long long times until
from the moment the patient presents for
the first time for example at a gp
until he or she gets the treatment she
needs
it can take up to 300 days
and if you think about especially cancer
time is really everything if you have
delays in your diagnosis
uh if you have delays in your next
referral that you need to go to another
center because you're not sitting at the
same pace
at the sa at the right place if your gp
doesn't really
understand what needs to be done next
and is delaying the process
this can be actually the death sentence
for the patients
and that's exactly why we need to speed
up and accelerate and create clarity in
all this patient journey
including testing including the proper
diagnosis at the right time
and this is where we also create really
the value for the patient by the end of
the day
and do we have a sense of i mean do we
just need to throw more money in is
there other some sort of health system
reform or
i think there is reform needed uh it's
also money needed so
it it starts with creating clear clarity
on standards
clarity or for the patient clarity in
the pathway the patient has to go
but also a lot of education on the side
of
of the medical community but also on the
paid uh
the site of patients to really help to
get through
this process and currently in many
countries it's a jungle
and the patient goes back and forward
and if if there is a certain kind of
test
needed it takes three or three weeks to
get the result
then it comes out that there is another
test needed because
potentially the uh the the specific
specimen is not not enough and so on so
it's a
and all of that needs to be streamlined
according to let's say
best medical practice
francesca what broad trends are you
seeing as far as
as health system investment and is there
any particular system that maybe is
getting the best
bang for the buck maybe they don't
actually spend the most per person but
they they have very good health outcomes
very difficult to say because actually
across you know all health system
in oecd countries around the world there
are
areas in which perhaps there are
excellence but also in the same health
system you will find
a lot of inefficiencies and waste that
happens
and so it's very difficult to say which
countries gets getting best
certainly i think there are some
messages that come out from the crisis
the first one
it has been mentioned yes we do need to
invest more in in health systems and
it's quite clear there are some critical
areas of under investment
um prevention that was mentioned uh if
we look across
countries it's only three percent of
total health budgets which are actually
devoted to prevention
so quite clearly we're not creating that
resilience in populations
by addressing uh underlying risk factors
by
addressing some of the social broader
social determinants
of health as was mentioned by the
minister as well that will allow us to
be much better prepared
to deal both with an infectious disease
and with
long and disabling um chronic conditions
so that's one thing
you know we do need to invest more we
need to invest more in prevention we
need to invest more in
better data systems it's unbelievable
how
health are still stuck in uh you know in
the previous century in terms of
the digital transformations in terms of
using data to understand
the pathway of care of an individual
in terms of linking data sets across
different parts of the whole system
for improving not just quality but also
the governance of the system
the research uh the the empowerment and
the people centeredness and so forth so
huge opportunities from data but we're
not using it
and all of that does require uh
additional investments
at the same time we probably need to do
things differently we need to make sure
that where there are
instances in which we have spending that
does not deliver
any value we address that you know
medical errors
uh which in many cases can be prevented
can be addressed and those are not
creating any value for health system of
course so we can redirect
resources rather than addressing a
medical error to really making sure they
improve
outcomes and and value and we need to
think also a health system which much
more fluid
with a strong clearly primary healthcare
you know it's like
from prevention people are taking care
early on in
in their uh journey um and
and making sure that the risks move also
functioning of the health system
across different different parts and
different silos so there is both
these needs of investing more but also
addressing
uh some of the clear weaknesses which
pre-existed
as i mentioned the kubernetes crisis but
the crisis has made it even more
um more prominent
uh obviously there is quite a lot that
needs to be done to make sure that we
are ready also for
an infectious disease and the pandemic
of uh the scale and proportion of what
we have seen and
that requires all sorts of things to be
done at the global
level as well as the national level
thank you and
and johanna i think we have your
connection working working well at this
point
um let's let's pick up on on one of the
points that um that francesca just made
about um
uh digitalization and i know that that
even before the pandemic that was kind
of a big
mission of the of the german health
system um
so how is that going and has it been
sped along
by the pandemic or is it still kind of
in the same going at the same pace
no i do think we have seen a lot of
innovation during the pandemic and in
some sense this has been a window of
opportunity i think to
to innovate at a pace that would not
otherwise have been possible
so i think we have seen digital
solutions we've seen the
we've seen the use of of contract
tracing apps for example
but we've also seen uh some work around
telemedicine
in uh in lower income settings so
so the center for international health
protection that i lead uh would
be able to support that and that's been
that's really helped
uh bringing some of the clinical skills
to countries where where there was less
experience and expertise are really
sharing as the waves of the pandemic
uh transform but for me i think uh
that speaks to a broader lesson from
this pandemic in many ways i think
health systems people what we have seen
is is that some of the systems we would
have classified previously as high
performing
indeed not do so whereas others were
able to do that and i think what that
really has shown is that for systems to
be resilient and to respond to a crisis
or
shock they need to be able not just to
not just to respond but really to adopt
adapt
and to transform in that response and i
think it's that
transformative capacity that we need to
invest in going forward
so that includes the prevention that
we've heard about that includes the
strong emphasis on determinants that
we've also
uh that was also already mentioned but i
think it's also been about
creating space to innovate for
healthcare workers
and and i think there are examples from
from
individual health facilities all the way
up through the health system that have
really shown
that this innovation capacity is quite
essential and that there
we need leadership and we need
governance structures that enable that
so yeah we hear we hear this idea of
health
transformation a lot and i've been
covering health policy actually at the
eu level for a long time and i still
don't always
totally have an idea of what that means
uh
joanna just gave us some examples of of
her conception of it
gabriella where did what what does
health system transformation mean
mean to you to get a little
philosophical first thing in the morning
so health system transformation so
that's really about
creating resilience in health system
creating the flexibility which we just
heard about
but i think also innovation is a very
important point here
and it is innovation when it comes to
applying new technologies
it is innovation and to do maybe things
differently also
data and analytics will play a major
role in the future
and i think there's a huge potential uh
to create efficiency in the systems and
to
create also better outcome for patients
but i think also what we need to
consider is
innovation need to be accessible to
patients
and that's one of the other issues which
we see in some of the
of the of the current systems that there
is too long
wait time until patients can actually
access and benefit from
new uh innovations from new technologies
uh after they have been brought to to
approval to
actually uh even in the european uh
level we see that uh so far access is
not
let's say equal across eu and
so it would be of course a desire to
create
equal opportunities in in kind of
benefiting from
a new innovation from new technology to
all patients across europe
and we see we see unfortunately
also here more on the eastern european
uh end that there are that there are
serious delays
until uh when patients or as of when
patients can
uh actually access and benefit from
these uh
innovations and there is a huge
discrepancy versus western europe
at the same time and i'm talking again
with uh on
on the example of oncology we see the
highest mortality
especially in countries where new
technologies
take longer to get to to be uh readily
available to patients
so there is a very clear connection
between outcome and innovation so to say
well and so i always if there's a if
there's somebody who works in the
pharmaceutical industry i have to ask
them is this lack of access
because prices are too high no i don't
think so
no i think there is today
a kind of an ability to to actually
discuss
on specific kind of agreements and we
are doing this as a company
depending really on the need of the
country so it's really target
target made and we have many examples
where
we had been able to manage with many
governments and all across europe
in different also economic conditions
to make products available and so very
often we see
a lot of a lot of bureaucracy is in the
way
a lot of very heavy bulky processes
which doesn't make it easier and fast
whereas in other environments we see
that there is also here much more
fluidity much more flexibility
to actually think about what do we want
to accomplish
and then to to to find and develop a
joint solution
to actually serve the need of patients
and
there are countries which enable that
which clearly also finally
find the benefit so in oncology and i'm
giving this example we have
molecules which have different uh
indications so it's the same molecule
but you can
today use it for or it had been approved
for melanoma and the next day it's in
in breast cancer and the third day it's
somewhere else but it comes in different
times
and every time you come with a new kind
of indication you need to go to the full
process of reimbursement which takes of
course many many months
or even years and with this although you
had already discussed some
economic grounds on this molecule you
still need to go through the same
process and
during that time imagine many many
patients might have
might have created a benefit from this
product if they could have gotten it so
we had an example in belgium where we
were able to
think about a long-term solution to come
to bring
all of these different indications under
one roof
and with this we created a massive
impact in terms of
patients how they could use it so
instead of
6 000 the patient lives impacted
we were able to have 11 000 patients
having a positive impact on
on their life so this is the difference
you can make through
flexible processes through innovation
through also of course
discussion coming to the table trying to
find solution
uh in an in a in a partnership and i
think that's very important
and martin what are some of the lessons
about transformation
that that we've dr we can draw from from
covid
right so um let's say the person has
a type 2 diabetes body mass index
greater than 35
hypertension he drinks smokes doesn't
move so his likelihood of actually
once getting a coffee to having a very
serious case actually dying is
a multiple of ten right and actually
this the same applies to
every other civilization disease to some
extent to a great extent
and the lesson learned is that um we
actually we saw this in uh in uh
in our on our own eyes on a daily basis
and
uh in order to make the leap we need to
make we need to make sure that people
who actually
are staying healthy are trying to uh
improve their health are
to some extent benefited because it is i
know that
in most of our health care system it is
we are based on a solidarity but where
is the solidarity in the fact
that somebody is actually looking after
his health and the rest are not because
we saw
how uh what the health outcomes of the
ones who
are not looking after are how much they
cost and everything so
in order to make all these
transformations i think mean to start
with the people
and i know this is not very popular i
know this is something that
uh politicians always love to tell that
they want to either
uh increase uh premiums for the ones who
don't behave well or motivate them to to
to get better uh but it never never
actually
implements or never is put in practice
but i think this needs to be done it is
very
unpopular but if we don't change the way
people behave we can
we can get into the market whatever
innovation whatever new product it will
never be enough
and if you look into how uh all these
risk factors and these behaviors have
changed since let's say 2000
in most countries it is still stable but
the levels are way too high
and for example in slovakia it is
estimated actually by oecd that uh
48 percent of all that can be attributed
to risk factors
which could have been prevented if uh us
as a population would be motivated to
get better
to behave uh in a different way and in
order to do this we need
we need to change the way how premiums
are calculated how prevention mechanisms
are
organized and make sure that we as
individuals as
inhabitants of the countries feel
responsible for our
well-being francesca and he invoked some
oecd research are there other things
that we know about how we can wield
policy
to to encourage healthier behavior
yes i mean healthier behavior is
obviously the results of
many different things some of them are
within the health sector some of them
are
outside of the health center so the
whole notion that we hear about
you know a whole of a society uh you
know
approach to health addressing the social
determinants
um clearly you know doing things also in
school in the education
systems are quite fundamental for uh for
prevention
and they're the type of approaches that
you can use can be
both addressed to the individual itself
or they can be more
addressed to the broader population so
if you have things like
uh making sure that you have goods
communication campaigns
about healthy uh behavior that are
addressed to the entire
population but you can also if you think
about a person who is obese have some
counseling
in primary health care which is more
directly targeted to
the individual affected as well and you
can have a mix of
more intrusive if you wants or more
you know stronger interventions uh
using regulatory mechanism uh using uh
also you know pricing and fiscal
policies
or you can have things which are more
trying to uh
nudge individuals into behavior through
education
through uh trying to to change their
perception and so forth and all of that
are important i mean the the the
analysis that we have done
on the economics of prevention at the
oecd has shown how
to really address those risk factors and
unhealthy behavior
you need the package the most
cost-effective way
of addressing it is through a package
which includes a mix of all those
interventions some
of them more targeted individuals some
of them more targeted population as a
whole
uh some of them uh that use nudging and
some of them which are a little bit more
compelling
uh through the use of fiscal or
regulatory policies
thank you and and joanna we've been
talking about kind of how to
how to drive individuals but what about
um healthcare workers how you know what
are we learning about how
how we can help train them to to
really maximize their impact on the
system
yeah thank you for the question i think
one of the big lessons again that has
been underlined
uh during the pandemic has really been
the
essential role of healthcare workers and
making a difference
and and allowing them the space to
innovate but also provide support to
them so
again i think what we have seen in a lot
of partner countries where we have been
supporting the response to covet is
really that the
the type of support available to
healthcare workers has made a huge
difference
and i think healthcare workers can
really can become big champions so
francesca already mentioned the primary
healthcare interventions that can be
targeted at individuals
if you think about the prevention of
non-communicable diseases
there again healthcare workers are big
champions can be big champions that make
a huge difference in those types of
interventions
and i think that um and and i think this
is the
the sort of thing where we need to
support healthcare workers to become
these types of champions
again they cannot do this on their own i
think it's very important to recognize
the approach you need the different
levers within the healthcare system so
you also
need to be able to have the regulation
you need to be able to regulate
especially when you talk about
addressing non-communicable diseases
that is an essential part that you can
that you can address the systemic
factors that
that drive these things but i think
healthcare workers really
are at the forefront of both addressing
the communicable disease pandemics as
well as the epidemics of
non-communicable diseases
and as such i think are essential if we
are thinking again about this theme of
resilient health systems of
of transforming health systems for the
future to me they're
a very essential building block and one
that we mustn't forget
thank you and before i go on are there
any questions in the room
for now not yet feel free to just raise
your hand at any at any point and i'll
i'll take note of it oh all right well
thank you please please um join us at
the at the microphone here
just yeah word to the wise if you wait
for the last five minutes to ask your
question
we might not get to it so thank you i'm
coming from a biomedical research area
and i clearly see a connection between
sustainable support of research and
excellent research performance with
the status or quality of the healthcare
system so
do you think that another lesson to be
learned from this pandemic is
the role of research and supporting the
role of research
to improve healthcare systems
thank you thank you for that um uh
francesca do you want to start um
uh with with that with the relationship
between
research and healthcare systems and and
i think it's
uh as was mentioned in in these
questions uh
again this pandemic what we have seen
it's a
huge role in uh in researching the
clique
in the quick r d and developments at a
speed that was completely
unexpected and unthinkable of new
vaccine in in
really less than one one year and that
would have not been possible without
having had the research and development
being done beforehand so you know the
the new platform
mrna uh is the results of uh years of
work that was done
before uh before that so it's there was
a
huge uh you know investments that was
done beforehand in understanding also
um you know what uh what was the
experience with previous coronavirus
um you know investigations that were
made in the past
that were helpful then to make sure that
vaccine rd
did not start from zero but could build
on something you know build on
something which already was known
building on new uh technology platform
building on extensive uh knowledge also
from uh previous vaccine and all of that
really
made clear um you know accelerated the
process of development
vaccine itself so i think there is a
clear role for ensuring that we have uh
research and strong investment in
research there is probably a need also
to
understand and making sure that we
direct the research
to highest priority needs for regulators
and that has to do also with things that
sometimes might be
neglected with areas where there is
perhaps less
less invest investments the mr mentioned
mental health for example we still have
very little by way of innovations in
mental health for example so there are
definitely areas in which there is a
role also for governments
to make sure that we create a different
mechanism for
uh you know prioritizing areas of
research thank you gabriella
as what role should should government be
playing in research and how can we drive
uh more focus on areas that have been
neglected and maybe are not very
easily commercially viable yeah so i
think
also here what we have seen now in the
in the pandemic and the development of
the vaccines is
partnerships so partnerships are really
helping
partnerships are driving us speeding up
and
and when you mention now areas where we
need more research and where it seems
from a commercial point of view not that
let's say
attractive it's a antimicrobial
entity resistance is the area
where we see that there is a big big
need of new
new antibiotics which are actually
still effective in an environment where
we see
increasing resistance our company is
investing a lot there also it's uh it's
um an
area which uh is not very attractive but
still
there is a great commitment and moving
things forward and
actually providing the benefit to
patients but i think these kind of
initiatives
would require a kind of a collaboration
it could be partnerships it could be a
different
type of of a consortium or whatever
could be funded around these and then uh
i think
one of the results which was which we
see now with all the the covet
vaccination is
is a result which uh could be uh
actually
kind of copied and pasted for other
areas as well so
i think there is a big chance but we
need to speak to each other we need to
uh to to to discuss what are the
objectives what are the needs and then
and then we will find solutions together
thank you johanna um especially dealing
with parts of the world where
um some of the diseases that affect them
tend to be
neglected auras where as we're actually
seeing with uh with kovid now
um the the global north is getting is
getting access to the vaccines much more
quickly than the global south
what do you see um as potential
solutions as far as research and then
also having access to those innovations
okay so i think you touched on two very
important things there so first of all
we definitely need the basic research
and we need to work
on a system where we can have uh where
we can speed up the equal access to the
fruits of that research to the to the
outcomes of that research and kovacs i
think is a good
is a good example for that we need
further support for co-workers thinking
about
covet but there's a big area of research
that we haven't mentioned here so far
and that's operations research so
operational research
understanding how health systems work
and how to make health systems
more effective and efficient um so what
types of policies what types of
financing arrangement works for example
work for example in addressing
antimicrobial resistance so i don't have
to
develop a new antibiotic that's you know
that that's of course
the golden end point but but there are
other things we can do we can innovate
within our health system and i think
operations research that looks at how
policies can be designed
to support interventions to ensure that
primary prevention works at primary
healthcare level
to ensure that we can use for example
when we think about nudging of behaviors
and ncps
what are the technical interventions
that work there are there certain things
on an app on a mobile phone mobile
telephony
using that using mobile telephony for
health insurance purposes
all of these are aspects which we need
operations research
alongside the actual intervention so for
me
um research is absolutely vital it's
been shown
the importance of that has been shown by
the really breathtaking speed of
innovation that we have seen
uh during the pandemic that is helping
us now
to to address the pandemic much more
effectively the the vaccine that was
discussed obviously
both the result of breathtaking speed
but sustained long-term investment and
research
of of those of the scientists in those
scientists
but alongside that also for me the other
side is understanding what types of
interventions we can do to
to best protect our healthcare workers
to best protect
our populations what are the policies
that incentivize a lot of the stuff
around prevention in the healthcare
system must not cost a lot of money
necessarily
it doesn't require a new drug
necessarily
and i think for me evidence and research
also there has a very very big role to
play and i think
again we have seen this and i think we
see this in the differential experiences
that countries have had that even within
countries different groups of
populations have had
in our healthcare systems when we look
at the health outcomes that they have be
it non-communicable diseases
albeit for covet thank you the really
great points
um so we have we have about uh 12
minutes left
so um in just a second i'm going to ask
the floor for if you have more questions
but first
um let's let's take a peek at the
results of our poll
uh which again was about the most urgent
health challenge
for systems over the next three years um
so yeah people are very concerned about
the the idea that people
haven't been um haven't been getting the
care that they need uh
for chronic diseases things like cancer
mental health
also very high up on there um
interesting that preparing for the next
pandemic and antimicrobial resistance
which could well end up being related to
each other interesting in this room that
that
that's not that's not a big factor um
what what
how would how would how would you two
answer martin what would your answer be
to that poll
yeah probably the same the the battle of
growing diseases because we
um did some preliminary calculations uh
based on
that the decline in number of diagnostic
procedures undertaken in the last
quarter of last year and when we
extrapolated in the future
uh we've calculated that for every
single day
of let's say decreased production or
decreased number of tests undertaken
uh 90 to 120 undetected cases
would happen right so every day we would
lose 920 of
cancer cases that otherwise would have
been
detected and out of the person out of
these 90 20
roughly 30 to 40 percent would be in the
stage 1 to 2 cancer which means
more or less treatable stage so for me
for sure
the backlog of chronic diseases and the
diagnostics would be on the first place
gabriella yeah yeah for me as well i
mean the first point is really the
urgency it might be not the importance
on a long term on a strategic
perspective but it's really the most
urgent piece so now
in order to to avoid more harm um
versus what we have already created with
the pandemic and of course the
disruption in regular therapy we need to
act fast and
uh and and uh get to get patients back
in treatment
yeah indeed i did put that three-year
time time frame on it francesca you're
uh
which would you choose in that poll uh
well
i think the first and the second can be
even brought together because uh
there is clearly a backlog also in
addressing uh
mental health issues but it's quite
clear that
uh you know as we uh move into the
pandemic
and once we have had the immediate
acute phase there is a issues about what
would be the longer term consequences so
you know the chronic conditions which is
not really just
the cancer care but also people with
cardiovascular disease for example
which you know also have a backlog of
care
and even in terms of preventions in uh
in maintaining also continuity
uh of care mental health as i mentioned
even um
elective surgery there's been uh you
know data
really starting to show up about delays
in uh
in electric surgery that why what they
may not be life-frightening
they do make a huge difference to the
quality of life and the questions really
is how to make health systems which are
both able to very quickly surge capacity
and react in very agile way to an
emergency
that has come up that obviously we hope
can be
if not prevented at least you know
reduce the the initial input through
better preparedness for for emergency
that will be fundamental
but how can we make those two things
coexist you know ability to search
capacity and to manage
um an unexpected emergency on the one
hand
with maintaining the continuity of care
for for all patients
thank you and johanna your your response
to the poll
i don't know if you're able to if you
were able to see it i can i can
or if you're still with us all right
well
um i'll see if there are any questions
uh on the floor for
now no okay we'll move on so
um preparing for the next pandemic uh
not seen as necessarily super urgent
over the next three years by by this
group but i'm curious
um uh and martin i'll start with you
how would you rate our preparedness for
the next pandemic
at this point are we going to be
starting from scratch or have do we have
we set up some good systems
uh well it depends what do you mean by
us and what do you mean by an expanded
mix
fair enough okay fair enough well that's
the problem we don't know what the next
pandemic is going to be right or else we
could start making the vaccine now but
another
another infectious disease um you know
people have said maybe we were lucky
with covid because it didn't affect
didn't really affect children um you
know most people
most people get but if there's an even
worse pandemic or a pandemic flu as many
had had predicted
will we handle will governments uh in
europe
handle handle the next the next one
better uh well it all depends on
what's going to happen with the lessons
learned if they are going to actually
put in practice or just ignore them
or have just some nice conferences and
discuss them for hours and do extra
nothing
um because well let's say that
because that always happens you know i
see that plenty of you have attended
such conferences or workshops and
the conclusion was that yes let's do
something but it has actually never
never happened
um well but let's say that uh most of
countries had the
first wave then a summer break second
wave and now it's going to be slightly
better and then we like it to have a
third wave
and just when you ask yourself what
actually changed between the first and
the second wave in some countries yes
they prepared for the second wave
they've
they've created more resilient systems
supported diagnostics procedures etc but
in many countries they just
they haven't done anything yet slovakia
czech republic for example is
a nice example of that and from that
perspective i'm afraid that there always
will be some countries
unless they are forced by eu commission
or another authority to change
that they will just uh claim that yes we
are going to change it as we are going
to prepare but
eventually they won't do it and if you
have one country which is
which is higher incidence than others
that it will always spread to
neighboring countries
then to the surrounding surrounding
countries and then you will have wave
coming from the west to the east from
the north of the
uh to the south so from my perspective
if
one country in the eu uh doesn't do the
job
all will suffer and i'm afraid that
unless as i said eu doesn't step in
and uh we won't be prepared for another
pandemics
gabriele are anything has anything
changed within the
pharma industry to prepare for the next
pandemic
i think what is always important and
that goes for our industry as well
is to learn from these events and then
to
clearly have conclusions learnings and
then to
to bring to to to act on it and that is
also
valid for for government uh for for
everything
in life i mean for every individual uh
once we have experienced the crisis we
learn from it but then we can only
become stronger if we act on what we
have learned on
and i think if we are not able to put
reforms into place when we have seen
that there is a
an issue and a lack of resilience in our
health care systems and even if we
increased it now over the pandemic i
think it's not enough
uh to to actually uh stand strong
in the in the potential next pandemic to
come
if we don't change things if we don't um
apply the learnings uh we will we will
we will
be in a in the same position again i
mean i'm sorry to put you on the spot
but is there is there a particular
change that you can point to that's
happened over the past year
uh within within msd that you can say is
the result of lessons learned
yeah i think there is a there is many
lessons learned and there is a clear
kind of understanding on how important
research is how
how important is also risk taking in
research for us as a company because i
mean our model is a
is a high risk model in all of the
investment in research but it
it really um it really um kind of uh
showed how important it is to take this
risk and to take even maybe the higher
risk because the
uh the messenger rna vaccinations which
are now proving very well
seem to be even and it's a much newer
technology than some of the vector
vaccinations and immunizations so the
risk was higher with uh with
messenger rna vaccines but it proved
that this was
the good thing to do and we
we should have johanna back and i'm glad
that she will be able to weigh in on
this question i asked
to what extent we can be confident that
changes
uh or if we can observe already that
changes as a result of this pandemic are
preparing
preparing us for the next pandemic or
does it still seem to be business as
usual in your view
i think we're seeing real change i think
the importance of
somebody who works in global health i
think the importance of health and
health systems and our preparedness
has been recognized by everybody on the
street and by the decision makers at the
highest level
so i do think it is now about the point
of con of translating that into concrete
actions
and i think that's where i see our
community and us collectively here in
this room and beyond
as as having a certain responsibility so
we need to make those changes happen
i think there are real i think there are
real changes afoot i
a really important point about the
importance of partnership
what this pandemic i think has shown
above everything else
not just about the importance of science
and evidence but i think about the
importance of partnership right so we
can only do this together
and i think this is the spirit that we
we have to use as
as a catalyst or have to catalyze to
strengthen i think
further strengthen the existing
political institutions the multilateral
system
the the the scientific community the
scientific system
and then to see where are their aspects
beyond that
so the pandemic treaty which is which is
will be discussed
in a special session at the world health
assembly this autumn is one such
instrument is already a sign um the g7
discussed extensively the leaders the
highest leaders of our of the
of the g7 governments did discuss health
extensively unlike ever before
and i think it's now about uh about a
host of
us in a way making these commitments and
making sure that these commitments are
turned into a new normal into reality
where we are
much more aware and preparing much
better for the next pandemic because not
only do we have the chronic diseases
that we know will continue
i think unfortunately we are also so
aware that antimicrobial resistance is a
real threat and we know there will be
other and further pandemics
so i think um i think this message must
not get lost but i
certainly have a real uh have a real
sense of optimism
that we can learn and galvanize this
energy now
great well thank you johanna so we we
have less than a minute left i'm going
to ask
one question from the slido that i think
is a cool question but
um we'll need very a very quick response
most public health intervention is
focused on changing the behavior of the
populations
rather than the governments or
regulators how can we improve
martin noted pressure from from brussels
as as one way
i only have time to let one of you uh
one of the rest of you answer anybody
anybody want to take that on francesca
johanna gabriel
yeah i think uh i think no i mean it's
the issues of changing population
behavior individual behavior is one part
of uh
of the equation but there is obviously
an important role of uh
of governments and you know making sure
that this is addressed more at
collective levels so a collective
population level and i think the two
must
must come together um because for some
individuals also
uh making you know the good healthy
choices is not necessarily the easier
choice to make or is not necessarily the
cheaper also choice to make so there are
obviously
things the governments need to do to
make sure that those healthy choices
here
becomes the easier choicer for
individuals so there is really a need
for both
it's changing individual behavior on the
one hand
but also facilitating that change
through government interventions
all right well on that note um we'll
we'll wrap up
uh thanks thanks to you francesca and
johanna for for joining us online
martin gabriela thanks for thanks for
being here in person likewise to our
audience
um thanks for being here in person and
online and for those of you who are here
in person
um coming up next in the habsburg room
where we are at 10 35
we have a session called strategic
autonomy versus global supply how to
secure value chains
also definitely a factor in this in this
health discussion
um and during the break in this room
we'll be live streaming
what's happening on the marietta stage
with a session called
towards the eu that delivers that'll
have state secretaries
of the ministers of foreign the foreign
affairs ministers from france and
slovakia so
lots of good choices thanks everybody
thank you
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