- Fewer resources are generally brought to bear on health challenges that predominantly affect lower-income countries.
- But there is much best practice to be learned from many of those same countries.
- A new programme is identifying the policies, strategies and programmes that have helped drive their success.
Despite the dedicated work of tens of thousands of scientists around the world, the novel coronavirus is still mostly a mystery. More than six months after it began infecting people, we do not know very much about how the virus behaves, why so many people seem to be asymptomatic, or why others get so sick.
Global health is full of puzzles. Many of them, like COVID-19, exact a great cost.
But here’s an uncomfortable truth: the coronavirus has attracted a lot of interest from researchers and likely will not remain a mystery for very long precisely because it afflicts both low- and high-income countries. Meanwhile, public health puzzles that exist exclusively in low- to middle-income countries generate far less interest – and their mysteries tend to endure. Moreover, research is already showing that COVID-19 will have a significant impact on maternal, newborn and child health in these countries because the pandemic will divert critical resources away from primary care and specialized treatments.
These mysteries include understanding how countries have systematized the learnings for reducing childhood stunting and under-five mortality rates, or how they have expanded childhood vaccinations to every child in every village.
There is no law of global health that says these answers are unknowable. It is simply a market-driven reality that no one has invested the research and financial resources to provide thorough, accessible and data-driven answers.
That’s why Gates Ventures, where I work, and the Bill & Melinda Gates Foundation have launched Exemplars in Global Health. This programme has forged collaborations between leading health researchers around the world and in-country experts from geographies which have made the most progress on key health topics to identify the policies, strategies and programmes that have helped drive their success.
The results of this collaboration have been surprising and groundbreaking – and have resolved more than a few mysteries.
Before our work, for example, few would have identified Kyrgyzstan as a global leader in reducing childhood stunting. Even the leaders of Kyrgyzstan would likely not have held themselves up as a model to be emulated. They simply hadn’t been tracking stunting rates as those rates declined by half, from 36% to 13%. But our research partners noted the country’s progress and worked with local health leaders to better understand what Kyrgyzstan got right – to identify programmes that can be adapted and adopted by other countries.
Our research partners have identified dozens of positive outliers like Kyrgyzstan around the globe.
It is hard to imagine a higher order of information for health leaders from dozens of low and middle-income countries around the world who have scarce resources and are looking for proven models they can follow to achieve their goals. The market, however, was ill-prepared to deliver.
This demonstrates three barriers to progress in global health that philanthropists and funders are uniquely positioned to solve:
1. The market often misses opportunities to serve those at the bottom of the pyramid. Philanthropists and funders can de-risk those investments to attract private sector interest or demonstrate the business case.
2. Too few researchers are working across borders to share perspectives and achieve new insights. Philanthropy and governments can seed global cooperation on important research. It shouldn’t take an pandemic the likes of the novel coronavirus to prompt global research cooperation.
3. Governments often have to make important decisions based on terrible data. Funders and philanthropists can help improve the data governments rely on to take the guess work out of global health.
The application of “precision medicine” to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseases—and disease in general.
But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.
The World Economic Forum’s Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access – across borders – to sensitive health data for the treatment and diagnosis of rare diseases.
The data will be shared via a “federated data system”: a decentralized approach that allows different institutions to access each other’s data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.
The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).
Through robust research and data analysis over the last two years, our research partners have gained a better understanding of how Kyrgyzstan, Peru, Nepal, Senegal and Ethiopia have reduced childhood stunting rates. They have identified Viet Nam, South Korea and Germany as early COVID-19 success stories. And they have identified the key tools adopted by Bangladesh, Ethiopia, Nepal, Peru, Rwanda and Senegal to cut under-five mortality. And, importantly, our partners have distilled their findings into data-driven, actionable recommendations for decision-makers – demystifying critical global health challenges.
We believe countries and funders can use our findings to accelerate improvements in health and ensure funding is put to the best possible use. Currently, our platform features research on the health topics of childhood stunting, under-five mortality, community health workers, and epidemic preparedness including COVID-19. More topics like vaccine coverage and maternal mortality will be added soon.
We believe there is no better time to invest in improving health outcomes. National leaders from Bangladesh to Brazil and Ethiopia to Zambia have made remarkable progress. The only mystery that remains is how quickly we can learn from these leaders and achieve our global goals.