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April 2, 2020Will COVID-19 Reshape the Global Health System?
The article tries to look at the need for large-scale investments in the health sector, funding the research and management of pandemics; role and use of artificial intelligence to create a more efficient health system to manage and control pandemics; the necessity of strong collaborative efforts of nations to ensure global health security; and the lasting impressions these may create on the global health sector, even after the world wins over the pandemic.
Sivapriya Kamath
The whole world is engaged in a battle to subjugate the coronavirus pandemic. The fight has brought various issues regarding the health sector to light. This article examines three important aspects of this new struggle, which may have lasting impressions on the Global Health Sector, even after the world wins over the pandemic.
The first and foremost aspect is the large-scale investments in the sector. Governments as well as businesses have joined the efforts of the international organisations to fund research to help in the management of the pandemic. The UN Foundation along with the Swiss Philanthropy Foundation has launched the COVID-19 Solidarity Response Fund to which individuals, philanthropies as well as businesses can contribute in order to support the World Health Organization (WHO) to help needy countries prevent, detect and manage COVID-19. The Gates Foundation, Wellcome Trust and Mastercard together have launched a US$ 125 million initiative named ‘COVID 19 Therapeutics Accelerator’ to speed up development and access to therapies for COVID-19. The government of Canada has announced that it will fund 96 research projects that focus on development and implementation of measures to detect, manage and reduce transmission of the virus. Various other corporations including Google, Microsoft, Amazon, Starbucks and Walmart have also contributed to these funds. The World Bank Group has initiated retroactive financing up to 40 per cent in all emergency response projects.
Funding medical research has become a necessary investment to sustain a healthy workforce and customer base for these entities rather than philanthropy. These have brought the researchers in biotechnology into the spotlight. The biotech stocks have managed to grab public attention in the past weeks. On one hand, this could lead to a significant increase in venture funding received by these firms. On the other hand, pandemic products are extraordinarily high-risk investments. The scale of investment required in this sector in order to ensure better methods to control and manage the impact of future epidemics is very huge. Hence, the pharmaceutical and medtech companies might soon, after the crisis period, adopt strategies to minimise their risk and loss. Though such strategic adjustments are necessary to ensure their continued and substantial involvement in the economy, these might not always be people-friendly.
There is every chance the governments may attempt to mobilise funds to minimise the risks faced by the venture capitalists. Economists often describing investment in health as a “cost without any return” is a past reference. This view had changed since the World Development Report 1993 of the World Bank, which asserted that governments spending more on health will reap the “economic benefits of human development”. Following this, the Lancet Commission on Investing in Health, in 2013, concluded that one-dollar investment in health in low and middle income countries would yield 9 to 20-fold returns on investment. A well-planned investment by the government would boost the confidence of other investors, thereby leading to higher funding. This shall also set market patterns more predictable and ready for investments.
The second important aspect is the emerging role of artificial intelligence (AI) in the health sector. As the pandemic is spreading across the globe at an alarming rate, doctors and professionals are finding it difficult to contain. A more efficient health system is the need of the hour to manage and control the pandemic. The White House Office of Science and Technology asked researchers to use AI to analyse 29,000 research papers on COVID-19. AI can be useful for various purposes such as to predict the epidemic outbreaks, speed up discovery and development of treatments and medications, curtail fatalities and manage diseases effectively.
Infervision, a China-based AI company developed an algorithm to distinguish COVID-19 images of lungs from other respiratory infections. This could reduce the burden on clinicians as they no longer need to manually read images one by one to identify the high risk cases. Apart from this, AI can also help prevent epidemics by identifying potential outbreaks and controlling it before it spreads. On December 31, 2019, BlueDot, a Toronto-based AI company, had flagged “unusual pneumonia” in Wuhan nine days prior to the release of the WHO statement alerting people on the emergence of a novel Coronavirus. Various biotech firms have also resorted to AI to develop vaccines and drugs. Insilico Medicine was able to use its AI system to identify thousands of molecules for potential medication in just four days. In the first week of March, Google’s DeepMind published a research discussing how they used AlphaFold—their AI system—in modelling the structure of various proteins associated with the virus and determining their physical properties.
Even though these are yet to be experimentally verified, they indicate the potential heights the technology can achieve in the near future. However, there are challenges associated with using AI as it works on a “garbage in, garbage out” principle, i.e., the accuracy of the results is determined by the accuracy and quality of the data supplied to the system. A number of national science advisers including those of India and the US have asked publishers to provide free access to the research relating to the pandemic. Strategic investment along with other supportive policies can develop AI into an extremely useful asset in this field. The downside is that the internationally fragmented governance of the digital economy might accept the practices during COVID-19 as norm-setting precedents.
The third aspect is the necessity of strong collaborative efforts of nations in global health security. In the globalised world, all countries are closely interconnected and an outbreak in any country could quickly spread all over the world. Although the current protective measures adopted by governments may prove successful in reducing the spread of the virus temporarily, a rebound is likely to occur when the restrictive measures are relaxed. There has been a rapid growth in the number of international migrants over the past few decades. Heterogeneity of the immigrant population poses a big threat to public health policy of all nations. There is a need to promote and build health systems for immigrants all over the world and to involve them in health policies. WHO and International Organization for Migration (IOM) should co-operate hand-in-hand to build a more inclusive global public health system so that the migrant exodus does not happen during pandemics anymore.
There has been significant pressure on the governments of developed countries to help Low-to-Middle-Income Countries (LMICs) whose health systems are not strong enough to handle the pandemic. This will help in slowing down the circulation of the virus. Given the economic impact of such an epidemic, a continuous effort is essential to prevent and control outbreaks in the future. Individuals, businesses and governments are holding hands with organisations like WHO, ISARIC, GloPID-R, etc. to ensure global health security.
The three aspects discussed above are highly complementary to each other. The need for global security can be viewed as the ultimate vision; technology serves as both the means and the catalyst; and the first aspect is the essential fuel that is required to actualise the vision. Yet, what is most important is that everyone must recognise the significance of these aspects and unite for the same. When the upheaval created by the pandemic dwindles, it is important to not forget these issues and to undertake appropriate action to secure a hale and hearty future for all.
Sivapriya Kamath is a contributing author for CPPR and also a Student at Chinmaya Vishwavidyapeeth (Deemed to be) University. Views expressed are personal and need not reflect or represent the views of Centre for Public Policy Research.
1 Comment
Nice article, well thought and methodologically penned. Kudos to Shivapriya and her mentors.
Thanks to CPPR for publishing this article in their series