The Private Sector's Role in Combating NCDs
February 26, 2011
Margaret Reeves
Fellow, Global Health Policy Center
CSIS is hosting a series of events to contribute to the civil society dialogue leading up to the September United Nations-High Level Meeting on Non-Communicable Diseases (NCDs). Dr. Harvey Fineberg, President of the Institute of Medicine, kicked off the series on February 2nd with an overview of the emerging NCD epidemic in low and middle income countries. CSIS next hosted Jean-Luc Butel of Medtronic, whose February 16th presentation is detailed in this blog. Future speakers include Dr. Thomas Frieden, Director, Centers for Disease Control and Prevention and Douglas Bettcher, Director of the World Health Organization's (WHO) Tobacco Free Initiative speaking about international tobacco control on April 12th and Dr. Mirta Roses, Director of the Pan American Health Organizaiton (PAHO) on June 28th.
February 16th CSIS hosted Jean-Luc Butel, Executive Vice President and Group President, International at Medtronic, who spoke about the very important role of the private sector in combatting NCDs. Medtronic has been contributing to this arena for a long time and has successfully used its intellectual, financial, and political influence to move the NCD agenda forward. Medtronic made a $1million contribution to the NCD Alliance as a sign of their commitment and has been an early and strategic leader in the NCD arena.
Butel began by noting that combating NCDs is too big an issue for one player to tackle and acknowledged that the upcoming UN meeting is an opportunity to mobilize a variety of players in a coordinated global response. He discussed three ways in which he sees Medtronic and other private partners contributing to the fight against NCDs.
- Advocacy & global policy: Private partners have a stake in maximizing the success of the September UN meeting and should define ideal outcomes of the meeting. Private companies can use their influence to put pressure on leaders to emerge from the meeting with measurable outcomes, targets and reporting mechanisms that can maintain focus and motivation after the meeting and provide a level of accountability.
- Strengthen healthcare system capacity to prevent, manage and control NCDs: Public medical facilities, and systems at large, are overwhelmed and under resourced. Health facilities are overcrowded and the few physicians who are available are often not able to spend the time with patients necessary to fully inform them of their choices for treatment and disease management. The private sector can play a valuable role by augmenting public services with additional patient education. For example, in partnership with the Chinese Ministry of Health, Medtronic has opened a Patient Care Center in Beijing to provide patients with the information they need to make informed decisions about their care and treatment. The center also provides physicians with therapy and product training. In many countries the shortage of healthcare providers severely restricts the population’s access to treatments. Medtronic has trained 30,000 physicians on new medical devices and solutions, increasing access to life savings therapies like smart implants to actively manage chronic diseases. Private sector resources can also be used to raise public awareness about the causes of NCDs and treatments available.
- Leading innovation in therapies and healthcare delivery: The private sector can greatly increase access to treatment by investing in new technologies that cost less and that more practitioners can implant, removing financial barriers and reducing bottlenecks due to lack of skilled providers. Investments in new technologies like mobile health solutions can help reach patients in more remote areas and innovative remote monitoring and sensor technology can facilitate effective patient follow-up.
Butel stressed the importance of connectivity and the need for broad partnerships with pharmaceutical companies, government, technology companies, and others to strengthen and make more efficient the full healthcare delivery cycle. Coordination among these stakeholders on developing standards for emerging IT-based healthcare solutions will be increasingly important as innovative therapies and delivery systems continue to be introduced.
Acknowledging that chronic disease is the second major threat to the global economy, the World Economic Forum’s (WEF) health group has committed to focusing on NCDs this year rather than on the usual infectious diseases of HIV, TB and malaria. Butel noted that discussion at the WEF meeting in Davos between private sector players and groups like the WHO were frank, with Margaret Chan expressing her skepticism of the private sector’s motives for involvement in NCDs. While acknowledging that this skepticism in some ways has been warranted in the past, Butel found that the corporations present at the meeting were taking this commitment seriously and looking beyond what changes mean to their bottom line, to solutions that benefit the global population. While WHO and other public partners made their expectations of private sector partners clear, the private sector also had its requests: that metrics and measurements for success be developed so that they have data available on which to make business decisions. According to Butel, at Davos, the political will to work together to combat a problem too large and costly to ignore was evident.
Hearing about the impressive commitments that Medtronic has made to combatting NCDs is heartening, and while the corporation does stand to profit from the treatment and management of NCDs, its efforts to reduce the impact of chronic diseases globally seem to stem from a genuine desire to improve people’s quality of life. However, it is one thing to engage corporations whose bottom lines benefit from combatting NCDs, but finding effective ways to incentivize positive actions in companies whose products contribute to NCDS –such as those involved in food processing and tobacco is a more difficult task. There are positive examples of private sector companies taking proactive steps to promote healthy eating. General Mills for example has taken independent measures to reduce sodium and salt in their products and the WHO has been working with partners across the globe on developing revised nutritional standards. With luck, the UN high-level meeting in September will elevate the profile of the looming NCD epidemic and raise awareness about the causes of NCDs as well as changes in lifestyle that can reduce the impacts or help people avoid them altogether. Both individuals and companies need to take action and be accountable for the choices they make.
Michelle Obama’s Get Moving campaign has made great strides in its first year to engage the private sector in constructive ways. For example, the campaign has partnered with Walmart to reduce sugar, sodium and trans fats in thousands of its products, and lower fruit and vegetable prices to increase access to healthy food choices. These are significant commitments, but savvy businesses will see that while combating the causes of NCDs may require an initial investment, if Get Moving and other healthy living campaigns are successful, there will be a market for healthier options and products and services that support good health and reduced risk for NCDs.
Similarly, private companies who invest in aggressive research and development agendas and in scaling- up promising technologies can increase profits and significantly impact the quality of life of those living with chronic diseases. Because the private sector can be more nimble and take greater risks than the public sector, they have an essential role in advancing the NCD agenda and supporting advancements in chronic disease management.
As Butel and Stephen Morrison, Director of the Global Health Policy Center noted, to date the NCD movement has lacked the strong czar-like figure that helped to move the HIV/AIDS agenda forward. Putting forth a single, influential and trusted individual to be the face of the movement would add credibility to the demands for action and provide a person to hold decision makers accountable after the UN meeting has passed. Although prominent individuals from the private, public and civil society sectors have been involved in ramping up, it does not appear that one figure will emerge as a clear leader to “own” the issue and make progress on NCDs the dedicated focus of their time before the September summit. While the NCD movement benefits from a stronger base of scientific evidence and a better understanding among a broad core of stakeholders of the diseases responsible and impacts of the crisis than the HIV/AIDS movement did, this lack of leadership may hinder further progress after the spotlight has left NCDs at the close of the summit.
Butel’s talk coincided with the release of the CSIS paper Getting the Politics Right for the September 2011 UN High-Level Meeting on Noncommunicable Diseases, authored by Devi Sridhar, Peter Piot, and the Global Health Policy Center’s Stephen Morrison, which outlines four key proposals that if acted upon in a timely way could raise the prospects of success for this high-level session. This paper is available at http://www.smartglobalhealth.org.
