The word ‘innovation’ gets bandied about regularly in development circles. It is the word that pushed Agenda 2030 for Sustainable Development forward after the closing chapter of the Millennium Development Goals in 2015.
But what, specifically, does innovation mean for the care and treatment of non-communicable diseases (NCDs)?
Often when I think about this word, I think of complicated technological advancements that make my eyes glaze over when explained. These advancements can be expensive, labour intensive and so complex that explaining them to the average person is difficult. But what if, for NCDs, innovation was a mix of the old and the new? Things that are relevant to the countries that they are going into and sustainable.
Easy to use
In Croatia, an electronic registering system developed by doctors to be used by doctors, which allows for the systematic recording and management of patient data, has helped to make health care more efficient at a low cost. This system has improved NCD care for almost four million patients. It allows doctors to spend more time explaining treatments and finding out about patient problems, and less time writing and checking past notes.
In Uganda, with cell phone penetration at more than 60%, healthcare workers are sending out SMS’s to make sure medicines are available whenever a patient needs them. In Nigeria doctors are using flip phones to do ultrasounds of pregnant women. But even with the easy to use, new and inexpensive technological advancements, there is still a shortage of doctors, data and health technologies in the places that need them most.
Power to the people
The point of healthcare is to increase people’s quality of life and safety. A John Hopkins study done in the U.S. found that medical error and health care inefficiencies caused over 250,000 deaths a year. IT is seen as the answer to this, specifically data mining patient information – like IBM’s Watson Health – and coming up with answers for care or treatment that the attending doctor might not think of. This helps reduce the possibility of mistakes but still has a person making the final diagnosis.
Blockchain, a list of records that are linked and secured using cryptography, could help people have more control over their data. This could allow healthcare professionals to access data throughout a person’s life – this way you don’t have to print and submit health files to a new doctor, they could just get your permission to see the files you want them to see. They could also send a prescription to your pharmacy or refer you to a specialist, as long as you give them consent to do this. The healthcare professional would not be able to share your data without your permission, which makes you responsible for your health.
At a conference at the Graduate Institute, Geneva Dr Ernst Hafen, Co-founder and President of MIDATA.coop, pointed out that it will be up to individuals to decide who they want to give access to their data, and to what extent they want to participate in data sharing. Soon people will be able to contribute to medical research and to clinical trials by providing access to their personal data. This opens the door to a new government co-operative model which constitutes a concrete alternative to the existing ‘winner-takes-it-all’ model of health data.
However, when the WHO and World Bank announced that more than half of the world’s population was unable to obtain essential health services, the story on healthcare innovations became even more pressing. It won’t be one thing that changes how many people NCDs kill per year. It will require a series of small changes and leadership from governments, communities and leaders, which will begin with getting treatment to those who need it, especially in low- and middle-income countries. As Ben Ramalingham noted in the Guardian in 2016: “…the inequalities in tackling health problems are not because of a lack of innovation, but because of a lack of access to innovation. The binding constraints, I would argue, are seldom technical but instead related to the political and economic choices, which determine how innovations get funded, resourced and supported, by whom and for whom.”
For everyone to have universal NCD care, everywhere, at any time, we must build the ship as we sail it. There is no other choice.