Over the last year, the COVID-19 pandemic has taken a devastating toll on global health and global economies. It has made plain how systemic inequalities affect health access and health outcomes. In the United States, morbidity and mortality have been particularly high among communities of color, with Latinx and Black Americans three times as likely as Whites to contract the virus. Globally, the impact of COVID-19 and distribution of vaccines is similarly skewed: At the end of February, 10 wealthy countries had used 75% of available doses while 130 countries had yet to receive a single dose. This highlights the well-worn patterns of inequality, with the harshest effects of the pandemic falling on the most vulnerable communities where access to healthcare is the most limited and exposure to disease is the highest.
So, on this year’s World Health Day, the World Health Organization (WHO) is shining a light on unequal healthcare access and outcomes, calling on global leaders to work together to address the issues of poverty and marginalization at the root of the problem. As Dr. Tedros Adhanom Ghebreyesus, Director General of the WHO, admonished at the end of February, “This is not a matter of charity. It’s a matter of epidemiology. Unless we end the pandemic everywhere, we will not end it anywhere.”
The WHO describes inequality as the prime source of preventable morbidity and mortality in vulnerable communities. And, in the midst of a raging pandemic, these same gaps in healthcare systems pose a global risk by providing fertile ground for dangerous viral variants to take root. The International Chamber of Commerce estimates that even if wealthier countries achieve high rates of vaccination this year, the failure to equally distribute doses to the rest of the world could cost those same wealthy economies $2.4 trillion in 2021 alone. And this economic figure merely hints at the net sum of misery that will be meted out where COVID-19 burns through unvaccinated communities unchecked. This global pandemic painfully demonstrates the gaps in healthcare access that exist worldwide.
Cross-Sector Collaboration for an Equitable Response to COVID-19
Though developing vaccines in record time was an impressive scientific feat, the pandemic and its aftereffects will not be resolved by clinical practice alone. Distributing vaccines, ending the pandemic, and resuming non-COVID 19 care will require solutions that cut across disciplines and international boundaries, navigating global complexities and inequalities.
Cross-sector collaboration has been—and will continue to be—key to success. We’ve seen it before: Take for example the Global Polio Eradication Initiative (GPEI), a partnership which has nearly eliminated the condition through robust collaboration between six NGOs and 200 national governments. Rotary International used their public advocacy expertise to launch the project in 1988. Their legwork was amplified with scientific expertise from the WHO and the US Center for Disease Control and Prevention, logistical support from UNICF and Gavi (a global, cross-sector vaccine alliance), and funding from the Bill and Melinda Gates Foundation. The partnership was based on a clearly defined mission to eradicate polio, and it has nearly succeeded, with each organization leveraging their distinct expertise to navigate the complex problem and reduce global polio rates by 99.9%.
As the COVID-19 pandemic set in, the WHO adapted a similar strategy, developing the Access to COVID Tools Accelerator (the ACT-Accelerator), which brings together governments, scientists, businesses, civil society, philanthropists, and global health organizations to catalyze global production of tests, treatments, and vaccines and to strengthen global health systems. So far, the ACT-Accelerator has made 120 million diagnostic tests, 2.9 million treatments, and 32 million vaccine doses available, an impressive feat considering that the partnership was developed under the stress of the global pandemic.
However, the ACT-Accelerator differs from GPEI in a critical way: Polio eradication was nearly complete in the United States when the partnership launched (the last case was recorded in 1979) and underway in other wealthy nations, but the ACT-Accelerator seeks to provide a global approach to solving COVID-19 in which all countries, rich and poor, get access to resources at the same time. A key pillar of this equitable approach is Gavi’s COVAX Facility Advanced Market Commitment, a mechanism to pool public funds from 180 participating nations with additional private sector resources to secure a bulk vaccine order of 2 billion doses, half of which will be distributed in 92 low- and middle-income economies. The world is still waiting to see how COVAX impacts worldwide vaccine access, but we are hopeful – COVAX has shipped more than 36 million doses to 86 countries as of early April 2021.
Moving Forward: Harnessing Cross-Sector Collaboration for More Equitable Health Systems
COVID-19 has spotlighted huge inequities in global health systems. But it’s also hinted at the power and potential of cross-sector partnerships to fix what’s broken. We believe that companies, in partnership with governments, foundations, and NGOs, have a key role to play in creating more effective, more sustainable, more equitable global health solutions—now and in the wake of COVID-19.
We offer the following 5 tips below for creating collaborative, inclusive health solutions.
5 Tips for Creating Collaborative, Inclusive Health Solutions
Build relationships and trust across the local health ecosystem.
Get to work mapping the local health ecosystem. Who are the players—patients, clinics, the local private sector, NGOs, universities, local government agencies, and international donors and businesses—who will interact with your planned health intervention? Build partnerships and relationships locally to increase your understanding of the system and the ultimate relevance of your solution.
Design health systems and solutions with end users at the table.
A key step to more equitable health systems? Engage patients and local health actors early in problem definition and solution design. The voices of patients and practitioners should shape solution design and how those solutions are built into local health systems and existing health ecosystems.
Have local innovators in the driver’s seat.
Case in point: Ghanaian social entrepreneur Gregory Rockson co-founded mPharma to address critical vulnerabilities in Africa’s pharmaceutical supply chain—helping patients access high-quality medicines when they need them, at significantly less cost. mPharma has vision and a keen understanding of the local landscape—and that vision is backed by strong partnerships, including with major drug manufacturers such as Novartis, Bayer, and Pfizer.
Tap digital health strategically to expand health access.
COVID-19 has accelerated the rise of digital health—with new digital solutions helping an ever-growing number of patients worldwide access health information and health services via their mobile phones. While the global digital divide remains a major barrier, we’ve seen that digital health can be a powerful tool for empowering patients, improving health outcomes, and creating more equitable health systems worldwide. However, digital health innovations—like most solutions to complex problems—require thoughtful, context-driven design and strong partner networks to ensure equitable access.
Embrace shared value collaboration and sustainable business models.
In the past, too many cross-sector health initiatives have missed the opportunity to engage companies as true, shared-value partners. They’ve sought to leverage private sector R&D, supply chains, and capital; yet, this support is difficult, or even impossible, for companies to sustain if the partnership is not backed by a sustainable business model and/or premised on aligned interests and shared value. Want more sustainable, more effective collaboration? Start by understanding the motivations, interests, and constraints of your partner. Then, work together to co-create an initiative that delivers core value for all involved.
COVID-19 has made it quite clear, in the U.S., and globally, that significant work remains to create equitable health systems. Yet, we’ve also witnessed the amazing strides we can make when we combine private sector ingenuity and reach with the networks, expertise, and resources of the public sector and civil society. Cross-sector partnerships—incorporating our tips above—can be a vital part of the solution we need.