Stefan is a partner and managing director in BCG’s Stockholm office. He is the Global Health topic leader for Europe, and a BCG fellow . Stefan has also presented a TED talk on value-based health care, "What Doctors Can Learn from Each Other," as part of a series of talks curated by TED and BCG
What are the current situation, dynamics, and trends in Global Health?
Currently, we are seeing a general trend toward professionalization in the global health area. This has been driven by a few strong players that have entered the space—the best example is the Bill & Melinda Gates Foundation. These strong participants demanded clear plans and concrete results, as well as proper evaluation of the impact of all projects. This has contributed to fundamental changes in several areas of global health, and BCG has supported a number of important transformations.
A second trend is the increase in money available to tackle major diseases.
Both trends together significantly increase the likelihood of success. However, in the very near term, some projects will likely be delayed or postponed as a result of the economic crisis and the reduction of funding around the world.
How can new drugs, vaccines, and treatments be developed as quickly as possible to help address the major diseases of the developing world?
Many of the predominant diseases, including malaria and tuberculosis, were not seen as attractive for the global pharmaceutical industry because most of the patients who suffer from these diseases don’t have the money to pay for prevention or treatment.
Recently, we have seen a very interesting and important innovative model for drug development, testing, and manufacturing pursued outside the conventional pharmaceutical industry. Many product-development partnerships and virtual development networks have arisen and facilitate a global collaboration, which is much more cost efficient than traditional structures. Some have relocated parts of the value chain to developing countries, where the patients live and the cost of business is lower. Not only will this reduce prices for drugs because of reduced costs in development, testing, and distribution, but importantly it can also become a positive force for industrial development in these countries.
Beyond this new networked model for development, there is still a need for money, as well as more innovative principles and approaches, to develop drugs. Both are in place but need to be scaled up significantly. This second area is one where BCG can help bring a huge improvement.
How can existing health systems be optimized to expand health coverage and lower costs?
Despite the many improvements in the way that drugs are developed and manufactured, one of the main challenges remains the distribution network. Most people affected by the major diseases like malaria, HIV/AIDS, and tuberculosis do not live in easily accessible areas. Not only is the deployment of drugs challenging, even more problematic is that the hospital and doctor networks can be difficult for people to access in these countries.
A way to improve that is to better leverage the village networks, train local personnel to teach basic sanitation standards, and support the distribution of medicines. These people do not always need to be highly trained health care professionals—in many cases, they can simply be gifted and motivated representatives of the village.
Another more logistical problem is the high level of “losses” in the distribution chain, when drugs are stolen and resold, instead of given to the people by the public health system. There are many ways to control the path of medicines between the center and the communities more effectively than was done in the past.
How can the best aspects of both the private and the public sectors be utilized in delivering health care, leveraging private-sector incentives and competencies with the reach of the public sector?
In the endemic countries, an established organization like the World Health Organization can play a very important role through its collaboration with governments and ministries. WHO is a trusted player in most of these countries and can make sure that the right private players are given the proper roles and access. It is important that proper coordination between the different players takes place locally to ensure that the interventions are aligned to local needs and that the many organizations that want to help do work together for maximum impact.
Also, globally, you need to increase the collaboration between the private and the public sectors through partnerships like the Roll Back Malaria partnership, which BCG has supported for several years. These partnerships offer a forum through which each sector can contribute different expertise and different perspectives, which makes the partnership organization much stronger.