Access principle 3: strengthening healthcare systems
A medicine is only as good as the system that delivers it. Improving access to healthcare requires long-term investments in healthcare infrastructure. We work with governments and partners to strengthen healthcare systems and lower barriers to healthcare delivery. Several examples are provided below. For more information on our health system strengthening framework, please see the Novartis corporate website.
Tackling SCD in Africa
Launched in Ghana in 2019, our Africa sickle cell disease (SCD) program is a public-private partnership that encompasses newborn screening, diagnosis, treatment, education, research and advocacy. In 2021, the program was active in Ghana and Uganda. Novartis continues to work with our partners, including the ministries of health in both countries, to strengthen healthcare systems for the safe and sustainable delivery of SCD treatments for patients. In 2022, we aim to launch the program in Tanzania and Kenya, where the government recently launched national guidelines for the management of SCD. As part of our efforts to support treatment for SCD in Africa, we received conditional approval for our SCD treatment crizanlizumab in Ghana in December 2021, only six months after submission. Also in 2021, we received approval in Ghana for a pediatric-friendly formulation of hydroxyurea to treat SCD (see “Adaptive development”).
Addressing malaria and SCD in India
India has the world’s highest burden of malaria and SCD outside of Africa. Novartis is running a malaria screening campaign under the umbrella of the Novartis Healthy Family program (Arogya Parivar) in seven districts in Odisha state, a highly endemic area that bears almost a quarter of the country’s malaria burden. Since the start of the campaign in September 2020, more than 121 000 people have been screened for malaria and potential co-morbidities at around 2 200 health camps. Separately, Novartis and local authorities in India established the National SCD council, which aims to address policy-related gaps in delivering healthcare services to SCD patients. This resulted in dedicated or increased funding for SCD diagnosis and treatment across 11 states in the country. We also collaborated with partners to conduct education and awareness programs on SCD in the states of Maharashtra, Madhya Pradesh and Gujarat, covering a total of 80 districts, 250 healthcare professionals and 1 150 healthcare workers. We plan to expand this project in 2022.
Since the start of the campaign, more than 121 000 people have been screened for malaria and potential co-morbidities
Eliminating avoidable blindness
One billion people worldwide live with preventable visual impairment due to a lack of access to basic eye care. Of these, an estimated 90% live in LMICs. In 2021, we implemented a program built upon an ecosystem of key partners, including Aravind Eye Care System, a network of hospitals in India that is one of the largest providers of eye care in the world, to tackle avoidable blindness in underserved communities in India. In addition, our eXcellence in Ophthalmology Vision Awards (XOVA) have funded 44 projects across 27 LMICs to elevate community health education activities, capability-building and training for healthcare professionals, and access to affordable eye care services. Moving forward, together with Aravind, XOVA and other global and local partners, we plan to expand the program to improve outcomes in underserved communities in SSA, Vietnam, the US and Bolivia.
The Novartis Foundation
The Novartis Foundation focuses on advancing digital and data-led approaches to population health, with a particular emphasis on cardiovascular disease (CVD), the leading cause of death globally.
Better Hearts Better Cities
Rapid urbanization in LMICs, and associated lifestyle changes, present increasing challenges to address CVD and its prime risk factor, hypertension (high blood pressure). Although therapeutic options exist, blood pressure control rates remain poor. In November, the Novartis Foundation published its strategy for addressing cardiovascular population health, known as the CARDIO approach, in the journal Cities & Health.
This approach has been applied across different continents together with local city authorities and partners in the Better Hearts Better Cities initiative, which addresses hypertension and its underlying determinants by increasing early access to quality care, promoting partnerships, and maximizing the application of technology to strengthen health systems. First results show that between 2018 and 2019, blood pressure control rates in patients treated with medication improved in São Paulo (Brazil), Dakar (Senegal) and Ulaanbaatar (Mongolia). Full results will be published in 2022.
Reducing inequity in cardiovascular health
Our health is influenced by where we are born, grow, live, work and age; these factors are referred to as social determinants of health (SDoH). During the COVID-19 pandemic, SDoH put a spotlight on health inequities worldwide, yet the differences in health outcomes between population groups reach far beyond the pandemic, especially when it comes to cardiovascular (CV) population health.
The Novartis Foundation and Microsoft are applying artificial intelligence and advanced analytics to a combination of clinical, SDoH and environmental data to deliver insights on how to identify communities at risk and improve CV health equity at a population level. Leveraging the foundation’s CARDIO approach and Microsoft’s data storage and data analytics tools, partners will work with city health authorities to better understand the factors that drive unequal CV health outcomes. Ultimately, the aim is to create roadmaps that translate these insights into action and prioritize the most impactful interventions.
For more information on the Novartis Foundation, please see www.novartisfoundation.org.
The Novartis US Foundation
The Novartis US Foundation seeks to improve health in underserved communities in the US by creating innovative and sustainable solutions to expand access to healthcare and build trust within the healthcare system.
In the US, health disparities affecting minority groups are endemic – an issue that was highlighted and exacerbated by the COVID-19 pandemic. In 2021, Novartis and the Novartis US Foundation announced plans to invest approximately USD 13.7 million to establish three research centers at Morehouse School of Medicine in Georgia, including a clinical trial center of excellence that could be a model for possible expansion to other historically Black colleges, universities and medical schools.
Please see the section “Deliver transformative innovation” for more details on how we work to address diversity in clinical trials. For more information on the activities of the Novartis US Foundation, please see the Novartis in Society US Report.