Sustainable Healthcare

Joseph Saba, CEO, Axios International

1. Dr. Saba, with your extensive experience in the healthcare sector, spanning over 30 years, what are your views about building sustainable healthcare access within Southeast Asia?

Health management and building healthcare access have been my passion and foremost priority through the 30 years of my professional experience. In the early stages of my career, as part of the Joint United Nations Programme on AIDS (UNAIDS), I worked extensively on the prevention of mother-tochild transmission of HIV and on establishing the first HIV/AIDS antiretroviral drug access programme in some of the emerging economies of the world. I worked with several healthcare stakeholders during this initiative, which helped me understand access deeply, and the need to build sustainable healthcare management for vulnerable populations across the world.

Healthcare access has definitely evolved over the past few decades in Southeast Asia, led by shifts in disease patterns, population trends, an improvement in universal healthcare plans and a rise in scientific breakthroughs. But healthcare actors haven’t leveraged technological advances to better follow patients with chronic diseases which became the bulk of

patients. The ongoing pandemic has further highlighted some of the glaring gaps in healthcare systems. Without addressing them, healthcare access cannot be made sustainable for populations within the region.

It is important to understand that healthcare access needs a multisectoral, multi-dimensional approach, especially when it comes to management of chronic diseases. Without collaboration between different stakeholders and across areas of healthcare delivery, healthcare systems cannot be made robust.

Access needs to be viewed as a long-term solution rather than a shortterm strategy and should be made more integral to overall healthcare delivery. This will help build solutions which will allow patients to have longterm access to treatment plans leading to optimum health benefits.

Also, sustainable access can only be built through a unified healthcare system. We need the public and private sectors to come together including governments, pharmaceutical companies, physicians, and access specialists like us so that our combined strengths can be leveraged to build efficient and resilient healthcare systems. Such systems will have the ability to withstand any public health emergencies and deliver under the most challenging of circumstances.

2. Access to hospitals around the world has been limited due to widespread lockdowns and the fear of people contracting the Covid-19 virus while visiting healthcare facilities. How can people continue to have access to healthcare services in such a scenario?

COVID-19 has caused unprecedented challenges within the healthcare sector, and patients having reduced access to healthcare facilities is one of them. Countries need to start looking beyond hospitals and put in place complementary, proactive mechanisms in order to reach patients wherever they are so that treatment schedule and medication can be continued without any interruption or delays.

This can be achieved through tapping into existing channels, such as partnering with private entities, and through deploying digital technologies for consistent engagement between patients and healthcare stakeholders, as well as reaching out to patients within their homes, thus ensuring the same care delivery but without exposing patients to any kind of health risks. specialised medication. Paying out of pocket by the public is also not a long-term solution as healthcare costs have risen significantly over the years, and a large population in Southeast Asia has been pushed into poverty because of these self-financed healthcare expenditures .

I believe that sustainable healthcare access can be built when government programmes are amply supported by private sector initiatives that keep access as one of their key priorities as part of healthcare delivery.

Sustainable healthcare access can be built when government programmes are amply supported by private sector initiatives that keep access as one of their key priorities as part of healthcare delivery.

3. With rising healthcare expenditures and a rapidly ageing population, treatment affordability has been a significant challenge in Southeast Asia. How can healthcare access be made more widely available and affordable?

In Southeast Asia, healthcare has always been a top priority. Governments have been spending big budgets to ensure that populations have access to healthcare services, and thus enjoy a good quality of life.

However, most of the government programmes are designed to deliver subsidised primary care but have limited reach when it comes to chronic and Non-communicable Diseases (NCDs) that typically entail long treatment plans and expensive

4. Beyond affordability, healthcare outcomes are a function of treatment adherence, which is especially relevant for chronic disease patients. How can adherence be built into healthcare delivery?

Yes, healthcare access has limited meaning till adherence is built-in as a crucial component. To maximise treatment outcomes, access solutions need to evolve from focusing solely on treatment affordability to offering services to support patients throughout their treatment journey – from diagnosis to treatment adherence.

And since each patient journey is unique, there’s a need for customised support programmes that can comprehensively meet the patient’s underserved needs and challenges in more personalised ways – not via a ‘one-size-fits-all’ approach. Healthcare providers need to be cognizant of this fact, and design healthcare delivery systems that have adherence built into their framework.

5. Covid-19 has put a spotlight on several inefficiencies within the healthcare sector. How do healthcare systems need to evolve so that they are better prepared to address future challenges of such magnitude?

Healthcare systems have evolved over the years through deployment of new modern technologies, improved healthcare infrastructure, and better

medical expertise. But inefficiencies still exist in the systems and the ongoing pandemic has brought them to light in an urgent manner.

Development of digital healthcare solutions, patient support programmes based on cost sharing models, and integration of treatment adherence into care delivery are some of the initiatives that are definitely going to improve the efficacy of healthcare systems, and their ability to offer sustainable healthcare access to people.

It is vital to build a network of support for the patient that extends beyond the hospital setting to complement the efforts of healthcare professionals. This includes creating holistic patient support programmes that address challenges across the entire patient journey, establishing follow up channels for better patient management, offering remote care to reach patients wherever they are, and digital solutions that keep the patient in mind to enhance these initiatives.

Apart from these, I would like to reiterate that there’s a need for collaboration between healthcare stakeholders across the private and public domains so that we can leverage each other’s strengths and create synergistic models that will have higher reach and better impact towards achieving sustainable healthcare access.

6. Integration of technology into healthcare can create new efficiencies and improve patient journeys. What role do you think technology can play in building sustainable healthcare access within Southeast Asia?

Technology is one of the important building blocks for sustainable development across sectors, and healthcare is no exception. Digital healthcare technology is one way of strengthening healthcare access by building connected care – with patients and stakeholders all seamlessly connected, better treatment understanding, and adherence can be achieved leading to optimum health results.

In addition, I see technology playing a crucial role in capturing accessrelated real-world insights (RWI) to better understand the impact of access interventions and continuously improve our support and services to the patients. It can help evaluate access solutions and re-design them for better efficacy and results. But I would like to emphasise that while digital tools are a positive force in building sustainable healthcare access, they should always be treated as enablers and not stand-along solutions. The focus should always be patient centric, and all other elements should be designed accordingly.

AUTHOR BIO

Joseph Saba is Co-Founder and Chief Executive Officer of Axios International, a global healthcare access company with 20 years of specialized experience developing practical and sustainable solutions to patient access challenges in emerging markets. Under his leadership, the company has launched a number of successful drug access programs and developed innovative access strategies and new models for healthcare systems strengthening.

A leap in cancer care

A leap in impact

Siemens Healthineers and Varian share a vision for shaping the future of healthcare and creating a world without fear of cancer, thereby strengthening its position as a holistic partner in healthcare. The combined company is creating a unique, highly integrated portfolio of imaging, laboratory diagnostics, digital and AI offerings, radiation therapy, interventional oncology and surgery for the global fight against cancer with significant potential for increased value creation.

Together a step ahead

They divide uncontrollably, tapping into blood vessels and invading neighboring tissues. The malignant cells spread into the body’s organs, bone marrow, or lymphatic vessels, causing one of humanity’s greatest scourges – cancer. Just a few generations ago, doctors and patients were defenseless against its ravages. Today, thanks to modern medicine, cancer treatments are getting better all the time, and many cases can even be cured. Still, of all the lives lost to cancer globally, about a third of them could be saved each year by better prevention, early detection and treatment.

Siemens Healthineers and Varian have recently joined forces. What is the vision of this combination?

ELISABETH: Siemens Healthineers and Varian came together as one united company on April 15th this year. We are now combining our strengths and are taking a leap in cancer care, and a leap in the impact on healthcare overall by accelerating the path from diagnosis to survivorship in one joint step. Our common goal is to ensure that every patient receives the right treatment at the right time. We want oncologists, physicians and clinicians to be supported as effectively as possible to take on the challenges caused by cancer. As combined companies, Siemens Healthineers and Varian are now teaming up to shape the future of healthcare and work toward a world without fear of cancer.

Give us a little bit of background, Kenneth, what is the burden of cancer in the Asia Pacific region? KENNETH: It is estimated that there will be around 29 million new cancer cases globally by 2040 and half of those cancer cases and deaths are projected to occur in Asia1. In many countries, cancer has become

1 The Cancer Atlas, The Burden of cancer. Retrieved May 24, 2020, from canceratlas. cancer.org/the-burden/ the second most common cause of death after heart disease. Leading causes of cancer death in Asia are lung, liver and stomach cancer and there are still stark disparities in the five year survival rate between the countries. We know about 57 per cent of the total number of cancer cases occur in low and middle income countries, yet, more than 50 per cent of those cancer patients requiring radiotherapy lack access to treatment2. Especially in India and many of the ASEAN countries, we must increase access for patients. This is where our transformative combination can make an impact to improve early diagnosis.

It’s been a few months since the combination. What feedback are you getting from healthcare providers so far?

ELISABETH: So far, we have received very positive feedback on our combination. What providers and clinicians are expecting is to ultimately achieve better clinical outcomes at lower cost. Considering the constant challenge to do more with less, staff shortages and increased disease burden, there simply aren’t enough

2 E.H. Zubizarreta, E. Fidarova, B. Healy, E. Rosenblatt,Need for Radiotherapy in Low and Middle Income Countries – The Silent Crisis Continues,Clinical Oncology,Volume 27, Issue 2,2015,Pages 107-114

Together we will achieve better outcomes and move even closer to living in a world without fear of cancer.

resources to take care of patients. Not surprisingly, there is the clear expectation that we will be able to create innovative solutions that result in more efficient and effective patient care leading to more precise treatments at lower costs. Also, end-to-end solutions across the continuum of cancer care are seen as a key driver for better clinical outcomes. KENNETH: Adding on to what Elisabeth has mentioned, what we aim to achieve really goes in line with what our combination is all about. We consider ourselves global pioneers in the field of medical technology are we are now united by a common aspiration to help people live longer and healthier lives.

ELISABETH STAUDINGER is currently President of the Asia Pacific Region within Siemens Healthineers. Leading a team of over 8000 people who are passionate about shaping the future of healthcare, is her source of inspiration. KENNETH TAN has been President for the region for Varian, a now Siemens Healthineers company that has been in cancer care for more than 70 years. AHHM has interviewed them together to get some insights on the recent combination of the two innovation leaders in healthcare.

Through accelerating our digital and AI offerings, broadening the scope of our service networks and combining our technology and oncology expertise - we aim to improve how diagnostic imaging, radiation therapy, interventional oncology and surgery can be coordinated and combined to beat cancer.

How do you feel personally about this combination? This has been one of the biggest milestones for Siemens Healthineers.

ELISABETH: I’ve really been personally touched by the purpose of Varian, which is to create a world without fear of cancer. I am convinced that together, we can make a difference for millions of patients and their families and loved ones. Especially in our region, there is a huge unmet need that we’ve outlined before where we can make an impact. Globally, we will now be a team of over 65000 highly skilled people that share the same vision of shaping the future of healthcare.

KENNETH: This combination represents a big leap in providing quality healthcare to patients across this region. To me, it accelerates the company’s impact on global healthcare and establishes an even stronger partner for customers and patients along the entire cancer care continuum.