Ensuring health policies transcend political cycles: a call for sustainable reform
Amid the global impact of the ‘year of the election’ and other political shifts, government leaders – many of whom are stepping into their roles for the first time – face a delicate and daunting task. The opportunity to strengthen the resilience of their health systems while boosting economic prosperity is within reach, but it comes with significant challenges
Global pressures and volatile political budgetary cycles can threaten even the most well-intentioned policy planning. New incumbents will find themselves navigating a landscape where numerous urgent causes compete for limited resources, especially given the austerity faced by many countries. However, these challenges coincide with a moment of unprecedented potential in health care: scientific breakthroughs are around the corner, promising to significantly improve public health. But this comes at a cost and it is imperative that we invest in sustainable financing solutions.
To fully realise this potential, our healthcare systems must be fit for purpose, capable of delivering these innovations to all patients. Lessons from Covid-19 taught us that short-sighted cost containment and a lack of investment in public health may be tempting but must be avoided. Investing in population health is essential for promoting social well-being, economic prosperity, health equity and a more sustainable environment. To build trust and fortify health systems, new leaders should adopt bold targets and a long-term vision, while humbly accepting that the full returns may only come once their political term has concluded.
High rewards for investing in health
Viewing health as a strategic asset and investing in ‘health care’ rather than ‘sick care’ can yield enormous benefits for people, societies, economies and the planet. At a fundamental human level, helping more people to live well, for longer, is of immeasurable benefit to patients, families and communities.
We also know investing in health pays off in the medium and long term. The five most common non-communicable diseases are
projected to cost the global economy $47 trillion between 2010 and 2030. These costs could be dramatically reduced through prevention and early intervention, with innovative medicines, digital solutions, technologies and data playing a crucial role in saving, extending and improving lives, thereby increasing economic productivity and workforce participation. For every $1 invested in research and development, there is a $10 social return, and better health could add an estimated $12 trillion to global GDP (2020–2040), an 8% boost compared with the baseline scenario.
Furthermore, we know too well the cost of a poorly prepared health system. Covid-19 triggered the largest global economic crisis in nearly a century, worsening financial inequalities within and between countries and increasing global poverty for the first time in a generation. Strengthening health systems now will better equip them to withstand future crises.
Moreover, we must urgently address the nexus between human health and the climate emergency. Climate change is causing untold harm to population health globally. However, treating disease – particularly at later stages – is environmentally costly. The health sector contributes around 5% of global greenhouse gas emissions, and up to 8% in advanced economies. Leaders should support the transition to greener healthcare delivery, which is what the Sustainable Markets Initiative Health Systems Task Force is striving to deliver through focused collaboration to decarbonise health systems.
And to maximise strategic investments, and as a moral imperative, we must tackle health inequities so that all segments of society, including underserved populations, have access to quality and timely health care. Policies in every sector can impact health and its determinants. New leaders must champion ‘health in all policies’, as coordinated efforts from the technology, environment and education sectors – to name a few – are essential to driving meaningful change across economic, societal and environmental fronts.
What needs to happen?
Investment must be targeted to areas where it could have the most positive impact, such as disease prevention, early intervention, innovation, R&D and care pathway coordination. Meaningful change will require sustained commitment beyond political cycles and a joined-up, multisector approach across stakeholders to share learnings and expertise. This is especially true when it comes to identifying and implementing bold solutions to ensure we have sustainable financing frameworks for health systems.
We have a responsibility to aid these efforts by changing the misguided perception that health systems are unproductive or cause economic drains. Rather, health interventions can generate direct savings to health systems in addition to unlocking indirect benefits from catalysing cutting-edge scientific innovation to boosting economic productivity and decarbonising health care. Project OPERA, for example, is an innovative programme that started in Glasgow, UK, which demonstrated that by optimising the digital diagnostic pathway for heart failure in the community, we can significantly reduce echocardiogram wait times and enhance access to care. This is a prime example of how innovative healthcare approaches can drive early intervention, delivering substantial benefits for patients, society and the broader economy.
With such practical, country-level, evidence-based recommendations, we can work together to ensure strategic investments help achieve national economic objectives, maximise spending efficiencies and reinvest savings. By breaking down budget silos, accelerating the adoption of digital tools and partnering to ensure sustainable health financing, we can reinvest savings and maximise benefits to secure a healthier, more prosperous future.
The complexity and magnitude of the problems facing health systems demand collaboration. Partnership is crucial for sustainable transformation of health care at scale, as it is only through diverse perspectives that we can truly understand solutions to these challenges. Collaborations such as the Partnership for Health System Sustainability and Resilience, the Alliance for Health Policy and Systems Research and the European Observatory on Health Systems and Policies are already generating evidence and sharing policy recommendations across key areas. The recent PHSSR global report provides several long-term governance strategies, resource allocation and transparency recommendations based on country-level research. We must sustain and bolster this work, engage new, diverse partners and ensure it is made available to leaders and their communities.
This is a pivotal moment. New leaders have a unique opportunity to strengthen their health systems and build trust through strategic, long-term investments. But it’s also a defining moment for those working in the health sector to advocate for sustained commitment to health spending, now and beyond political changes, and safeguard population health in the long term. The economic benefits are clear, but the value of better health for people, society and the planet is truly priceless.
