Healthcare needs transformative change after the pandemic if it is to tackle chronic disease.
Getty Images/iStockphoto
Nearly three years after the height of the COVID-19 pandemic, preparedness has emerged as the top public health priority for 2024 and beyond. The backdrop for this focus is compelling: The next pandemic is already here. We face an ongoing crisis of chronic disease that not only generates huge economic and societal costs, but also increases the risk from emerging infectious diseases and seasonal viruses.
We need more than just a new pandemic playbook; we need transformative change to healthcare, which must be led by academic medical centers partnering with both the public and private sectors.
Life expectancy has grown dramatically, but so have chronic conditions like diabetes, cancer, Alzheimer’s and heart disease. Widespread healthy aging is the only sustainable path forward, as recognized by the U.N.’s Decade of Healthy Ageing.
The challenge is not just one of science and medicine, but also organization and mindset. Operating at the intersection of research, education and care, academic medical centers are poised to shape the models for the future.
We need a health policy agenda that links, scales and strengthens all available tools to address chronic disease, at every level. As a former federal secretary of health, I saw this need as we worked to modernize the health system in Mexico — progress that has stalled in recent years. As the president of the University of Miami, home to the only academic health system in South Florida and one of only three NCI designated cancer centers in the state, I now see Florida as the frontlines: home to the second-oldest population in the U.S., the second-highest number of new cancer diagnoses, the highest overall diabetic healthcare costs and the second-largest population of people living with Alzheimer’s disease.
Here’s a bold, concrete goal to jump start the change: build a comprehensive effort that mobilizes funding and collaboration for chronic diseases, much like how the Vaccine Alliance (Gavi) and the Coalition for Epidemic Preparedness Innovations (CEPI) have expanded global vaccine access. Diseases like cancer, Alzheimer’s and diabetes are the ideal change catalysts because they are such massive challenges, and also the focus point for a wave of potential breakthroughs.
Alzheimer’s, for instance, is projected to affect nearly 140 million families by 2050 and generate $2.8 trillion in annual costs by just 2030. I am proud to serve on the board of the Davos Alzheimer’s Collaborative, which is striving to provide tools to every person and family impacted by the disease, and to drive the shifts that will lay the foundation for the future of healthcare. Efforts at the Sylvester Comprehensive Cancer Center and the Diabetes Research Institute at UHealth are similarly focused on both individual and community well-being. Three shifts, for which academic health systems can serve as the tip of the spear, are necessary.
First, embrace the primacy of primary care. Primary care is the key to any high-performing health system, yet it is too often treated as a mere gate-keeping function. Instead, we must establish primary care as the central hub that empowers people as “co-producers” of good health.
Second, shift from reacting and repairing to anticipating and preventing. Here, primary care can join high-tech tools with high-touch engagement. Technologies like digital cognitive assessments, blood-based biomarker tests and genomic tests have tremendous potential, particularly paired with community health worker insight.
Third, integrate primary and community care within high-performing networks. People should have access to the best resources, knowledge and experts, concentrated in specialized centers-of-excellence but available to all through telehealth.
These concepts all coalesce around early intervention, since precursors for chronic disease often begin years before the onset of symptoms. This means people need early access to information and detection tools to benefit from new medicines, all knitted together within high-performing health systems.
That’s also exactly the kind of system we need to meet the growing challenge of chronic disease — in Florida and around the world. Chronic disease readiness led by academic medical centers leveraging research dollars offers a blueprint to not only address intractable, deadly and expensive diseases, but also build a new, stronger care model for a new era of demographics and health.
Julio Frenk is a global public health expert and president of the University of Miami.
link