Pandemic could prompt healthcare overhaul

One of the very few upsides of the COVID-19 pandemic has been the astonishing speed with which effective vaccines were developed, tested and manufactured. Setting aside the problems Europe has faced with supply and distribution, few in spring 2020 would have predicted that vaccines might be available within a year.

That extraordinary achievement was the product of intense cooperation across the public and private sectors. Is that sustainable after the crisis subsides? Or might it at least highlight better ways of addressing other health priorities in the future—including those that COVID drew attention away from.

On 5 May 2021, Science|Business and Novartis brought policymakers and pharma industry leaders together to discuss what post-COVID healthcare might look like, and how the experience of developing vaccines and treatments against COVID-19 might be adapted to strengthen healthcare more broadly.

“COVID already showed that we can work faster and more effectively,” said Andrzej Rys, director of health systems and innovation at DG SANTE, the European Commission’s health policy department. He hopes that experience can be used to address future challenges, adding: “we also have to think about long term process,” as the Commission prepares a package of legislation on cross border healthcare for publication in 2022.

Co-operation beyond COVID-19

The question of how to apply the lessons of COVID-19 is particularly important because Europe’s healthcare systems remain under huge strain. The pandemic diverted resources and attention from other serious health problems, leaving some patients undiagnosed. Life after COVID-19 “will be even more stressful,” because for many diseases, “the diagnostics were put aside, so we will need to deal with that,” said Momir Radulović, executive director of Slovenia’s Medical Products and Medical Devices Agency.

Cristian Bușoi, a Romanian doctor and member of the European Parliament (MEP), expressed confidence that cooperation among member states and EU institutions on COVID-19 could be turned to other health priorities. “I’m sure that this cooperation, this dialogue, this solidarity will continue,” he said. “Maybe, when we are not in a crisis, it will be difficult to have the same level of engagement—the same number of meetings—but the determination will be there, everybody understood that we could do more at the EU level.” To that end, the new €5 billion EU4Health programme will build reserves of medicines and personnel for quick deployment around Europe.

Another example of the EU planning to “do more” is the European Health Data Space, which aims to make it easier to securely transfer electronic health records, genomics, and other patient data across borders. Francesca Colombo, head of health at the Organisation for Economic Cooperation and Development (OECD), said Europe needs better management of health data. “I think there is an issue of the information infrastructure being still quite weak,” she said. “We need very much an integrated data system,” that can give doctors the “whole picture” of a patient’s medical history, and “we need to make sure that data can be shared in a safe way,” added Colombo.

But securing major investment in digitisation can be politically difficult, because the public tends to value more visible infrastructure, such as hospitals, noted Slovenian MEP Klemen Grošelj. “The problem with digital is it’s not tangible: you cannot see it, you cannot feel it,” he said. That’s why the EU’s €672 billion “Recovery and Resilience” fund to help member states get over the economic devastation of the last year is unlikely to do much for digitisation of healthcare. “The majority of the money that is there will be spent on physical infrastructure,” said Grošelj.

Call for a massive data upgrade

Nevertheless, “I think we have a unique opportunity now that the value of health for society is so clear to everybody,” said Janneke van der Kamp, Europe chief for Novartis. Now that healthcare is “the number one societal topic,” policymakers have a chance to overhaul it, including through digitisation. Van der Kamp said there needs to be “a massive upgrade of our data capturing,” because a lack of accessible data remains one of the biggest obstacles to developing health systems that focus on patient outcomes, rather than established processes. Colombo agreed. “COVID-19 has shown significant underinvestment in health systems,” she said. “We need to make sure that we use this crisis to make the health systems more agile.”

The experts also identified the health priorities that most need to be addressed as COVID wanes. Better disease prevention is especially important, said Bușoi. “We seem to forget the challenge that an ageing population, the lack of proper prevention or addressing of health risks, the lack of addressing chronic or infectious diseases, and the risk of transferred diseases, pose,” he said. For example, the EU has ambitious plans for cancer prevention and treatment in its “Beating Cancer Plan” and a forthcoming research “mission” for cancer in Horizon Europe.

Van der Kamp argued that since cardiovascular diseases are the leading causes of death in Europe, they should receive similar attention to cancer. “We have an EU cancer plan, what about writing an EU plan on how to address this biggest risk factor, this biggest killer in Europe and the one that creates the most inequality?” she asked. “Who is in to develop a cardiovascular plan?”