Institute of Global Health Innovation

By Stella Nikolaou, Clinical Research Fellow, The Royal Marsden Hospital and Imperial College London and Shahnawaz Rasheed, Consultant Surgeon, The Royal Marsden Hospital and Senior Lecturer, Imperial College London.

Worldwide, there are more than 5 million people who die from violence and injury¹. Uncontrolled bleeding causes more than 40% of trauma-related deaths¹. More than 530 000 women die each year during pregnancy, childbirth or post partum and 99% of these women are in low and middle-income countries with severe bleeding being the commonest cause of death¹. Safe and affordable surgery, therefore relies on access to a sufficient volume of blood which can be safely transfused². Unfortunately this is not the case in most of the world².

Blood donation rates are lowest in nations, which are afflicted with high rates of malnutrition, chronic anaemia and transfusion-transmissible infections (TTIs) which further decrease the blood donor pool².

The Lancet Commission of Global surgery recommends blood donation of at least 15 units per 1000 people per year³. However according to the WHO data in 2015, the median blood donation in low income countries (LICs) is 3.9 units/1000 people/year and 11.7 units/1000 people/year in Middle Income Countries (MICs) which is a tenth of what high income countries are estimated to have (36.8 units/1000 people/year)⁴.

These figures are likely to be overestimated as they include blood that is unsafe to use due to TTIs (e.g. AIDS, malaria and syphilis)². (more…)

Read World Blood Donor Day: What can you do? Give blood, give now, give often in full

Developing country governments and aid agencies face difficult decisions on how best to allocate their finite resources. Investments in many different sectors – including education, water and sanitation, transportation, and health – can all reap social and economic benefits. This report, ‘Investing in health: The economic case’, which is to be discussed at today’s World Innovation Summit for Health (WISH) focuses specifically on the health sector. It presents compelling evidence of the value of scaling-up health investments. The economic case for increasing these investments in health has never been stronger.

Having made progress in reducing maternal and child mortality, and deaths from infectious diseases, it is essential that policymakers do not become complacent. These gains will be quickly reversed without sustained health investments. Scaled-up investments will be needed to tackle the emerging non-communicable disease (NCD) burden and to achieve universal health coverage (UHC).

Report focus

This report presents compelling evidence of the value of scaling-up health investments, addressing three key questions:

1. What is the economic rationale for investing in health?
2. What is the best way to finance health?
3. Which interventions should be prioritised?

Report insights

The report insights are organised around answers to the above three key questions:

1. Investing in health is an investment in economic prosperity through multiple pathways:

• Education – well-nourished children are more likely to go to school and to further their education, which is linked to higher earnings in adulthood.
• Productivity – healthy people work harder and better, and are less likely to take days off.
• Investment – people are more likely to save money when they expect to live longer and businesses are more likely to invest in countries with healthier populations. • Resources – access to natural resources is opened up when endemic diseases such as malaria are tackled.
• Demographics – when mortality rates fall, women have fewer children, which temporarily increases the ratio of working-age people to their dependents.

2. Without public financing there will be individuals who cannot afford the care they need, resulting in sickness, and potential mortality and financial ruin. This is a devastating choice that pushes 150 million people into poverty every year.

3. Investing in interventions that are targeted to local needs is the fastest and most effective way to reduce mortality. Dramatic health improvements are possible through scaling-up best buys, even when social and economic conditions are poor. These interventions provide high levels of health and financial protection with impressive economic returns.

Further Reading  

Read the full report here.

Read all the WISH forum reports here.

About the World Innovation Summit for Health (WISH)

WISH focuses on some of the most pressing global health challenges facing governments, health systems and populations. WISH brings together internationally renowned experts, who work with advisory groups to publish evidence-based reports on a range of healthcare topics each year.

Chaired by a team of experts drawn from academia, industry and policymaking, the WISH Forums look in depth at the challenges faced in each area – surveying the literature and interviewing experts in the field. The Forum reports present some of the very best innovations that have been shown to have real impact across the developed and the developing world.

During the Summit, the Forum reports will form the basis of a series of panel discussions hosted by leading experts. The Chair of each Forum will open the panel discussion, focusing on ways key issues can be tackled and considering some of the available innovations that might help.

For further information about WISH and previous conferences, visit their website.

Read Investing in health: The economic case in full

The fact that patient safety is an important issue in healthcare is not up for debate. We can all agree that it is unacceptable that almost one in 10 patients are harmed while receiving care in the hospital. However, it is also worrying that we rely on estimates of safety levels because of the lack of comprehensive information.

Through a combination of a review of the literature and a qualitative survey of eight organisations, this report compares how health systems measure patient safety. The report of the Leading Health Systems Network (LHSN) 2016 reviews which information sources are used and to what end. Discussed at this afternoon’s World Innovation Summit for Health (WISH) aims to highlight ways for all care providers to improve the measurement of patient safety.

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Read An international perspective on information for patient safety: What can we learn about measuring safe care? in full

In much the same way that genomic technologies are changing the landscape of biomedical research, the ethical issues these technologies generate are setting today’s agenda of ethics research. The distinct ethical issues concerning the management of incidental findings represent a serious challenge that has occupied the minds of

Western bioethicists for a while, but has yet to capture due attention from specialists in the Muslim world.

Incidental findings are generally defined as results that arise although they were not part of the original purpose of the research project or clinical test. Ethical management of these findings is not a simple matter, because while they can be lifesaving, they can also lead to harmful consequences for the individual and community at large, and at other times lack any clear significance.

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Read Genomics in the Gulf region and Islamic ethics in full

Most countries have well-established mechanisms to pay for medical treatments. However, many innovations – telemedicine, use of community health workers and lower-cost versions of treatments – are inadequately reimbursed, if reimbursed at all.

Payment systems are often slow to support new care models, and understandably so: additional payments for innovations create fiscal concerns; innovations may not be cost-effective unless integrated appropriately with other services; and existing institutions may lack experience or clear authority to support new services. Accountable care can help to overcome such barriers.

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Read Implementing accountable care to achieve better health at a lower cost in full