Tackling healthcare for the very poor

By Joe Jimenez
January 27, 2012

This year in Davos, there is a lot of talk about transformations and new business models that will be important in our global economic recovery. In healthcare, new models will be a significant part of expanding access to patients in need. While it is clear there is lots of growth potential in emerging markets, it’s also important to address the larger societal challenges associated with this growth. This is especially true in the developing world where access and affordability are major issues.

Nearly half of the world’s population lives on less than $2 per day. I was recently in India, where I got to see firsthand what this means. According to the latest estimate from the World Health Organization, there are more than 835 million people across rural India — more than twice the entire population of the United States. Only 35 percent of these people have access to essential medicines. For those of us in the developed world, this is a seemingly unimaginable gap.

As CEO of a global healthcare company, I believe it is critically important to help improve the health of people everywhere by expanding access to medicines in a sustainable way. However, there are many obstacles to delivering care in developing countries, and overcoming them requires adapting to local needs. Poor infrastructure, poverty, inadequate sanitation systems, unclean drinking water and a lack of trained health workers all compound the problem. The question is: With problems so large, how can we be part of the solution?

At Novartis, we realized it was important to take a step back and consider not just how we can enter a market but also how we can adapt to better consider local conditions. We saw that there was a need for a new model in emerging markets like India. That is why we developed Arogya Parivar, meaning “healthy family” in Hindi. This is what we call a “social business” model, meaning it blends corporate citizenship with entrepreneurship.

While many have highlighted the cost of medicine, there is not enough emphasis on solving the associated distribution and social challenges. Arogya Parivar addresses what I believe are the two most important issues in developing countries: healthcare education and infrastructure. The program works by recruiting and training locals to become health educators and tour villages, schools, and health centers. They conduct community health meetings and talk directly to patients about disease prevention and encourage them to seek timely treatments. Also, the local teams address the infrastructure issue by organizing health camps — mobile clinics that provide access to screening, diagnosis and therapies to patients in remote villages who don’t have regular access to healthcare. In 2010, we hosted more than 3,000 health camps, reaching an estimated 140,000 people.

To make treatments more available and affordable, we also sell over-the-counter medicines in smaller packs with doses for only one to three days. While patients need to purchase the packs more frequently, one local doctor mentioned that this helps them better track a patient’s compliance and helps keep weekly out-of-pocket costs low. Importantly, this initiative turned profit-positive this year after four years of losses. This is critical for its sustainability.

Our model is based on the understanding that access to medicines in the developing world is bigger than a pricing issue. Insufficient infrastructure and lack of healthcare access are larger problems that need to be addressed. What is needed is entrepreneurship that creates jobs, expands access to health education and works closely with patients in the context of local customs. Health solutions must be tailored to meet diverse local needs.

Since launching the program in 2007, we have improved access to medicines for more than 42 million people living in 33,000 villages across 10 states in India. We are currently rolling out similar models across Asia and sub-Saharan Africa, and our aim is to reach more than 100 million people.

However, there is so much more to be done. This is a vastly untapped market with serious needs. While business models like ours can make an important difference, we have to find ways to work with governments and NGOs to improve health and infrastructure. Together, we can make a difference.

PHOTO: Javed Sheikh, 61, is helped by his daughter as he washes hands outside their house in a slum area on the outskirts of Mumbai, October 29, 2011. REUTERS/Danish Siddiqui

3 comments

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I don’t know whether to laugh or cry when you talk of a “global economic recovery”, “new business models” and “emerging markets” in health care even as you state that “nearly half of the world’s population lives on less than $2 per day. They remind me of the person who “cannot see the forest for the trees”.

First off, words matter. The “developing world” in many cases is a misnomer. In many locales it is NOT “developing” and likely will not. In much of the middle east, Africa, India, Pakistan, etc. over half of the population is under 30 and actively fertile. How will these people do in just a few years when challenged to live on $1 per day?

With huge populations already largely uneducated, unemployed, and unemployable without even a place with suitable soil and water to grow food, each new mouth is NOT a resource but additional drain on already inadequate resources. Those existing 835 million people across rural India alone in nine months could add 200 million more empty mouths and brains that must somehow exist from the same area of land, the same amount of water, and will compete for the same few “jobs”. That isn’t a “developing” situation but an increasingly imploding one.

You propose improving the existing survival rate of the inhabitants of such areas. The inevitable result will be even more and more people reproducing whose children will have even less hope of a long, productive or enjoyable life; virtually doomed from birth to be forever dependent on alms from a sympathetic and misguided world.

If the word “developing” is ever to be appropriate, those “trained locals” need to understand and educate their villages about the effect of too many people for too few resources. Talking directly to the villagers about family planning and conducting community health clinics explaining pregnancy prevention in the context of local customs could be tailored to meet diverse local needs.

Uneducated people frequently do not yet comprehend that in today’s world each new child is an economic debit and NOT an economic credit! They need to understand that for a given amount per day to live on, fewer mouths means a better life. Get THAT message across and you will make a far bigger “difference”.

Posted by OneOfTheSheep | Report as abusive

This article reads more like an advertisement for the healthcare industry than anything else, and has no merit whatsoever in terms of presenting a viable solution to healthcare problems.

PseudoTurtle
CPA/MBA

Posted by Gordon2352 | Report as abusive

Pharmas are not compassionate, they are bottom line.

Posted by myownexperience | Report as abusive