Why we need a ‘great new contract in health and healthcare’

Over the past year, health and healthcare systems that were already known to be unsustainable because they are too costly and fundamentally inefficient also demonstrated their inability to anticipate and respond to crises with agile, effective and timely intervention.

A lack of preparedness, ineffective global governance mechanisms, inequitable access principles and missed opportunities to leverage Fourth Industrial Revolution (4IR) technologies to their fullest potential have combined to create the impetus for what we are calling the “Great New Contract in Health and Healthcare”.

Climate change, new infectious diseases, and the ease with which we can engineer biology are increasing the likelihood that we will continue to face crises analogous to the current pandemic. A number of potentially impactful initiatives have emerged that collectively, when developed at a high pace and in a coordinated fashion, could represent the chance of a lifetime for multi-stakeholder collaboration to deliver on a critical aspect of this new Contract, by building a new “immune system for the world”.

A Great New Contract for Health and Healthcare would first start by supporting a federation, or network of the most promising of initiatives aimed at increasing the forecasting of new biological threats, like emerging infectious diseases or human engineered pathogens. The World Economic Forum will leverage its assets, capabilities and communities to inspire the design of and system-wide acceleration of the much-required adaptation to a society in which healthcare systems are not ready to respond to the next pandemic or crisis. Even more practically, the impact of the federation of initiatives will be to resource, scale-up, globalize and accelerate the most rigorous and sustainable efforts led by Forum partners.

Covid Action Platform

To start with, such a federation or network of initiatives would continue to leverage the mobilisation of stakeholders and our collaboration space under the COVID Action Platform launched in April 2020. The COVID Action Platform is engaging more than 1,800 executives from around the world, bringing more than 1,200 organizations from all industry sectors to collaborate on more than 40 ongoing projects.

All of the Forum’s communities have been engaged in the COVID Action Platform: stakeholders from business, governments and international organizations, civil society, young leaders, academia and science, and media have been leading over 40 initiatives and projects. These activities range from the evidence-based adaptation of public health and social measures to suit local contexts in Africa, to the open access delivery of a ventilators specifications and designs database in support of 3D printing manufacturers, to the contribution of a Common Trust Network with a global registry of accredited COVID-19 testing labs that can provide COVID-19 tests to travellers.

The federation of initiatives will underpin the Great New Contract in Health and Healthcare. Strategic direction of the initiative will be governed by a high-level Task Force of health and healthcare experts and influencers, selected for their ability to mobilise resources, the diversity of voices they represent, the complementarity in their expertise, the multi-stakeholder representation they collectively provide, and – when relevant – their ability to reach outside of the health and healthcare industries.

Importantly, this task force would be designed so as to not compete with any of the COVID-19 response bodies created by normative institutions such as the World Health Organization (WHO) to review and improve the global governance epidemic responses. Rather, the Task Force will serve as a public-private collaboration influencer for such reviews, be they led by the World Health Organization’s Global Preparedness Monitoring Board, the Independent Panel for Pandemics Preparedness and Response, or the International Health Regulations Review Committee.

Epidemic anticipation, preparedness and response

While the COVID Action Platform has been, to date, mostly focused on the immediate response to the COVID-19 pandemic, the Great New Contract for Health and Healthcare will investigate the future when it comes to epidemic anticipation, preparedness and response.

Thematic priorities will have to be reviewed and selected by the Task Force members. That said, Forum partners have already suggested that select areas of work would ideally leverage the assets, capabilities and communities that the Forum can galvanise. For example, the Forum partners’ leadership could help increase the availability of critical supplies and equipment, building on the pre-existing work from the Pandemics Supply Chain Network.

An open-source access database on prevention-relevant data should also be built, from which could emerge a decentralised network of academic institutions and healthcare delivery systems collaborating to exchange the genetic sequences and relevant biological information of unknown pathogens. Such data sharing is particularly critical to enable rapid detection of the next outbreak or pandemic.

As the international organization that built and launched GAVI and CEPI and meaningfully contributed to the launch of ACT-Accelerator in partnership with the European Commission, the Forum could additionally facilitate global conversations to ensure that the best response instruments developed in the past year, such as the COVAX Facility or the ACT Accelerator Diagnostics workstream, become permanent features of the new pandemics response global toolkit.

Finally, consistent with the Forum partners’ commitment to environmental, social and governance (ESG) goals, the Forum could catalyse the formation of a Chief Health Officers community – one that would meaningfully augment private sector companies’ ability to best protect employees and consumers when new threats materialise.

Those opportunities are a few examples of initiatives that could be developed and rolled out over the next months and years. There may be many more that could, in aggregate, deliver on this better “immune system for the world”.

We count on the commitment of all Forum stakeholders to embrace the Great New Contract for Health and Healthcare and join the collaborative platform we will remember years from now for the positive impact it will make in the fields of epidemic anticipation, preparedness and response.