5 steps towards health equity in low- and middle-income countries through tailored innovation

The world faces a persistent chasm of health inequity, with low- and middle-income countries (LMICs) bearing the brunt of the burden. Put simply, too many people in LMICs lack access to essential healthcare services, a problem further compounded by deep-seated social determinants of health like poverty, discrimination and gender inequality. The COVID-19 pandemic served as a stark reminder of these inequities, highlighting the urgent need for concerted global action.

In addition, the rise of non-communicable diseases (NCDs), coupled with the ongoing burden of infectious diseases, places an overwhelming strain on already fragile health systems. The lack of access to essential medicines and diagnostics, coupled with weak health information systems, further impedes progress.

To achieve health equity, we need a comprehensive approach, addressing not only immediate healthcare needs but also the underlying social, economic and political factors that perpetuate these disparities. Climate change further complicates this picture, as its effects, such as extreme weather events, waterborne illnesses and disruptions to food security, disproportionately impact low-income communities. This places additional stress on healthcare systems and worsens health outcomes.

Innovation is key to fueling the fight for health equity in LMICs. By prioritizing the development of cutting-edge diagnostics, treatments and vaccines tailored to the specific needs of these regions, innovation can significantly increase the availability of essential medical tools. Reaching remote and underserved populations demands innovative delivery mechanisms. Digital health technologies and artificial intelligence (AI) hold immense potential to revolutionize healthcare delivery in LMICs. We can leverage these tools to enhance disease surveillance, optimize healthcare workflows and empower individuals with improved access.

Here are five game-changing steps that would make a huge difference:

By fostering collaboration between public and private sectors, Product Development Partnerships (PDPs) harness the strengths of both, ensuring that health innovations are accessible and affordable for LMICs. Investing in such partnerships is essential for augmenting the tools needed to address everyday health concerns like maternal and child health, infectious diseases and chronic conditions.

Simultaneously, we need to invest in a dynamic ecosystem capable of rapidly responding to emerging health threats, such as novel pathogens or outbreaks, ensuring that LMICs are not left behind in the face of global health crises. This dual focus on strengthening routine healthcare and bolstering preparedness is paramount in achieving sustainable health equity. A prime example of the power of PDPs is the life-saving meningitis A vaccine for Africa, made possible by public sector support for the private sector, which has virtually eliminated meningitis A across the continent.

The mRNA platform, which is the backbone of some COVID-19 vaccines, has immense potential beyond the pandemic. mRNA technology allows for speed of development and the ability to rapidly scale manufacturing, giving us a real chance to meet the 100-day mission: having a vaccine against a newly emerging pathogen ready for emergency use at scale in just 100 days. The robust efficacy of the mRNA COVID-19 vaccines opens the door to vaccines against many other diseases being developed on the platform, and accelerates the pace of bringing new vaccines to the market years earlier than traditional platforms.

By fostering self-sufficiency in production, LMICs can ensure a stable supply of life-saving medicines, vaccines and diagnostics, reducing dependency on often unpredictable imports. This not only strengthens health security but also injects vibrancy into local economies through job creation and knowledge transfer. This is why, for example, the African Union is operationalizing the Platform for Harmonized Africa Health Manufacturing to reach the regional target to manufacture 60% of the continent’s vaccine needs by 2040 and strengthening consolidated purchasing power through the establishment of pooling mechanisms to create a robust future market for medical products for African manufacturers.

The G20, under Brazil's leadership this year and South Africa's in 2025, is uniquely positioned to spearhead this initiative. By facilitating the voluntary transfer of health technologies, establishing and supporting streamlined regulatory and procurement arrangements, and advocating for investments in local production facilities, the G20 can empower LMICs to take charge of their healthcare destinies. This will ultimately reduce vulnerability to supply chain disruptions and contribute to keeping us all safer against emerging health threats.

Women and girls in LMICs are chronically underserved by health systems, facing barriers to accessing adequate care, services and products designed for their specific needs. Research and development often neglect their health concerns, as evidenced by the meagre 4% of pharmaceutical R&D dedicated to women's health. PATH has long worked on health innovations to improve health technologies for women through initiatives such as HPV vaccine development and delivery, contraceptive technologies, and essential maternal health interventions.

PATH's involvement in informing global guidance, developing training tools and clinical guidelines, and providing technical assistance to countries for scaling up these essential interventions underscores its commitment to women's health. As a proud member of the Global Alliance for Women's Health, PATH firmly believes that we have an opportunity to leverage the collective power of innovation, research and advocacy to create a world where every woman and girl has access to the healthcare they deserve.

AI has the potential to revolutionize various aspects of healthcare in LMICs. In the realm of product development, AI can accelerate the identification of promising drug targets and optimize clinical trial design, leading to faster and more efficient development of new therapies. AI-powered tools can also enhance clinical trials recruitment by identifying eligible participants and predicting their likelihood of enrolment, thereby streamlining the process and reducing costs. But perhaps most importantly, AI can be deployed as a product, offering invaluable support in clinical decision-making and disease screening, particularly in resource-constrained settings. Imagine AI-powered diagnostic tools that can analyze medical images with exceptional accuracy or virtual assistants that can provide personalized health recommendations.

Building digital public infrastructure for health in low-resource settings is critical now to generate the data needed to fully leverage the exciting advances in AI. Then, by fostering a supportive regulatory environment and addressing ethical concerns, we can unlock AI's immense potential to improve the quality of primary healthcare in LMICs, delivering on-demand, expert-level information and guidance to the most remote corners of the globe.

By investing in health innovation, strengthening health systems and prioritizing the needs of the most underserved populations, we can forge a path towards a healthier, more equitable world for everyone. The time to act is now, and the opportunity for transformative change is within our grasp.